Allergy Medications: Antihistamines Versus Decongestants

The temperature is rising along with the pollen count, and it seems everyone around you is sniffling and sneezing. If you decide to battle Mother Nature by stocking up on allergy relief medications, you have two options: antihistamines and decongestants. These products treat different symptoms and cause different side effects, so follow these guidelines when it comes to choosing the right medication.

Constant Combat

Allergic reactions are your body’s response to an allergen. Cells in the body release histamine — a chemical that reacts with nasal mucous membranes and causes sneezing and a runny nose to block more allergens from entering the body. Antihistamines are drugs used to fight histamine. These drugs — available in tablet, nasal spray, eye drop and liquid forms — are suitable for pre-emptive or daily use so long as symptoms persist. Antihistamines treat congestion, runny nose, itchy eyes and pressure in the nasal passages.

Some antihistamines cause drowsiness to improve sleep quality. If you’re taking an antihistamine during the day, read the label closely to ensure it says “nondrowsy.” If you choose an antihistamine that causes drowsiness, you should refrain from driving.

Common brands include Claritin, Zyrtec and Allegra.

Extreme Relief

Decongestants deal primarily with stuffy or runny noses. They narrow the blood vessels in the lining of the nose, which limits blood flow to the swollen tissue and shrinks it. This eases congestion and improves airflow. Decongestants should be used only when you need serious relief, and not for more than three days in a row. Your body can become dependent on decongestants with overuse, causing the medications to lose effectiveness.

Decongestants, which are available as pills, nose sprays or drops, often require a prescription. However, brands such as Afrin, Vicks Sinus, Sudafed PE and Sudafed 12-Hour are available over the counter.

Best of Both Worlds?

Some antihistamines contain a small dose of decongestant, so they are safe to take on a daily basis if symptoms persist. However, they can increase heart rate, so it is recommended that they be taken first thing in the morning and not before bed.

Combination antihistamine and decongestant medication brands usually end with “-D.” Examples include Claritin-D, Zyrtec-D and Allegra-D.

Quick Check

An effective at-home test is feeling for sinus pressure; if you press your thumb and forefinger to the bridge of your nose and feel a painful pressure behind your eyes, you are suffering from allergies, and an antihistamine or decongestant might be your best treatment option.

You should consult a physician if you have heart conditions or are taking other medications. Allergy medications should not be mixed if they treat the same symptoms, and prescription medications should not be mixed with over-the-counter therapies.

If over-the-counter allergy medications aren’t giving you the relief you need, it might be time to consult an allergist. He or she can perform allergy testing to determine the cause of your symptoms and recommend treatment that can help.

To find a Texas Health Resources allergist, visit

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