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Which Allergy Meds Are the Most Effective?

From Zyrtec to Flonase, here's how to find the pill or spray that will be most effective for treating your seasonal allergy symptoms.

by Maggie Puniewska
Oct 9 2018, 7:34pm

Getty Images/CSA-Images

A new study found that just 17 percent of people picked the best OTC medication to treat their allergy symptoms. Really, who can blame them? With all the pills, sprays, and syrups out there, making a decision at the drugstore can be an outright nerve-wracking experience. Here’s how to demystify the allergy aisle so you can find relief sooner.

How do I know it’s allergies and not a cold or something else?

This can be tricky. “Common cold and allergies can have overlapping symptoms like congestion and feeling tired,” says Anju Peters, an allergy and immunology specialist at Northwestern Memorial Hospital in Chicago. But they do have their differences: “A cold will typically last up to two weeks and your symptoms will improve within that time frame,” Peters says. “If you don’t treat allergies, they can last for weeks or even months.” With allergies, you probably won’t have a fever, body aches, or sore throat like you might with a cold, but they do often cause itchy, watery eyes, rashes, and more sneezing, says Jay Portnoy, an allergist in the division of allergy, asthma, and immunology at Children’s Mercy Hospital in Kansas City.

The time of year might give you some insight—most people experience seasonal allergies in the spring, summer, or fall, but it’s not always a dead giveaway. “Some regions have active allergy seasons all year and indoor allergens like dust mites, mold, and pet dander can bother you in any season, too,” says Andrew Murphy, an allergist and immunologist based in West Chester, PA. “If you’re really unsure, have a doctor check you out—they can give you a more accurate diagnosis.”

Which products are most effective for treating allergies?

Antihistamines and decongestants are the two main types of OTC allergy meds, but each one tackles different symptoms. Antihistamines block histamine, a substance released by the body when you come into contact with an allergen, which brings on symptoms like itching, sneezing, and runny nose, Portnoy says. If those are your main issues, Claritin (loratadine), Zyrtec (cetirizine), or Allegra (fexofenadine) are a good bet.

Antihistamines are all pretty much the same—it’s not been found that one works better than another—though Zyrtec and “older generation antihistamines” like Benadryl (diphenhydramine) can make you drowsier. Some people can experience the side-effects of one antihistamine more than the other, so if you’re not feeling great, try a different one, Murphy says. But there’s no way to know how you will react, so you can make your first pick based on which one is the most affordable for you, he adds.


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If congestion is your main gripe, a decongestant could help. Decongestants decrease the fluid in the lining of your nose by constricting blood vessels, Murphy says. They’re safe to use up to three days; any more than that and you can get rebound congestion, which basically means stuffiness gets worse. “Decongestants also hike up heart rate and blood pressure, and cause nervousness or insomnia, so they’re not for everyone,” Portnoy says. If you just need runny nose relief for a few days—say, you traveled to a new region where pollen counts are way higher than where you live—decongestants are a good option.

Are nasal allergy sprays more effective?

Steroid nose sprays like Flonase or Rhinocort also target congestion, and if you ask most people who struggles with allergies, they’re often considered the holy grail of OTC products. “Steroid nose sprays work to decrease inflammation in the nasal passages to relieve congestion and runny nose,” Peters says. “But they don’t cause a tolerance like decongestants might, so they’re safe for long- term use and especially helpful for people who get seasonal allergies every year.” If that’s you, Peters recommends using these sprays a few weeks before allergy season kicks in. “Doing so will help prime the nasal passages and make the inflammation from the allergens easier to treat,” she says.

What if OTC allergy meds aren’t working?

If you don’t see improvement within a week of taking a drugstore buy, head to an allergist who can help you come up with a better medication plan and perhaps prescribe something stronger, Portnoy says. “You might also want to make sure you’re not inadvertently inviting allergens to your surroundings,” Peters adds. Small steps like taking a shower before bedtime, running the AC instead of opening windows, and vacuuming regularly can reduce your exposure and help keep symptoms in check.

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