March Health Tip

Non-Prescription Therapies for Allergic Rhinitis

Tiffany Fischer-DiMarco, Pharm.D. Candidate
Alexander Molina, Pharm.D. Candidate
Nancy Borja, Pharm.D.

Allergic rhinitis is the swelling of the inner linings of the nose usually caused by inhaling things such as pollen, animal dander, smoke, or molds.

• Seasonal allergic rhinitis (or hay fever) is usually caused by pollen and is more common in warmer months.
• Perennial allergic rhinitis is usually caused by things in your environment, such as dust mites, that occurs year round.

Classic symptoms of allergic rhinitis include:

• Runny nose
• Stuffy nose
• Itchy nose
• Sneezing

To help prevent seasonal and perennial allergic rhinitis:

1. Try to avoid outside activities when pollen counts are high (south florida has highest pollen count in the spring and summer months)
2. Close outside vent/windows and put air conditioners on re-circulate
3. Wash bedding weekly in hot water to kill dust mites
4. Dust and vacuum the house frequently
5. Clean or replace heating/cooling filters every month
6. Avoid smoke or dust exposure
7. Clean away any mold that may be in the house

Non-drug treatments for allergic rhinitis:

• Breathe Right Nasal Strips can help open nasal airways and relieve congestion
• Become more aware of what kind of allergens are outside by registering onto a web site where daily pollen counts are given, such as www.pollenlibrary.com.

Non-prescription (over-the-counter) medications for allergic rhinitis:

• Antihistamines- blocks histamine which is involved in the allergy process.
  
  
1. Alavert and Claritin both contain loratadine.
2. Benedryl Allergy Kapseals capsules contain diphenhydramine.
3. Chlor-Trimeton contains chlorpheniramine.
4. Zyrtec contains cetirizine.

• Antihistamines + Decongestant- blocks histamine and decongestants shrink the blood vessels in the nose so you can breathe better.
  
  
1. Actifed Cold & Allergy Tablets as well as Sudafed PE Sinus & Allergy both contain chlorpheniramine (antihistamine) and phenylephrine (decongestant).
2. Claritin D 12-hour and 24-hour tablets contain loratadine (antihistamine) and pseudoephedrine (decongestant).
3. Dimetapp Cold and Allergy Elixer contains brompheniramine (antihistamine) and phenylephrine (decongestant).
4. Sudafed PE Sinus and Allergy Tablets contain chlorpheniramine (antihistamine) and phenylephrine (decongestant).
5. Zyrtec D contains cetirizine (antihistamine) and pseudoephedrine (decongestant).

Precautions:

* Antihistamines may cause sleepiness!

• Products containing diphenhydramine, chlorpheniramine, or brompheniramine have the MOST amount of sleepiness.
• Products containing loratidine or cetirizine have the LEAST amount of sleepiness, when taken at their recommended doses.
• As per the box recommendations, the following medications can be taken in patients who are:
• Older than 6 years of age: Claritin, Alavert, Benedryl Allergy Kapseals capsules, Chlor-Trimeton, Zyrtec, Actifed Cold & Allergy Tablets, Dipetapp cold and Allergy Eilxer, and Sudafed PE Sinus and Allergy Tablets.
• Older than 12 years of age:  Claritin D-12 hour tablets, Claritin D-24 hour tablets, and Zyrtec D.

* Decongestants containing pseudoephedrine should NOT be given to people with high blood pressure!

* Please note that some antihistamines will interact with medications for depression (MAOIs), as well as medical conditions such as glaucoma, an enlarged prostrate, or breathing conditions (such as emphysema or chronic bronchitis).

* Patients who are pregnant, breastfeeding, or under the age of 2 should not use antihistamines or decongestants unless directed by a physician.

* Disclaimer- Please see your physician or pharmacist if there are any questions you may have.

References:

Finkel R, Pray WS.  Pocket Guide for Nonprescription Product Therapeutics.  2005.  Lippencott Williams & Wilkins.

DeShazo RD, Kemp SF. Management of allergic rhinitis.  UpToDate Online; Ver:  15.3/2008.  Available at: UpToDate Online.

Clinical Pharmacology (Clinical Pharmacology OnHand) [computer program].  Gold Standard Pocket PC Standard and IV Alert;  Ver:  2.20/2007.

Thompson Micromedes (Thompson Clinical Xpert) [computer program]. Thompson Healthcare Inc; Ver:  6.1/2007.

Gendo, K, Larson, EB. Evidence-based diagnostic strategies for evaluating suspected allergic rhinitis. Ann Intern Med 2004; 140:278.

Pfizer Web Site.  Available at: www.pfizer.com.  Accessed on February 17, 2008.

Alavert Web Site.  Available at:  www.alavert.com.  Accessed on February 17, 2008.

Claritin Web Site.  Available at:  www.claritin.com.  Accessed on February 17, 2008.

Dimetapp Web Site.  Available at:  www.dimetapp.com Accessed on February 17, 2008.

Zyrtec Web Site.  Available at:  www.zyrtec.com.  Accessed on February 17, 2008.

Pollen.Com Web Site.  Available at:  www.pollenlibrary.com.  Accessed February 17, 2008.