OTC Allergy Relief: My Go-To Medicines

Allergy season never used to affect me. Sometime in my mid-twenties, I began to steadily be affected more and more by pollen, weeds, trees, grass, flowers, etc. With a strong love of the outdoors, I began my research for the best OTC allergy relief out there.

Giant disclaimer: I am not a doctor and do not recommend nor advise any of these medications. This entry is a collection of my own findings and experiences with allergies. You should consult your own doctor before taking anything mentioned here.

The Magic of Fexofenadine

Kirkland Signature Aller-Fex is my current favorite and most economical. In fact, anything with fexofenadine is a great choice. For my own body, my allergies are greatly reduced and I don’t suffer from any of the drowsy side effects. So what is this magical stuff?

Fexofenadine is used to relieve the allergy symptoms of seasonal allergic rhinitis (”hay fever”), including runny nose; sneezing; red, itchy, or watery eyes; or itching of the nose, throat, or roof of the mouth in adults and children 2 years of age and older. It is also used to relieve symptoms of urticaria (hives; red, itchy raised areas of the skin), including itching and rash in adults and children 6 months of age and older. Fexofenadine is in a class of medications called antihistamines. It works by blocking the effects of histamine, a substance in the body that causes allergy symptoms.

This drug is a third generation antihistamine. Third-generation H₁-antihistamines are second-generation antihistamines informally labeled third-generation because the active enantiomer (levocetirizine) or metabolite (desloratadine & fexofenadine) derivatives of second-generation drugs are intended to have increased efficacy with fewer adverse drug reactions. Fexofenadine is associated with a decreased risk of cardiac arrhythmia compared to terfenadine. However, there is little evidence for any advantage of levocetirizine or desloratadine, compared to cetirizine or loratadine, respectively.

Also known as: Allegra, Fexidine, Telfast, Fastofen, Tilfur, Vifas, Telfexo, Allerfexo, Flexofen.

Nasal Sprays

Okay, so Fexofenadine isn’t quite doing it for you? Time to try a nasal rinse. Flonase Nasal Spray is going to be your best bet. This spray is used to treat asthma, allergic rhinitis, nasal polyps, and more. Have dust mites? This is the solution for you.

Flonase is made with Fluticasone propionate. Sound familiar? This same drug is used and applied topically in the treatment of various skin disorders. It can be given orally in the treatment of Crohn’s disease and ulcerative colitis. Some benefit was also reported in coeliac disease.

Now that you have a nasal spray, don’t screw up spraying it. Here’s a video which demonstrates how to properly apply:

Nasal Rinses – The Holy Grail Which is the Neti Pot

If I’ve been around a lot of pollen, but don’t quite want to take drugs, I’ll turn to a nasal rinse. The Neti Pot works wonders. It uses warm water and saline to clean out your entire sinus cavity. It takes a bit of getting used to, and once you get over the fact you’re putting a blue penis in your nose, you’ll never turn back. I’ve found after using I feel temporarily congested, but the feeling quickly passes for relief. There is also a squeeze bottle which can sometimes help if you’re really clogged and need a little extra pressure. However, I don’t like this one as much as it often leaves a bit of saline at the bottom.

Important: ALWAYS boil water or use distilled water for the neti pot or squeeze bottle. Water in your nasal cavity can allow bacteria or viruses to reach your brain if not sterile, which can have devastating effects. Its not worth the risk.

Allergy Shots -Allergen Immunotherapy – Not OTC

Allergen immunotherapy, also known as allergy shots, is a form of long-term treatment that decreases symptoms for many people with allergic rhinitis, allergic asthma, conjunctivitis (eye allergy) or stinging insect allergy.

Allergy shots decrease sensitivity to allergens and often leads to lasting relief of allergy symptoms even after treatment is stopped. This makes it a cost-effective, beneficial treatment approach for many people.

How Do Allergy Shots Work?
Allergy shots work like a vaccine. Your body responds to injected amounts of a particular allergen, given in gradually increasing doses, by developing immunity or tolerance to the allergen.

There are two phases:
•    Build-up phase. This involves receiving injections with increasing amounts of the allergens about one to two times per week. The length of this phase depends upon how often the injections are received, but generally ranges from three to six months.
•    Maintenance phase. This begins once the effective dose is reached. The effective maintenance dose depends on your level of allergen sensitivity and your response to the build-up phase. During the maintenance phase, there will be longer periods of time between treatments, ranging from two to four weeks. Your allergist / immunologist will decide what range is best for you.

You may notice a decrease in symptoms during the build-up phase, but it may take as long as 12 months on the maintenance dose to notice an improvement. If allergy shots are successful, maintenance treatment is generally continued for three to five years. Any decision to stop allergy shots should be discussed with your allergist / immunologist.

Source

Here is what one person has reported about the cost of taking allergy shots:

Insurance/regional context: I live in the midwest with a generally low cost of living, and my health insurance was billed for all this. The costs have all been passed onto me though, because I had a $2,500 deductible, which I haven’t hit yet.

Testing: I was tested for roughly 80 allergens on my back. They placed each one onto a grid to see what I reacted to. In general, I came back allergic to most items. The cost of this procedure was $334.81. (They billed my insurer for ~$1,290 for this) At the end of this, they prescribed me a new medicine to replace what I was using as well. (Nasal corticosteroid – it’s a spray for your nose) This improved my daily symptoms significantly.

Vials: Once they know what you’re allergic to, they’ll have to order vials that contain your specific mixture of allergens. This is by far the most expensive part of the whole process. I needed 3 vials for each round, which I believe are split into molds, pollens, and trees. (I could be wrong on the last one) I needed 2 sets of each, because they have different concentrations for different stages of allergy shots. In total, there were 6 vials, and those ran me $814.50, which was billed to my insurer for $2850. I believe this will vary on how many things they want to treat you for, and because I came back allergic to nearly everything (even if only to a small extent), mine was probably particularly pricey.

Rush Immunotherapy: I opted for a Rush IT process, which got me through 6 rounds of shots in 1 afternoon. This shaved a lot of time off of my regimen (6 months or so) and also allows you to see benefits sooner. It ran me $495.50, which was billed to my insurer to $1,415.

Ongoing Shots: Now it’s finally more reasonable. I’m on a regimen of 2 shots per week for 11-12 weeks and then it decreases to 1 shot every other week for maybe 6 months. Finally, I go to 1 shot per month for another 12 months or so. Each shot is $10.68, which gets billed to my insurer for $28.

In total, I’ve spent about $1,644 to date plus $10-11 per shot. By the time I’m done, my best guess is that I’ll have spent ~$2,100.

Justification: The way I thought about this was that I was spending probably close to $20 in allergy medicine (mostly all in the pseudoephedrine), which is $240/year. Because allergy shots should get you to a point of not needing medicine, the savings alone should recoup the immunotherapy in about 9 years. In addition, there were too many really miserable days and side effects from the pseudoephedrine that I didn’t mind it.

November Update: I’ve been going through immunotherapy for about 4 months now and am almost at my “maintenance dosage,” which is what I’ll maintain for the remaining 2/3rd’s of the entire process. I’ll have a better idea next spring and summer, but so far, I’ve noticed that my conditions are a lot better in the fall. I am not on pseudoephedrine any more and I don’t need my antihistamine on most days. I’d say I’m down to probably 1 or 2 days a week when I use it, and sometimes that’s when I’m out near a bonfire. Bonfires always gave me a lot of reactions, but it was significantly reduced this time. So far so good.

March 2015 Update: I’m about 9 months into the immunotherapy progress now. I went from getting 1-2 rounds of shots per week for the first 6 months to the point of getting just 1 round every 2 weeks at this point. After a while, I will be switched to 1 shot per month. The costs have been very reasonable because I’m just paying the $10-11 for the routine shot at this point. I did have to pay something like $250-300 for another set of vials however. My allergies have been significantly better and I mostly just take zyrtec as needed, maybe once or twice a week, and that is usually just when I’m going to be exposed to a good bit of something I react to like dust (spring cleaning, etc.) or something like a bonfire. Outside of that, day to day, I’m much better than before.

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