How will you manage allergies this spring?

Allergy season is right around the corner. Even if you did not realize that, the warring drug commercials on television would alert you. On the same program, you can see ads for Xyzal, Allegra and Nasacort. There also are spots for Flonase and Claritin-D.

Drug companies are competing in part on how many symptoms the product relieves. Some brag that they can ease sneezing, nasal congestion, itchy eyes and a runny nose. Others claim that their product manages even more symptoms. In addition to the usual sneezing and drippy nose, an added oral decongestant is supposed to alleviate sinus congestion and pressure.

Regardless of how many symptoms the ad agencies are crowing about, allergy products fall into just a few categories. Most of the advertised products were once available by prescription only.

Corticosteroid nasal sprays such as fluticasone (Flonase Sensimist) and triamcinolone (Nasacort Allergy 24HR) are powerful anti-inflammatory drugs. Such corticosteroids can calm an overactive immune response to a wide range of allergens.

On the other hand, they may dampen the immune system’s reaction to infections. That is why the drug facts labels on packages warn: “Stop use and ask a doctor if you have, or come into contact with someone who has, chickenpox, measles or tuberculosis.” In the case of infections, people need to have their immune systems functioning at full power.

People may not always be able to distinguish allergy symptoms such as runny nose, sneezing and nasal congestion from an upper respiratory tract infection. That is why the label warns customers to stop use and see a doctor if symptoms don’t improve within a week. Steroid nasal sprays also may cause change in vision or severe or frequent nosebleeds.

Antihistamines work differently. They literally block the effect of histamine. That is an inflammatory chemical released when cells in the nose are challenged by allergens such as pollen, cat dander or dust mites.

Old-fashioned antihistamines like diphenhydramine (DPH or Benadryl) are effective at easing some allergy symptoms, but they make many people drowsy. Non-sedating antihistamines such as levocetirizine (Xyzal) and fexofenadine (Allegra) are less likely to affect driving ability compared with diphenhydramine (Human Psychopharmacology, May 2016).

One drug you probably won’t see advertised on television this allergy season is cromolyn (NasalCrom). This unique allergy medicine does not seem to have a big advertising budget.

Cromolyn works by stabilizing mast cells in the nose, eyes and lungs. These cells contain histamine as well as other inflammatory chemicals called kinins.

Regular use of cromolyn makes mast cells less likely to react to allergens. However, NasalCrom spray must be used a couple of times daily to produce benefit. That’s inconvenient for some people.

Here are some reports from readers who found this medication both safe and effective:

“NasalCrom has been a lifesaver for me. My allergies are under control for the first time in years!”

Another reports: “NasalCrom actually works better for me than the allergy pills that cause side effects. It gets a lot of word-of-mouth recommendations, and I think that’s why we don’t see a huge advertising budget for it.”

Finding the best allergy treatment for you this season might require some trial and error. Don’t be swayed by slick commercials.

Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. In their column, the Graedons answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website:

2018 King Features Syndicate

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