Culprit	Pollen
When	Rosefever (flowers and trees)- April Grasses and weeds- end of May and June Hayfever- Second week of August until frost (about the end of September, but varies)
Where	Temperate areas of the world, especially midwest United States
Symptoms	Nasal Congestion Clear Nasal drainage Watery itchy eyes Sneezing Fatigue Lack of Energy Wheezing if asthma tendency
What to do	Avoid the pollen Stay inside Keep car and building window closed Use air conditioner Drink plenty of water
Treatment	Over-the-counter antihistamines, with or without decongestans. There are so many different options that it is impossible to list them all. I will just mention a few. Use what gets the job done without causing intolerable side effects. Cost may be a factor in choosing.

The following drugs are ones that I recommend frequently. The following prices and amounts I obtained from the shelves of my local Wal-Mart Supercenter. This is just to give you an idea for comparision.

Drug	Size	Cost	Cost per Pill	Comment
Benadryl	24 pills	$2.97	$0.12	One of the original, also has combination with decongestant.
Chlor-Trimeton 4hr.	24 pills	$4.72	$0.20	Have 4mg, 8mg and 12 mg strengths. Can be combined with decongestant.
Chlor-Trimeton 12 hr.	24 pills	$8.96	$0.37
Tavist	24 pills	$5.97	$0.25	One of the newer ones to jump from prescription to OTC
Tavist D	24 pills	$5.97	$0.25
Dimetapp extentabs	24 pills	$7.07	$0.33	Long acting combination of brompheniramine and phenylpropanolamine. Other preparations under the Dimetapp label. Dimetapp elixir is one of my all time favorites for kids.
Actifed	24 pills	$4.38	$0.18	Contains combination of triprolidine and pseudoephedrine.
Dristan	20 pills	$4.47	$0.22	Name very familiar, effect only lasts 4 hours.

 

Other tips in choosing and taking the medicine

Follow labeling for directions and side effects. The most common side effects in my experience are drowsiness, stimulation, and dry mouth. Effects of medicine will vary from patient to patient. Men with enlarged prostates could have increased trouble urinating. If you have medical conditions you should always check with your own doctor for advice on allergy medicines, although if medical conditions are stable, a short course of these medicines is usually tolerated. Your own doctor would know your situation best. For best results, try drugs with different ingredients (read the label) in order to see which one works best for you with the least side effects. Don't just use a different brand name, because they may have the same ingredients. The drugs listed above are, for the most part, different from each other in some way.

Prescription Drugs

There are many prescription antihistamines available. Your doctor will know which one is best for you. The newest drugs are, of course, the center of attention, and many marketing $$ are spent on the public, and on doctors, so that these are prescribed. There is no question these new drugs work and have less side effects than previous antihistamines, but they certainly are expensive, and probably should not be used unless others have been tried unsuccessfully, or are not an option. Prices will vary with pharmacy.

Drug	Size	Cost	Cost per Pill	Comment
Allegra	60 pills	$60	$1.00	Allegra is www.allegra.com twice a day, Claritan and Zyrtec are once a day. You may or may not get by taking Allegra once a day, but if you do you will save $$. Otherwise, the cost is about the same. Allegra D and Claritan D are decongestant combinations which some patients may find beneficial. Furthermore, with Allegra, if the patient has trouble sleeping at night because of the decongestant, then I will have them take the plain Allegra at bedtime and the Allegra D in the AM. In my experience, Zyrtec may be a tiny bit more potent, but also has a very slight chance of sedation. Nasal sprays with corticosteroids are also an option that work quite well for allergic rhinitis. It may come down to patient choice and whether you want to use a pill or a spray. For patients that can't tolerate the oral medication, or need additional help in controlling their allergies, then the nasal sprays may be an option. Again cost may be a factor. Some representative corticosteroid nasal sprays follow. Flonase and VancenaseDS are once a day sprays, while Nasarel is twice a day. Once improved though, you may be able to maintain symptom free status with just once a day, thus saving money. The selection of one spray over the other may be a preference of how the spray feels. What I like to do is give the patient samples and let them decide what works.
Claritan	30 pills	$59	$1.97
Zyrtec	30 pills	$57	$1.90
Flonase	120 sprays	$50	$0.42
Nasarel	200	$44	$0.22
Vancenase DS	120	$56	$0.47

 

Other prescription antihistamines and nasal sprays not mentioned above

Atrohist Bromfed Dura-Vent A Extendryl Fedahist Hismanol Kronofed A Naldecon Nolamine Periactin Rynatan Semprex D Trinalin

Beconase Dexacort Nasacort Nasalcrom(OTC) Rhinocort

 

What else

If nothing is working make sure you've seen your doctor. If you've already seen the doctor, then see the doctor again. What I use frequently for hayfever when additional medication is needed, or even as a first line treatment because of simplicity or patient choice, is a corticosteroid such as prednisone orally, or an injection such as triamcinalone. The additional benefit is that these medications are not very expensive.