“This is a first generation antihistamine, which means it’s older, it crosses the blood-brain barrier a lot more, and there are more side effects associated with Benadryl,” Dr. Otsu says. She also notes that this medication stays active for about 46 hours. “It’s not a 24-hour medication, but it’s highly sedating and it can cause impaired motor skills, cognitive dysfunction, like brain fog, dry mouth, dry eyes, all sorts of things.”
Dr. Brooks observed the common misconception that experiencing side effects means your daily allergy medication is working better—one reason why he suspects patients are “so attached” to Benadryl. “But generally I would rather someone have tried Zyrtec, Claritin, Allegra, or Xyzal first,” he says. Dr. Brooks also notes that some research shows that when people take Benadryl before bed, it reduces their sleep quality in the same way that alcohol does.
Nasal Sprays
Both Dr. Otsu and Dr. Brooks actually recommend intranasal allergy sprays over oral pills as a first line of defense for nose and eye symptoms (also known as allergic rhinitis and rhinoconjunctivitis). But not all sprays are created equal. Ahead, the experts break down the difference between two common types of nasal spray.
Flonase, Nasacort, Nasonex, and Rhinocort are all common steroid nasal sprays. These medications are applied directly to the inner nasal passageways, and work to reduce both inflammation and mucus in order to make breathing easier. Dr. Brooks notes that steroid sprays need to be used consistently—at least a week or two at a time—in order to be effective.
If you experience allergy symptoms around the same time every year, Dr. Otsu recommends starting use before peak allergy season. “You need about two or three weeks of regular use before it becomes effective,” she says. “So people who have springtime allergies, we often tell them to start using their intranasal steroids in Colorado in February.”
If you have any history of glaucoma, Dr. Brooks says to consult your eye doctor before using a steroid nasal spray, which can make the condition worse.
As for which over-the-counter steroid spray is right for you? “I give the same recommendation for topical steroid nasal sprays: Rotate every so often, or switch to another brand if one brand doesn’t work for you,” Dr. Malchuck says. “They’re all pretty equal between the steroid nasal sprays, and you can use them all for similar periods of time,” Dr. Brooks adds. Since his patients usually report similar results across brands, he often recommends Flonase as a cost-effective option to start.
Rhinocort 24 Hour Allergy Relief
Dr. Otsu prefers Nasacort, Nasonex, and Rhinocort. “Nasonex (mometasone) is very well tolerated; it’s water-based, and it’s probably the mildest steroid,” she says, also noting that Nasocort (triamcinolone) is a sensitive-friendly option for long-term use. Dr. Otsu also notes that since Flonase is alcohol based, it can dry out the nose and cause nosebleeds in some people.
Read the full article here
