Allergy treatments vary depending on the severity of your condition and the type of allergy you have.

If your allergies are severe enough to significantly interfere with your quality of life, it’s important to see a doctor who specializes in treating allergies in order to identify what you are allergic to and provide access to the full range of prescription options.

If your allergies are less severe or merely annoying, you may be able to find an effective over-the-counter (OTC) treatment. A pharmacist can help you choose the best allergy treatment options according to your symptoms.

Nasal Sprays

There are several different nasal sprays available for allergy treatments, both OTC and prescription, that can temporarily help relieve sinus-related symptoms.

Steroid Sprays

Nasal steroid or corticosteroid sprays work by reducing sneezing, inflammation, swelling, and mucus in nasal passageways. For people with allergic rhinitis (hay fever), nasal steroid sprays can “provide relief from one of the most bothersome allergy symptoms: nasal stuffiness or congestion,” says Clifford Bassett, MD, a clinical assistant professor at NYU Langone Health in New York City who specializes in allergies.

Nasal steroids are particularly helpful allergy treatments for severe or persistent symptoms, but they can take 7 to 10 days to start working. If you have seasonal allergies, your doctor may advise that you start using nasal steroids about a week or two before you expect symptoms to begin. They can be used daily for seasonal or year-round symptoms.

Some examples of nasal steroid sprays as treatments for allergies include

Nasal steroid sprays are generally safe for adults, and some types are safe for children ages 2 and older. They can cause side effects, including dryness, burning, or a stinging sensation in the nasal passage; sneezing; throat irritation; nosebleeds; and infection.

Antihistamine Sprays

Antihistamine sprays can treat hay fever and allergy symptoms, including runny nose, sneezing, and itchy nose.

Examples of antihistamine nasal sprays as treatments for allergies include:

There is also the combination nasal antihistamine and steroid spray azelastine and fluticasone (Dymista).

Decongestant Sprays

Decongestant sprays can temporarily relieve nasal congestion, but they are not recommended for treating chronic allergies. People who use OTC decongestant sprays can build up a tolerance to them (known as the rebound effect), requiring ever-increasing amounts of the medicine to manage their congestion.

Saline Nasal Sprays

Saline nasal sprays, such as sodium chloride Simply Saline, are saltwater solutions. There is some evidence to suggest they might help with keeping the nose moist and preventing the complications of nasal allergies.

You may also want to consider nasal irrigations, such as a neti pot, which involve mixing sterile water with salt (and often baking soda) and flushing it into the nose to rinse out mucus. Be careful to use only distilled water, since tap water can be contaminated and well water is not adequately filtered.

Allergy Drugs

Besides nasal sprays that relieve sinus-related symptoms, there are medication treatments for allergies that can help reduce your body’s reaction to allergens. These drugs, both OTC and prescription, can be taken as liquids or pills.

Here are some common allergy medicines.

Antihistamines

Antihistamines work by blocking the effects of histamine (a chemical in the body that can cause allergy symptoms).

Examples of antihistamines include:

Common side effects of antihistamines include:

Drowsiness or tiredness
Dizziness
Dry mouth or eyes
Increased appetite and weight gain
Upset stomach
Thickening of mucus in the airways
Changes in vision, such as blurriness
Rapid heart rate
Low blood pressure
Headache
Cough
Sore throat

You may need to avoid certain foods, such as grapefruit and grapefruit juice, while taking an antihistamine because they can affect how these drugs work in your body.

Talk to your doctor about any symptoms or concerns you may have.

Decongestants

These medications offer quick, temporary relief of congestion by shrinking swollen nasal tissues and blood vessels. They are often prescribed along with antihistamines.

Examples of decongestants include:

Mast Cell Stabilizers

These medications block the release of immune system chemicals (histamine, leukotrienes) that trigger allergic reactions of the eyes (allergic conjunctivitis) or nasal passageways. They are better at preventing than treating allergic symptoms, so they are given to people with seasonal allergies starting about two weeks before allergy season begins.

Examples of mast cell stabilizers include:

lodoxamide (Alomide), as eye drops
nedocromil (Alocril), as eye drops
cromolyn sodium (Nasalcrom), as a nasal spray

Corticosteroids

Corticosteroids are a man-made form of the steroid that the body produces to fight illnesses and injuries. They can help reduce allergy-related inflammation in the nasal passages, lungs, and skin. In addition to nasal steroid sprays (see above), here are some other examples.

Aerosol formulas

Eyedrops

Oral corticosteroids (for more severe symptoms)

Leukotriene Inhibitors

Leukotrienes are chemicals the body releases as a response to allergens. They can cause airway constriction, inflammation in the lungs, and increased mucus production.

Leukotriene inhibitors are drugs that work by blocking the actions of leukotrienes in the body. One type of this drug, montelukast (Singulair), is used to treat allergic rhinitis.

Epinephrine

Epinephrine is used to treat anaphylaxis — a severe, life-threatening allergic reaction — until emergency treatment can be administered.

Anaphylactic reactions are commonly caused by:

Foods
Insect stings, including bee or wasp venom
Medications
Latex

Prescribed by your doctor, epinephrine comes as a single dose in an auto-injector (such as an EpiPen). Always call 911 or seek emergency medical care if you experience anaphylaxis, as a second injection is sometimes needed.

Immunotherapy

Allergy immunotherapy is a form of treatment to prevent allergic reactions by building up the immune system’s resistance. This is done through controlled exposure to substances that the person may be allergic to.

“[It] slows the progression of allergies, reduces symptoms, and hopefully eliminates the allergy,” says Dr. Bassett. “In children, it may prevent or slow down the progression from allergies to asthma.”

Immunotherapy can be administered as allergy shots, drops, or biologic medications.

Allergy Shots

Allergy shots involve injecting small amounts of allergen extracts into the body to stimulate the immune system without causing an allergic reaction. Your doctor may increase the allergen dose over time to help desensitize you to environmental allergies.

The shots work like a vaccine, as your body develops immunity and tolerance to particular allergens after being exposed to them.

Allergy Drops

Allergy drops are also known as sublingual immunotherapy (SLIT). In this form of immunotherapy, a small dose of an allergen is delivered in liquid or tablet form under the tongue to boost tolerance and immunity and reduce allergy symptoms.

Several SLIT tablets are available by prescription, including ones that contain dust mites (Odactra), extracts from pollens of different types of grass (Grastek), or weeds such as ragweed (Ragwitek).

Biologic Medications

Biologic medications are another form of immunotherapy used for an ever-expanding list of allergic diseases such as asthma, eczema, sinus disease (nasal polyps), and hives. Most are given as injections to target a specific reaction in the immune system and try to prevent it from occurring. Some of the most commonly used biologic medications on the market now include dupilumab (Dupixent) to treat allergic skin reactions and omalizumab (Xolair) to treat asthma or hives.

Other medications more recently available for asthma and sinus disease include mepolizumab (Nucala), benralizumab (Fasenra), reslizumab (Cinqair), and tezepelumab (Tezspire).

Talk to Your Doctor Before Taking Allergy Medicine

Many allergy medications cause side effects, and some should not be combined with other medications. Even if you are taking OTC allergy medication, talk to your doctor first if you are:

Pregnant or breastfeeding
Have a chronic health condition, including diabetes, glaucoma, osteoporosis, or high blood pressure
Taking other medications, including herbal supplements
Treating allergies in a child (children need different doses or different medications)
Treating allergies in an older adult (certain allergy medications can cause confusion, urinary tract symptoms, or other side effects in older adults)
Already taking an allergy medication that isn’t working

Additional reporting by Lynn Marks.

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