Allergy Medicines: Which Is Better OTC or Prescription?

Although seasonal allergies are often harmless, you may find that common symptoms are impacting your quality of life. 

“Patients who have upper respiratory allergies often experience a runny, itchy nose and itchy, watery eyes. Nasal congestion and eczema can also occur. This tends to be seasonal and related to the pollen content of the air—but dust, pet hair, dogs, and cats are also allergens,” says Sandra Gawchik, D.O., allergist and co-director of Asthma and Allergy Associates in West Chester, Pennsylvania.

Know that you’re not alone if you can’t stop clearing your throat come spring and summer: the Asthma and Allergy Foundation (AAFA) experts estimate about 30 percent of adults and 40 percent of kids have “allergic rhinitis” (AKA seasonal allergies or hay fever). So chances are you—or someone you live or work with—struggles with sniffles at least some of the year.

And although pollen is inevitable, you don’t need to suffer whenever it's around. In addition to avoiding environmental triggers, several medications have been proven to help your body bounce back from allergens that trigger the body to release an antibody, immunoglobulin E (IgE), that result in reactions, according to the AAFA.

Many of the same options are available over the counter and as prescriptions, explains allergist and immunologist Clifford W. Bassett, M.D., author of The New Allergy Solution and medical advisor for AFAA.

“The medication is often the same in a prescription brand of allergy medicines,” Bassett says, but they may differ in cost based on your insurance coverage. For this reason, your doctor might write a prescription for an OTC medicine so that it's covered by your health insurance and saves you money. 

Before taking any new medicines, it’s best to consult your doctor so you can work together to land on a targeted approach that will provide as much relief as possible, and as quickly as possible. Your allergist will ask about your medical history and the length and severity of your symptoms. If you can, take notes leading up to your appointment so you can be as specific as possible with your doctor. 

"Before visiting your doctor, pay close attention to how often you experience symptoms. If they’re intermittent, or less than four days per week, try OTC options first. If symptoms are significant, or more than four days per week, visit your doctor to rule out any other conditions—and if it’s allergies, then try a prescription,” Gawchik says. “Definitely visit your doctor if you’re unable to sleep or are feeling overly tired due to allergies or the OTC meds you’re taking to treat them.”

According to AFAA, the main OTC and prescription allergy medicine options include:

• Antihistamines. “These block histamine receptors that make symptoms occur,” Gawchik says, and can be found in tablet, pill, liquid or tablet form. Medications include loratadine (generic Claritin), cetirizine (generic Zyrtec), and fexofenadine (generic Allegra).

• Oral corticosteroids. Only used in severe cases, these ease swelling and squelch extreme allergic reactions. Since these can have serious side effects, work closely with your doctor if these are part of your allergy medicine regimen. Medications include prednisone (generic Deltasone).

• Nasal corticosteroids. “Nasal steroid sprays can reduce congestion and stuffiness, a very bothersome and common symptom attributed to allergic rhinitis,” Bassett says. These are the best option if you experience nasal swelling or discomfort, but do take three to 10 days to reach their most effective level,” Gawchik says. Medications include triamcinolone acetonide (generic Nasacort), mometasone (generic Nasonex), and fluticasone propionate (generic Flonase).

• Corticosteroid ointments. From itchiness to rashes, these creams are made for easing skin symptoms. Medications include crisaborole (generic Eucrisa) and desoximetasone (generic Topicort).

• Mast cell stabilizers. Available as a nose sprays or eye drops, these prevent histamine release so you’ll have less eye and nose itchiness. Medications include lodoxamide (generic Alomide), Alamast, and ketotifen fumarate (generic Claritin Eye, Refresh Eye Itch Relief).

The American Academy of Allergy, Asthma & Immunology (AAAAI) offers a complete guide to all allergy medicines on the market if you’re seeking more in-depth brand and dose details.

After you and your doctor decide on a treatment plan, Gawchik recommends to “start using the medicines when you see trees start budding. Don’t wait until spring is in full effect.”

If you’re struggling with allergy symptoms, visit your doctor or an allergist to discuss treatment options. If your treatment plan includes new medications, check to see if your prescription is available for less with Blink Health.