Allergy medicine: An expert guide to short-term and long-term relief options

The three main types of allergy treatment are avoidance, regular short-term relief medication and allergy immunotherapy.¹ The best allergy medicine for your symptoms is something the doctor will discuss with you after allergy testing and diagnosis. Treatment plans can change over time because allergies can change¹ so know your options. 

It’s important to try and avoid breathing in pollen, pet dander or dust mites, eating a particular food or being stung by a bee or wasp if you’re allergic to these triggers. ¹ But it won’t always be possible so this guide covers some of the different allergy medicines that could help you or your family (there are types especially for children).

A medication available over the counter (OTC) might be enough to control your allergy symptoms. Or your GP may think you need something stronger and write you a prescription. It’ll depend on how severe your symptoms are and if they’re affecting your well-being as well as your physical health.¹ The risk of allergies progressing can be a factor in their advice too.¹ 

Short-term relief medicines treat common allergy symptoms like a stuffy nose and sneezing.¹ Meanwhile, allergy immunotherapy tackles the allergy itself.^1,2 Find out why your doctor might suggest this course of treatment, as well as the different forms it can take depending on age and allergy. Any medicine may have side effects and you can read about those too. 

What does allergy medicine do?

Allergy medicine is treatment to counter the effect of having an overactive immune system.² Short-term relief medicine eases the symptoms of an allergic reaction. Allergy immunotherapy tries to stop the symptoms happening or greatly reduce them.² It retrains the body to accept the allergic trigger, aiming to bring long-term relief. ²

Short-term relief medicine could be antihistamine. This aims to block the effects of the histamine that makes you itch, sneeze and get watery eyes.⁴ Another common type is corticosteroids, which can reduce allergic inflammation and help with nasal congestion.^1,3 Different medicines work best for different allergy symptoms and at different speeds.

Allergy immunotherapy involves a course of regular tablets, drops or injections, each one containing a dose of the allergy trigger.² The goal is that tolerance builds over time and lasts after treatment ends,² reducing the need for other allergy medication.¹ 

Ask your doctor which type or combination is best for your needs.

What are the differences between over-the-counter and prescription medicines for allergy?

Allergy medicines considered safe, effective and simple to use without monitoring by a doctor are available over the counter (OTC). Stronger medicines need a prescription. These can treat allergy symptoms that are severe, complex or hard to control with OTC allergy meds. An effective treatment plan could include either or both.

Which allergy medicines are more effective?

Effective allergy medicines are whatever works for you and the doctor recommends. Antihistamines and corticosteroids are first-line treatments for different allergy symptoms so can be a good place to start.^1,3 Over-the-counter types may be enough for mild to moderate allergies. And sometimes drugs can work better in combination. ¹

Research published by the European Academy of Allergy & Clinical Immunology has shown that some people with hay fever respond well to combined antihistamine and corticosteroid nasal sprays,¹ or using an antihistamine and decongestant together. ¹ Oral antihistamines may also make leukotriene modifiers more effective in calming runny nose, sneezing and itching.¹

Allergy immunotherapy aims to retrain the immune system in order to reduce allergy symptoms.² It can be effective during and after the treatment.²

Which allergy medicines are stronger?

The potency of allergy medicines, including prescription types, will vary from person to person. It can depend on body chemistry and medical history, as well as how precisely you follow the dosage and timing instructions. Allergy medicine for adults is generally stronger than for children although it may be the same drug. 

Allergy medicines may also be considered stronger if they cause particular side effects. So your GP may prefer not to prescribe them if there’s an alternative. Examples might be oral corticosteroids or a steroid injection, which is less common.³ Both are sometimes used to treat symptoms requiring severe allergy medicine.³ 

When might a doctor's prescription be necessary for allergy relief medicine?

You might need a prescription if regular over-the-counter allergy relief isn’t enough. Poorly controlled allergy symptoms can be distressing and lead to other problems. A constantly blocked nose may increase the risk of painful ear and sinus infections.³ Troublesome allergic rhinitis, allergic asthma or eczema could stop you getting a good night’s sleep, with all that entails.¹ 

If you’re struggling, a stronger prescription medicine might be more effective for you. 

What kind of allergies can be treated with medicine?

Many allergies cause similar symptoms affecting the eye, nose and sinuses, breathing or skin so can be treated with the same types of medication.^1,5 Basically, short-term pollen allergy medicine can be the same as pet allergy or dust mite allergy medicine.³ Meanwhile allergy immunotherapy treats specific allergic triggers.²

Which allergy medicine give the best short-term relief?

You might ask what’s the best allergy medicine for a stuffy nose. And there are certain treatments that are considered more likely than others to help with particular symptoms. Here are 3 examples:

1. Corticosteroid nasal sprays are generally recommended for a stuffy nose and other hay fever symptoms. ^1,3,5 Also sinusitis and allergic eye conditions like itching and watering.¹ 

2. Antihistamine tends to be the preferred treatment for hives, an allergic skin rash.¹ 

3. A corticosteroid inhaler can reduce the symptoms of allergic asthma.¹

What are the different types of short-term medication for allergic reactions?

These are some of the types of anti-allergy medication you might take regularly to manage your symptoms, perhaps alongside drug-free remedies like saline: ³

• Antihistamines³
• Corticosteroids³
• Decongestants³
• Anticholinergics³
• Leukotriene modifiers³
• Mast cell stabilisers¹

Your allergy symptoms may still bother you. In which case, allergy immunotherapy could be an option.

Antihistamine: Probably the most common allergy medicine

Antihistamine is one of the most common symptom-relief allergy medications, often taken as tablets and other oral forms, as well as topically.^1,3,6 It helps people manage allergy symptoms like a runny nose and itchy, watery eyes.^1,2,3,6 Antihistamine reduces the physical response to histamine released  when your body feels under attack.² That is, when you’re having an allergic reaction.² Histamine is the chemical behind a lot of your cold-like symptoms.²

Doctors prefer the newer non-drowsy types of antihistamine like cetirizine, fexofenadine and loratadine.^1,6 

Corticosteroids: Nasal sprays and other allergy medicine

Corticosteroids are another common allergy medicine.¹ They can help with conditions like hay fever (allergic rhinitis), eczema (atopic dermatitis) and allergic asthma.¹ Corticosteroids work by copying a hormone made by your body.¹ They treat the inflammation that’s part of an allergic reaction.¹

Topical corticosteroids target a specific part of your body. That could be a nasal spray, maybe combined with an antihistamine in one medication. ¹  This reduces inflammation in your nose and may help with the itching and sneezing.¹ A corticosteroid inhaler is a common topical treatment for inflamed airways if you have allergic asthma.¹

Systemic corticosteroids treat your whole body. They come either as pills or injections and are only prescribed in more severe cases.^1,3

Other types of allergy medicine

Other medicines work in different ways to relieve allergy symptoms. Here are some to ask your GP  about:

• Decongestants can help with stuffiness but have little effect on a runny nose, itchiness or sneezing. You shouldn’t use these nasal sprays for more than a few days though or they may make these allergy symptoms worse.^3,4 
• Anticholinergic nasal sprays can reduce the mucus in your nose too.^1,3
• Leukotriene modifiers are an allergy medicine to ease lower respiratory symptoms, such as wheezing and shortness of breath, caused by allergic asthma.^1,3 They can also relieve hay fever symptoms in people with asthma but only on prescription.⁷ Leukotrienes are another chemical released by the body when the immune system detects an allergen.¹ 
• Mast cell stabilisers combined with antihistamine in eye drops may be most effective for eye allergies and work for longer than an antihistamine on its own.⁸

Drug free allergy relief

You may have heard of some of these simple home remedy-style allergy treatments. That’s because people have been using them for years to calm mild-to-moderate symptoms. Here are 5 you could try:

1. Soothing saline:⁹ Nasal sprays and eye drops are available without a prescription from a pharmacy. A saline spray may also make allergy relief medicine like antihistamine work better.

2. Water vapour:¹⁰ Taking a hot shower or inhaling steam from a bowl of boiled water can loosen mucus in nasal passages and may ease an allergy cough. A humidifier could help with this too.¹¹

3. Honey: Try water with honey and lemon for throat irritation. A spoonful of honey (not for children under one) might be as effective as cough medicine too.¹¹ 

4. Filtering the air: Research suggests wearing a face mask helped reduce nose and eye symptoms in people with pollen allergy during the covid-19 pandemic.¹² Indoors, an air purifier with a HEPA filter can remove triggers like pollen, dust mite, mold spores and pet dander particles from the air.¹

When might allergy immunotherapy be an option?

Your allergies could be making daily life quite a struggle.^1,3 Symptom-relief medication might not be working for you. And you might be worried about your allergic rhinitis (hay fever) leading to allergic asthma if you can’t get it under control.¹ Then your doctor might suggest considering allergy immunotherapy.

Allergy immunotherapy tackles the root cause of your condition.² The aim is to reduce your symptoms, and need for antihistamines and so on, during and after treatment.^1,2 Allergy immunotherapy works naturally with the body. Repeated doses of the trigger gradually retrain your immune system to tolerate the substance.^1,2 

For people with insect venom⁶ or peanut^1,2 allergies, immunotherapy can help lower the risk of severe systemic allergic reactions.

What does anaphylactic shock itself look and feel like?

When someone’s in anaphylactic shock their skin may be cold and pale,^3,4 even though they’re sweating.³ Their heart may start racing, breathing may become rapid and crackly,⁸ and it’s possible they’ll lose control of their bowels.³ Disorientation and agitation are also common.⁴

The end point of anaphylactic shock can be a slowing of the heart rate, unconsciousness and cardiac arrest.⁴

What form can allergy medicines have?

Allergy relief comes as nasal sprays, eye drops, creams, gels and lotions to target a specific symptom like a stuffy nose. Tablets, injections or liquid allergy medicine treat a range of symptoms at once. Allergy immunotherapy can be tablets or drops (SLIT), or injections (SCIT).

You want an allergy medicine that makes you feel in control of your condition. For that, it also needs to fit conveniently into your daily routine. Consider when, where and how frequently you have to take it. Does the dosage schedule work for you? If not, it may be harder to stick to and the medication is likely to be less effective.

What are dosage frequency options for allergy medicine?

Allergy medicines like antihistamines and corticosteroids can damp down symptoms for as long as they’re in your body. The patient leaflet will say how often to take them. Allergy immunotherapy is a course of treatment over a certain period of time. The dosage frequency depends on which form you have. 

Allergy immunotherapy tablets and drops are taken daily, the first time at the doctor's office and after that at home.⁵ Treatment time is around 3 years.⁵ Injections start at once or twice a week in the build-up phase.⁵ The amount of allergen increases towards the maintenance dose. ⁵ Then the injections are more spaced out. ⁵ Treatment time is up to 5 years.⁵ 

Early allergy immunotherapy may prevent the development of new allergies and allergic conditions as well as tackling current symptoms.¹

Can children take allergy medicine?

Children can take short-term allergy relief as long as it’s designed for their age group. The dose is likely to be lower than adult medication and the instructions may vary according to their age and weight. Allergy immunotherapy is usually available from 5 years old,⁵ depending on your child’s allergic trigger (4 years old for peanut²).

Talk to your GP before giving kids any medication. It’s parents who manage a child’s treatment plan day to day. Why not keep an allergy diary of how well it’s working and take it to your next appointment. At home, store medicines safely out of reach.

What are the side effects of allergy medications?

The side effects of allergy medications are listed in the patient information leaflet. As you’d expect, these vary depending on whether you’re taking older or newer types of antihistamines, corticosteroids¹ or allergy immunotherapy..⁵ Always report any new symptoms to your doctor so they can consider changing the dose or drug.

• Short-term allergy relief: Older types of antihistamine tend to cause drowsiness.1Topical corticosteroids can have local side effects where you used them (skin, nose and so on).^1,4 There can also be systemic side effects affecting your whole body,⁴ as there can with steroid pills and injections.¹ That’s more likely with a high dose or if you take them for a long time, which doctors try to avoid.¹
• Long-term allergy relief: It’s at the start of a course of allergy immunotherapy that local side effects are more likely.⁵ But your body should become more tolerant and less likely to react with each dose of allergen. To manage any risk of a severe reaction, injections always happen at the clinic.⁵ You’d also go in the first time you have a tablet or drops to check how you respond.⁵

Your doctor will need to know about any other medications you’re on because drugs can interact with each other. Tell them if you’re pregnant or breastfeeding too as it could influence the treatment plan.

Can allergy medication make you sleep?

Older, first-generation antihistamines may make you feel sleepy.¹ They usually carry labels warning against driving or operating heavy machinery after taking them. So you may prefer this type if hay fever is stopping you or your small child³ getting a good night’s sleep. Otherwise the newer second-generation antihistamines are now recommended for allergic rhinitis and hives (urticaria).¹

First-generation antihistamines include:⁶

• Chlorphenamine
• Promethazine
• Alimemazine
• Cylcizine

Can you take allergy medicine while pregnant?

Pregnant mums may be able to take oral antihistamines and topical corticosteroids.¹⁵ But avoid oral corticosteroids and decongestants in the first trimester and other drugs altogether. ¹⁵ Allergy immunotherapy can probably continue if treatment is going well but the advice is not to start a new course until after the baby comes.^5,15 

About a third of women with allergic rhinitis (hay fever) will find their symptoms get worse in pregnancy. ¹⁵ Many others feel as if they’ve suddenly developed allergies but pregnancy-induced rhinitis is likely to go soon after they give birth. ¹⁵ Your obstetrician will be able to give you advice on all this as well as your allergist.

Can you take allergy medicine while breastfeeding?

Most medicines can pass through into a mother’s milk but usually it’s in very small amounts. Always talk to your GP first but it should be fine to use an antihistamine or decongestant while breastfeeding. Pick a type you take every 4-6hrs so it’s out of your body fast.  And wait until after a feed. ¹⁶

Short-term allergy relief can also affect your milk production. Again, tell your doctor as soon as you think that could be happening. In any case, they may advise using nasal sprays instead of oral allergy relief while you’re still breastfeeding and a single rather than a combined medicine. ²⁴ You can try saline too for a drug-free option.¹⁶

What can happen if you take allergy medicine without allergies?

Some allergy medicines are also treatments for non-allergic rhinitis. That’s a stuffy nose and so on caused by a virus, the weather, hot or spicy food, alcohol or breathing in something irritating like smoke or a chemicals instead.¹⁷ And corticosteroid, antihistamine or decongestant nasal sprays could help.¹⁷

But if you don’t know what’s causing your allergy-like symptoms, these may not be the best or even the right medications for you. There could be side effects, as we’ve mentioned. And you might be delaying proper treatment. Consult your GP and get a diagnosis.

Should I do any test before taking allergy medication?

You may need a test before taking allergy medicines to help confirm the condition and identify your allergic trigger. Retesting may also be helpful if your symptoms have changed. Your doctor will interpret the skin prick test or allergy blood test results alongside your medical history.¹

Keep a note of when and where you get any of the common allergy symptoms (see below) and take it to your appointment. Other important information includes any family history of allergies.¹

Certain types of allergy relief medicine can interfere with test results. For instance, you must stop antihistamines before a skin prick test.¹ Let the clinic know if you’re on any other medication too. They’ll tell you if you need to pause it and for how long.

What are the most common allergy symptoms?

Common allergy symptoms include an itchy, runny or stuffy nose, sneezing, itchy watery eyes, skin rashes and swelling, coughing and wheezing, and stomach problems.¹ It depends on where the allergic trigger touches your body. Managing allergy symptoms starts with avoiding that substance, which isn’t always possible.

Itchy runny nose and sneezing^1,3

Airborne allergens like pollen, dust mites, mould and pet dander mostly affect your respiratory system because you breathe them in. The symptoms include an itchy runny nose, sneezing, nasal and sinus congestion, and post-nasal drip. Collectively they’re called allergic rhinitis or hay fever.

Coughing and wheezing¹

One allergic condition can lead to another and people with allergic rhinitis may go on to develop allergic asthma. Other than coughing and wheezing, symptoms can include a tight chest and shortness of breath.

Itchy watery eyes¹

The same airborne triggers can cause allergic conjunctivitis when you breathe them in or they land on the surface of your eyes.⁸ It’s so common for eye and nasal allergies to go hand in hand that you’ll see the two written together as allergic rhinoconjunctivitis.¹ The common name is pink eye because redness is another telltale symptom.¹

Skin rashes and swelling¹

Eczema and hives are two of the common skin allergy symptoms. And hives often goes hand in hand with swelling. An itchy rash can affect the area where you had contact with the allergen. It can also be part of a systemic allergic reaction, for instance to food, drugs or insect venom. 

Stomach problems

Food allergies can make you feel sick and actually vomit, as well as causing diarrhea and cramps.¹ It’s possible to confuse food allergy symptoms with food intolerance,¹ which is why it’s so important to talk to your GP to get an accurate diagnosis.

The short version

Managing any allergy starts with avoiding the trigger.¹ Your doctor can help with how to do that and will work with you to devise the best treatment plan.

Many types of short-term allergy relief medicine are the same whether the trigger is pollen, dust mites, pets or mould. Antihistamines and corticosteroids are the most common. They come as tablets, nasal sprays, eye drops and creams and can block or mask allergy symptoms in the short term.³ Other triggers are more likely to cause a severe systemic allergic reaction, for which the treatment is adrenaline.¹⁴ 

For some respiratory allergies, peanut and insect venom, allergy immunotherapy may be an option.⁶ This tackles the root cause of the condition with a course of regular doses of the allergic trigger.² The idea is gradually to teach the immune system to tolerate the substance better.² Fewer symptoms then means less need for regular short-term allergy medicine.^1,2 Allergy immunotherapy is available for some allergies as tablets, drops or injections depending on age.⁵