Best Allergy Medicine For Adults And Children Of 2022, According To Allergists

Allergies refer to a “chronic condition involving an abnormal reaction to an ordinarily harmless substance called an allergen,” according to the American Academy of Allergy Asthma and Immunology. If that sounds vague, it’s because it is—allergens and reactions to those allergens are incredibly wide-ranging.

Allergens can include aeroallergens (such as dust mites, mold, tree weed and grass pollen), food allergens (such as milk, egg, soy, wheat, nut or fish proteins), animal dander, latex, certain medications and insect stings. Allergy skin tests are an efficient and accurate way of determining allergic sensitivities.

If you’re allergic to a particular allergen, your body mistakes that otherwise harmless substance (like pollen) as a harmful intruder, triggering the immune system to produce immunoglobulin E (IgE) antibodies in an effort to protect your body from the intruder. Those antibodies cause your cells to release histamine and other chemicals, thus resulting in an allergic reaction. Symptoms of an allergic reaction can include:

• Itching (in nose, roof of mouth, throat or eyes)
• Sneezing
• Stuffy nose (congestion)
• Runny nose
• Teary eyes
• Dark under-eye circles
• For food allergies: vomiting, diarrhea, respiratory symptoms or even anaphylaxis

For our ranking, we only included medications that treat symptoms of aeroallergens.

There are various ways to combat unpleasant allergy symptoms, including:

• Medicine: An array of medicines—both over-the-counter and prescription—effectively and safely treat allergy symptoms. Different types of medications treat allergy symptoms in different ways, ranging from reducing swelling to keeping your body from releasing histamines.
• Immunotherapy treatments: These treatments consist of giving a patient either an allergy shot or sublingual immunotherapy (SLIT) tablet with a dosage of the allergen to lower their sensitivity to it gradually. With allergy shots, you need three to six months of injections with increasingly higher doses of the allergen to build up immunity or tolerance. Once you’ve reached an effective dose, you can expect to receive an injection every two to four weeks. Allergen immunotherapy may reduce the need for medications to control symptoms.

OTC allergy medications use a variety of methods to fight symptoms. Three of the most common OTC allergy medication types are:

• Corticosteroids: This type of OTC allergy medicine works by preventing swelling and inflammation. It’s applied via nasal spray, treating nasal allergies. Corticosteroids are Dr. Passer’s preferred format of OTC allergy medication—while they mainly help with congestion and post nasal drainage, they can also help with itching and sneezing, she says. “These work by soothing the sensitive tissue in your sinuses by coating them with the best anti-inflammatory medication,” says Dr. Passer.“Therefore, when you are exposed to allergens, those tissues remain calm, cool and collected and don’t have the over-exaggerated response of swelling and producing lots of mucus.” Indeed, one study confirms corticosteroids are superior to antihistamines when it comes to treating allergies. In the study, 88 patients with ragweed allergies received either a corticosteroid or an antihistamine. After four weeks, the steroid nasal spray group reported far fewer allergy symptoms than the antihistamine group^[3]Steroids More Effective Than Antihistamines When Used As Needed For Allergies. University Of Chicago Medical Center. Accessed 05/13/2021. .

• Antihistamines: Many big-name brands are antihistamines, treating allergies by blocking histamine, the trigger of allergic swelling. Antihistamines can treat indoor and seasonal allergies and come in a variety of application methods, from tablets to nasal sprays. Studies confirm that antihistamines are effective at relieving itch caused by the release of histamines^[4]Randall KL, Hawkins CA. Antihistamines and allergy. Aust Prescr. 2018;41(2):41-45. .
• Decongestants: This common type of OTC allergy medicine reduces nose stuffiness by shrinking swollen membranes in the nose. But be wary—with repetitive use, decongestants are known to cause your nose stuffiness and swelling to worsen. “If used correctly, the nasal steroids are just as good for congestion,” says Dr. Passer.

When determining which type of OTC allergy medication is right for you, consider your worst allergy symptoms.

“There is a lot of crossover among the different categories, but in the most simple terms, antihistamines are best for itchy, sneezy noses and help itchy eyes,” says Dr. Passer. “Nasal sprays are best for congestion and post nasal drainage, but help itch quite a bit, too, and decongestants help with congestion. OTC eye drops are best for eye symptoms.”

“I don’t think there is any differentiation between the medication categories for pollen versus, say, indoor allergens like dust or dog dander,” she adds. “It really is all the same process in the body—it just comes from different sources.”

OTC allergy medications vary significantly in price, according to our analysis. Costs ranged from around 25 cents for an antihistamine tablet to nearly $20 for a month’s supply of nasal spray.

Our Best OTC Allergy Medications for Adults and Children ranking didn’t include the vast number of generic versions with the same active ingredients as many brand name products. Generic products (such as the store brands for CVS, Walgreens, Amazon and more) are held to the same FDA regulations as brand name products, making them just as effective as their brand name counterparts but at a lower price.

If you find that Claritin, for example, is an antihistamine that works for you, you may want to consider a generic version of loratadine (Claritin’s main active ingredient) as a more affordable alternative.

For our Best OTC Allergy Medications for Adults and Children ranking, the Forbes Health editorial team consulted with Dr. Fineman and Dr. Passer on their top recommendations. Star ratings were determined solely by the Forbes Health editorial team, and were based on the following metrics:

• Drug class
• Average cost for one month’s supply
• Average user rating
• Non-drowsy
• Provides all-day relief
• Available in various formats, including orally-disintegrating, gel capsule or chewable formats