Prescription Considerations for Allergy Medications

Seasonal allergies affect anywhere between 10-30% of people worldwide.¹ Allergies to one or more common allergens are reaching upwards of 40-50% in school children.¹ Allergies occur due to an immune response to something the body considers “foreign,” in other words, strange or unfamiliar. When in contact with the “allergen,” the body produces antibodies which release a chemical called histamine. Histamine and some other chemicals are what cause allergic reactions.^1,3

Symptoms of a seasonal allergic response include but are not limited to:³

• Sneezing and a runny nose
• Itchy nose and throat
• Itchy, watery eyes

Symptoms of a more severe allergic response include:

• Shortness of breath
• Rash
• Welts
• Swelling of mucous membranes

What to Do

When seasonal allergic symptoms occur, you should talk to your primary healthcare provider for help. While your physician can prescribe medications to minimize these symptoms, it is rare that they would be covered by your insurance. This is because most of the medications used for allergies are “over-the-counter” (OTC) medications. This means these medications can be purchased without a prescription, and can be easily found at your local drug store. If you are expecting a medication to be covered by your insurance, but find that it is not, there are options for you. Despite these medications being OTC, they can still be rather expensive, and if you need the medication consistently, the cost can add up. So, what are your options when it comes to these medications if your insurance won’t cover them?

There are many resources available to help you find the best price for OTC medications. The ScriptSave^® WellRx app is free and can help you find the best price based on your location. If your physician writes a prescription for an OTC medication, you can use the ScriptSave WellRx app or discount card to get savings on that drug. You can visit www.WellRx.com to download a free card and find the cheapest cash price at a nearby pharmacy.

Lastly, your local pharmacist is a great resource when it comes to cost savings. They are a wealth of knowledge as it pertains to medication information and cost, and if they do not know the answer, they will know where and how to find the answer.

Allergy Medication Options

So now that you have the resources to find the best price, how can you decide which medication to choose? There are so many different types of medications for seasonal allergies, it is hard to know which is the best for you.

Antihistamines are the most common type of medication used for seasonal allergies.¹ These are divided into two types, which are the first and second-generation antihistamines. The first-generation antihistamines are more likely to cause drowsiness and sedation compared to the second generation.² The OTC first-generation antihistamines include:

• Benadryl or diphenhydramine
• Chlorpheniramine

The OTC second-generation antihistamines include

• Claritin or loratadine
• Zyrtec or cetirizine
• Xyzal or levocetirizine
• Allegra or fexofenadine (technically considered a third-generation antihistamine)

Second-generation antihistamines are not only less sedating, but also last longer, and are most often only needed once a day, whereas first-generation anti-histamines may need to be taken multiple times a day. All of these examples can be found as tablets, capsules, or suspensions.²

Some common side effects to look out for are:²

• Dizziness/drowsiness (more common in first-generation)
• Dry mouth
• Blurred vision
• Nausea/vomiting
• Confusion

Another type of medication that can be used for seasonal allergies is nasal decongestants.¹ These medications help to shrink the blood vessels in your nose to reduce the amount of leaking from your nose. These medications result in rapid relief of nasal congestion; however, they are only recommended for 3-5 days of use. Using these medications any longer than the recommendation can cause “rebound congestion,” basically making your symptoms worse. There are several different forms of these medications including topical, oral tablets and nasal sprays.⁴

• Afrin or oxymetazoline
• Phenylephrine
• Sudafed or pseudoephedrine

Some of the side effects of these medications include:⁴

• Rapid and irregular heartbeat
• irritability
• nasal dryness
• high blood pressure
• difficulty sleeping
• loss of appetite
• urinary retention
• dizziness

Keep in mind that there are daily and monthly limits to the amount of Sudafed you can purchase based on state laws. Although these medications can act rapidly and help with symptoms right away, they should not be used for more than 5 days at a time.⁴

One last common type of OTC medication used for seasonal allergies is nasal corticosteroids¹. These medications act to slow down the body’s immune response to the allergen, reducing the amount of inflammation. Although there are corticosteroids that work for the whole body, these are nasal sprays that are directed to the nose to help with symptoms that occur locally or in the general area, therefore, there are very few of the normal side effects of steroids because the medication is specifically targeted to the nose. Most of the side effects that can happen are in the nose/throat area, although they are not very common.⁴

The current nasal corticosteroids include:

• Flonase or fluticasone
• Nasacort or triamcinolone

The side effects of these medications can include:⁴

• Nausea
• Headache
• Cough
• Nose bleeds
• Congestion
• Throat swelling/irritation
• Upper respiratory infection.

There are many options for treating your allergies with over the counter medications, including medications that are not antihistamines. If your doctor prescribes a medication and it is not covered by insurance, talk to your pharmacist about OTC alternatives and use the resources available to you to find the best price. That way you can treat your symptoms, feel better, and keep more money in your pocket.

References

1. American Academy of Allergy, Asthma & Immunology. (2018). AAAA. Retrieved from http://www.aaaai.org/. Accessed on 5/16/2018.
2. Carson S, Lee N, Thakurta S. Drug Class Review: Newer Antihistamines: Final Report Update 2 [Internet]. Portland (OR): Oregon Health & Science University; 2010 May. Introduction. Available from: https://www.ncbi.nlm.nih.gov/books/NBK50554/
3. Jeffrey L. Kishiyama, M. (2014). Pathophysiology of Disease: An Introduction to Clinical Medicine, 7e. Gary D. Hammer, MD, PhD, Stephen J. McPhee, MD.
4. Platt, Michael. International Forum of Allergy & Rhinology. Sep2014 Supplement, Vol. 4, pS35-S40. https://www.ncbi.nlm.nih.gov/pubmed/25182353

If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!