You May Want To Skip Allergy Meds With Decongestant In The Ingredient List

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Who doesn't love when the weather starts to warm up? But one downfall of those higher temps is…allergies. Being congested, sneezing, and coughing can definitely put a damper on your day, but fortunately, over-the-counter allergy medicines can help.

More good news: Over-the-counter allergy medications are as effective as most prescription ones, says Evan Li, MD, an assistant professor of medicine, immunology, allergy, and rheumatology at the Baylor College of Medicine.

In fact, a lot of OTC allergy medicines actually used to be prescription meds, adds Purvi Parikh, MD, an allergist with Allergy & Asthma Network, so you can bet you’ll get relief from a click of Amazon’s "add to cart" button. If you continue to experience symptoms, of course, talk to your doctor about your other options.

Check out a preview of the best OTC allergy medicines:

Curious how allergy medicine works? The main active ingredient is antihistamines, which “work by reducing histamine levels in your body which is a chemical released by allergy (mast) cells in response to an allergen,” says Dr. Parikh.

This phenomenon causes allergy meds to work almost instantly. “Oral antihistamines can begin working 20 to 180 minutes after ingestion, while nasal steroids work best when used daily,” says Rabia Chaudhry, MD, an allergist and immunologist at South Florida Food Allergy Center. (You can take antihistamines daily, too, BTW.)

Some people even give allergies a one-two punch, but talk to your doctor before combining medications: “It’s not uncommon for a patient with severe allergies [to take] daily nasal steroids and oral antihistamines,” says Dr. Chaudhry.

One thing to note: If you're having any breathing symptoms like coughing, wheezing, dyspnea, chest tightness, or any symptoms below the chest, do not treat this with an over-the-counter allergy medicine (including pseudofed and decongestants like oxymetazoline), Dr. Parikh says. Instead, seek medical attention because this could be asthma and symptoms such as these can be life threatening, she adds.

WH narrowed down the best expert-approved OTC allergy medicines to choose from.

Meet the experts:

Evan Li, MD, is an assistant professor of medicine, immunology, allergy, and rheumatology at the Baylor College of Medicine.

Purvi Parikh, MD, is an allergist with Allergy & Asthma Network.

Rabia Chaudhry, MD, is an allergist and immunologist at South Florida Food Allergy Center.

24-Hour Allergy Relief Tablets

Zyrtec, a.k.a. cetirizine hydrochloride, offers up relief in the form of a tiny, easy-to-swallow pill backed by Dr. Parikh. The 24-hour histamine with little to no side effects is said to work fast and keep on delivering all day. Just note: It's important to take it every day in order for the medication to be as effective as possible.

Adult 24-Hour Allergy Tablets

Both Dr. Li and Dr. Parikh say that Allegra—or its generic form, fexofenadine—is a winner. Allegra is an antihistamine that helps tackle symptoms like sneezing, runny nose, itchy and watery eyes, and an itchy nose or throat.

Flonase Allergy Relief Spray

Flonase is a steroid nasal spray that helps keep your body from overreacting to allergens like pollen. After reading the Quick Start guide, just use one or two sprays in each nostril daily to clear up symptoms. Dr. Li recommends combining it with Allegra for maximum benefit.

24-Hour Allergy Chewables

Unfortunately, kids aren't spared from allergies. Dr. Parikh says an OTC medication like Claritin for Kids can work great. It's not a bad idea to check in with your child's pediatrician first, though, just to make sure it won't interact with any other medications they may be taking.

24HR Allergy Nasal Spray

Nasacort offers 24-hour relief from those pesky allergy symptoms, specifically in the nose, like congestion, sneezing, and a runny or itchy nose. It's also non-drowsy, scent-free, and alcohol-free—and Dr. Parikh is a fan.

Allergy Tablet

Xyzal, a.k.a. levocetirizine, "is the best prescription-strength oral antihistamine," Dr. Li says. It helps with sneezing, a runny or itchy nose or itchy throat, and watery eyes. It starts working within an hour to give you fast relief from allergy symptoms, but you can take it at night to make sure the pollen symptoms don't hit you first thing in the morning.

Antihistamine Eye Drops

Struggling with itchy, watery eyes? Just one drop of Zaditor, expert-approved by Dr. Parikh, will provide up to 12 hours of relief. It purportedly starts working in minutes, whether your eyes are watering from pet-related allergies or being outside.

Antihistamine Allergy Relief Tablets

It can be tough to get to sleep when your allergy symptoms are really bad. Benadryl can give you relief and help you drift off. "Generally, the most popular antihistamine for sleep aid is diphenhydramine—Benadryl—which is the active ingredient in many nighttime formulations of cold and cough remedies," Dr. Li says.

AllergyCalm Tablets

Hundreds of Amazon reviewers swear by this medicine for natural allergy relief. AllergyCalm uses ingredients like histaminum hydrochloricum and ambrosia. Just keep in mind that homeopathic medications aren't regulated by the FDA the same way other medications are. And according to Dr. Parikh, "AllergyCalm is a mix of herbs which do not have any data that show they work in treatment of allergies, so I do not recommend it as the first line [of] treatment," she says.

24-Hour Allergy Medicine

Claritin—aka loratadine—is said to provide relief of symptoms that can be triggered by more than 200 different allergens, including pets, pollen, dust, and mold. Dr. Parikh backs this medicine, since it's a 24-hour histamine with barely any side effects.

Sensimist Allergy Relief Spray

“The benefit of a nasal steroid is that it is not a systemic medication,” says Dr. Chaudhry. Since the whole body is not being affected, this 24-hour relief nasal mist has fewer side effects and gets right to the problem, she explains.

Allergy 24-Hour Gelcaps

Allegra Gelcaps, a type 1 histamine blocker, work best for skin symptoms, according to Dr. Chaudry. These fast-acting capsules are said to offer 24-hour non-drowsy relief and start working within an hour to help control all itch receptors in the skin.

How Our Team Chose The Best Over-The-Counter Allergy Medicines

For the past two years, Women’s Health editors and writers, including Korin Miller, Andi Breitowich, our editorial assistant Addison Aloian, and senior commerce editor Neha Tandon, have researched the bestselling, most popular, most reviewed, and top-rated over-the-counter allergy medicines. Our team consulted experts Evan Li, MD, Purvi Parikh, MD, and Rabia Chaudhry, MD to narrow down the best 12 items for a wide range of allergy needs and preferences.

What should I look for in an OTC allergy medication?

There are certain ingredients that you should look for when you’re reading labels. If you’re shopping for an OTC allergy medication in pill form, you want to “look for ingredients that indicate there are antihistamines,” Dr. Li says. Here’s a list of active ingredients to search for:

• cetrizine

• levocetrizine

• fexofenadine

• diphenhydramine

• lortadine

For nasal sprays, you’ll want to look for steroids. “These are generally the most effective nasal sprays and do not cause rebound nasal congestion,” Dr. Li says. (Rebound nasal congestion or rebound rhinitis, ICYMI, is when the lining inside your nose becomes inflamed after using certain medications like decongestants for too long.) Instead, Dr. Li recommends keeping an eye out for these ingredients:

• fluticasone

• mometasone

• triamcinolone

Pro tip from Dr. Parikh: “Avoid anything with decongestants, because they can make symptoms worse and have side effects.” Some of them include habit forming and an increased blood pressure and heart rate. If you feel like you really need to use a decongestant, it’s important not to do it for more than three days in a row. Otherwise, you run the risk of rebound congestion, Dr. Li says.

What is the most effective type of OTC allergy medicine?

"It depends on the symptoms," says Dr. Parikh, but she recommends starting with the type of medicines listed above and make sure they're suited to treat your symptoms.

What is the best type of OTC allergy medicine for pollen?

It usually depends on the individual, Dr. Parikh says, so it's tough to recommend a general OTC allergy medication for pollen. Flonase, for instance is "good to try first," she says. "But remember you need to do it for six to seven days minimum for it work," so adding in a 24-hour antihistamine tablet at same time or an antihistamine nasal spray while waiting for it to work is helpful.

You can also check out the other suggested allergy medicines above, as they're expert-approved.

What is the best type of non-drowsy OTC medicine?

"Newer 24-hour antihistamines are less drowsy, with fexofenadine being the least drowsy," says Dr. Parikh. You can also check out nasal sprays and eye drops, since they are non-drowsy, too.

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