Ask Your Pharmacist: Controlling your seasonal allergies

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Q: Last year my seasonal allergy symptoms were the worst they have ever been. What is the best medication to control them?

Seasonal allergies, also referred to as allergic rhinitis or hay fever, are about to hit us as spring weather is fast approaching. Symptoms may include watery eyes, sneezing, runny nose, nasal congestion, coughing and itching in the nose, throat, eyes and mouth. These symptoms occur when our immune system reacts to allergens in our environment such as pollen from trees, grasses and weeds, and from molds. People with asthma and eczema can experience a flare-up of their symptoms during allergy season as well.

Many people noticed last year to be a particularly bad year for allergies, and global warming is partially to blame. Rising temperatures allow plants to bloom earlier and stay in bloom longer. The heavy rainfalls we have been having allow plants to release more pollen when they bloom, verses seasons with less rainfall. Warmer, wetter weather also produces a favourable growing environment for molds, which release tiny spores into the air when they reproduce. Things like shifting wind patterns have the potential to carry pollen over longer distances, which can expose you to different types of pollen that weren’t in your environment before.

Pharmacists in New Brunswick can assess and prescribe for allergic rhinitis. There are several medications available both over the counter and by prescription to help alleviate your symptoms. Starting some of these medications one to two weeks ahead of the allergy season and continuing them for the full duration of the season may help to keep your suffering to a minimum.

Antihistamines are commonly used to treat watery eyes, sneezing, runny nose, nasal congestion and itching. You can get them over the counter in eye drops, pills and liquids. They help by temporarily blocking a chemical called histamine that is released by our body and is partially responsible for creating our symptoms. In a pill form it is best to opt for the non-drowsy options such as Aerius®, Reactine® and Claritin® as they last longer and are more appropriate for daily use.

Decongestants can be used for a few days to treat a runny nose and nasal congestion. They work by constricting blood vessels in our nose, which helps to open our nasal passages and dry up congestion. You can get these as single agent products or in combination with antihistamines. Always speak to a pharmacist before using a decongestant as they interfere with many medications and medical conditions.

Corticosteroids nasal sprays improve runny nose and nasal congestion by reducing inflammation in the nasal passages that is caused by the allergic reaction. Unlike decongestant sprays that should only be used for a maximum of three days, corticosteroid sprays can be used for a longer duration making them the ideal choice for allergy related congestion. Dryness or a stinging sensation in the nose are common side effects and can be reduced by using the spray after a shower or after using a nasal saline spray. There are a variety of corticosteroid sprays available over the counter and by prescription. Dymista® is a prescription nasal spray that contains both a corticosteroid and an antihistamine for people who do not get sufficient relief with a corticosteroid spray alone.

Trying to reduce your exposure to allergens is also important. During peak allergy season pay attention to the pollen reports and stay indoors in the early morning and late afternoon as this is the time when most plants release pollen. Keep windows in your home and vehicle closed. Change or clean air filters more frequently in your air conditioners, heat pumps and vehicles. Wearing a mask outside can help to reduce the number of allergens we inhale and changing your clothing when coming in from outside can reduce the number of allergens we track back into our home. A quick nasal saline rinse can also help to flush allergens away.

When allergy symptoms are severe or not well controlled with the above medications and allergen avoidance, speak to your doctor or nurse practitioner about a referral to an allergy clinic. An allergy clinic can run tests for specific allergens, often by conducting a skin prick test where they put small amounts of allergens on your skin then scratch the spot with a needle to see if a reaction occurs. They can prescribe immunotherapy that helps to desensitize you to your allergies. Allergies to grass pollen can be treated with a pill while other allergens are treated with injections.

Erin Thompson (BSc, BScPharm) is a graduate of Dalhousie University and a community pharmacist practicing at Shoppers Drug Mart in Quispamsis N.B. Her opinions expressed in this newspaper are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. Send your questions to AskYourNBPharmacist@gmail.com.