Hay fever is characterized by a runny nose, repetitive sneezing and, often, a classic and extremely annoying itch of the roof of the mouth. Hay fever usually appears in childhood, but may occur for the first time in adults who have recently moved to a different area and are confronted with new pollens. Once a diagnosis of hay fever is established, a variety of medications is available to manage the symptoms. For most people with mild, occasional hay fever, antihistamines are the standard treatment. These agents tend to be relatively inexpensive and can be purchased over-the-counter without prescription.
Over-the-counter antihistamines can be a great help for hay fever sufferers. However, many cause significant side effects and may seriously impede lifestyle and performance. The worst side effect is drowsiness; virtually all of these medications carry a warning to not drive or operate machinery while taking them. This sedative side effect can be a disaster for the person who has to take antihistamines during work or study. Over-the-counter antihistamines also can interfere with REM sleep, preventing a good night’s rest and leaving a person even drowsier the next day.
Fortunately, three nonsedative antihistamines-Claritin, Hismanal and Seldane-are now available by prescription. These agents relieve mild and moderate hay fever symptoms. Claritin is administered once per day and works rapidly. Hismanal relieves skin rashes caused by allergies. Seldane provides relief for itching and excess tearing.
It has long been known that cortisone relieves severe hay fever. Initially, cortisone was administered in only two ways: either orally, in the form of prednisone, or by injection. However, both methods have potential toxic effects and are rarely used today except in people with very severe symptoms who have been unresponsive to other therapies. High doses or long-term use of cortisone can reduce the body’s ability to fight infections and may cause osteoporosis and cataracts. Children are particularly vulnerable to these adverse side effects.
Cortisone Nose Sprays
Fortunately, new, synthetic cortisone nose sprays provide the benefits of steroids without the side effects. These drugs are broken down by the body within a few minutes, before they can cause problems in other organs. Physicians now routinely recommend intranasal steroids for moderate to severe hay fever sufferers who cannot tolerate, or whose symptoms do not respond to, antihistamines detoxic cena.
Unlike antihistamines, intranasal steroid sprays take several days to work. Hay fever symptoms do not stop immediately after a spray; relief occurs several days later. This is important to know, otherwise some people might stop using their medication when they find it doesn’t work immediately. It is also important to understand that intranasal steroids are not effective unless they are taken regularly. For most people, it is a good idea to begin the sprays about two weeks before allergy season begins and continue them until after it ends.
Intranasal steroids now on the market are Beconase, Vancenase, Nasalide and Nasacort. Only Nasacort is effective when taken once a day; the others must be used more often. Nasacort is also the least likely to burn or irritate nasal membranes.
Beconase, Vancenase and Nasacort are not approved for children under 12, but many doctors ignore this limitation and frequently prescribe the drugs for children as young as six. Nasalide is approved in children over six. Unfortunately, Nasalide often irritates and burns the nose and many children find it intolerable. Like the other sprays, Nasalide takes several days to work.
The recommended starter dose for intranasal steroids is usually one to two sprays in each nostril two or three times a day. After that, a person should determine the least amount of spray that relieves symptoms and discontinue the drug when it is no longer needed.
Nasalcrom, a new prescription nasal spray for hay fever treatment, contains a solution of cromolyn sodium. It must be administered more frequently than intranasal steroids and is not as effective. It’s also generally no more effective than nonsedative antihistamines. Other new intranasal steroid-like and cromolyn-like drugs for the nose should reach pharmacy shelves over the next several years.
Hay fever can be maddening, but it is manageable. Over-the-counter antihistamines can be a great help to many mild sufferers. For people who are bothered by the sedative side effects of these drugs, or who have more severe symptoms, prescription antihistamines and topical steroid nose sprays can make breathing easier throughout the allergy season.