Any Old Actress

//The Drug Store - An Allergy Log

I spent 17 years virtually allergy free. Sure, I'd popped the odd Benadryl when I was covered with Poison Ivy, but the for the most part I was antihistamine free. I didn't suffer with months of sniffles, irritation and congestion. That all started with a sinus infection in February '99. Slowly but surely my nasal allergies have escalated into a near-constant reign of terror. I dust religiously, but fear dusting because it inflames my sinuses. Inflamation leads to sneezing and running, chapped nose and congestion, congestion leads to headaches and swollen eyes and soon I'm a nasty snotty mess. And since elaborate allergy testing isn't really an option, I've been managing my allergies with a series of over the counter antihistamines/decongestants. This is what I've learned.

//Big Fat Disclaimer

I am Not. A. Physician. I absolutely am not giving medical advice. I'm just a stupid homeschooled kid who can't even take an OTC capsule without fully analysing and appreciating it's impact. I'm a lable reader, convinced that you should know what you're getting into. And if people have a better appreciation of their symptoms, and an OTC drug's potential, then they can treat themselves more effectively; and without the unnecessary chemicals you get stuck with in those combo deals ("allergy sinus" "cold & flu"). Since most chronic allergy sufferers turn to doctors at some point, I'm also going to cover the prescription medicines I've experienced. So many people have allergies that most of these drugs go OTC in a matter of months anyways.

Antihistamines

Loratidine
Brand Name: Claritin (also Allavert)
Function: Oral Antihistamine Claritin used to be a prescription-only miracle. My doctor first put me on a Claritin/Antibiotic/Vancenase combo, to treat my infection and alleviate the constant irritation. It worked. Wonderfully. Nipped every itchy, irritated, inflamed, sneezey reaction in the bud. No dry sinus cavities, no snot-block swallowing expectorant. It was excellent. I used this periodically for about 9 months. The only trouble I had with Claritin was headaches. AH side effects are usually either drowsiness or excitability. And every time I went on Claritin I'd have a day or two of tension headaches and a generally twitchy feeling. Ultimately, Claritin quit working - couldn't even touch my allergies. I suppose I developed a tolerance for it, and it maybe could work for me again in the future. But considering the introductory headaches... I won't be investigating it in the future.

Diphenhydramine HCl
Brand Name: Benadryl
Function: Oral Antihistamine Once my Claritin prescription ran out (and before I realised it was useless), I was in a pretty miserable place with no way to manage my allergies. Irritation would set in, and a histamine reaction took over. A hostile takeover even. Itchy eyes, nose and skin (what do nasal allergies have to do with itchy legs, I'd like to know), and rapid fire sneezing so violent I was just grateful I didn't end up with whip lash. So I turned to the Benadryl my mom keeps around. It has drowsy side effects, I'd known this since childhood. But you reach a point where you wouldn't mind zombie-hood if it would only mean your nose quit running. A person can only take so much chapped nose. Besides, Benadryl targets all the basic allergy symptoms - runny nose, sneezing, itchy watery eyes, and itching of the nose and throat. Histamine lock down. The only trouble was that it stopped my runny nose by impacting my sinuses. Irritated tissue, swollen, and complete utter congestion. Sinuses so solid it hurt, and mouth breathing to boot (attractive).

Chlorpheniramine Maleate
Brand Name: Chlor-Trimeton
Function: Oral AntihistamineIn an effort to avoid block-head, I found an AH in a decongestant combo ("Sudafed Cold & Allergy"). And this one was pretty effective. I found it stopped allergy attacks quickly, before the viscious cycle of sneezing, itching and irritation could really take off. Like all antihistamines, it was less effective the longer I waited to take it. No excitability/tension or drowsiness, so this one was easy to take as needed (without taking it preventatively, or suffering side effects). I ultimately quit using it due to viselike sinus headaches (which I suspect was due to the decongestant). I don't think I ever grew tolerant to Chlorpheniramine Maleate, and will definitely use it again, without the decongestant.

Clemastine Fumarate
Brand name: Tavist Allergy
Function: Oral Antihistamine I've been taking these since I gave up on the AH/DC combo. Mostly though, they're just ineffective. The box offers 12-hour relief, and warns against drowsiness, but I've found that even when I take them at the very beginning of an allergy attack that they barely take the edge off the subsequent irritation and sneezing. This may just be my system, they may be more effective for other people. At any rate, I'd still use this to control my allergies before I took Benadryl again. While Clemastine Fumarate only did a little to relieve my symptoms, it relieved them without creating a range of side effects (drowsiness/congestion/headaches).

Decongestants

Pseudoephedrine Hydrochloride (HCl)
Brand Name: Drixoral
Function: Nasal Decongestant This is the only OTC decongestant available orally. Seriously. When you survey the drugstore shelves, the combination drugs, the straight decongestants, you'll find that in every single instance, Pseudoephedrine Hydrochloride is the active decongestant ingredient. Even the much touted "Claritin - D" uses a variety of Pseudoephedrine Hydrochloride. And no wonder - this stuff definitely makes an impact. I initially took this with an antihistamine hoping to avoid the concrete-head syndrome of Benadryl. After about a year's worth of occasional use, I started getting headaches. My sinuses weren't inflamed and my nose wasn't running, so I could rule out pressure headaches. Still, a hollow throbbing pain behind my eyes persisted. As far as I can tell, the decongestant was doing its job unneccesarily, causing pain instead of relieving pressure. The box doesn't warn of any side effects, but I'm convinced this should be used with more caution than other OTC drugs. From what I understand from a neurologist, decongestants work by compressing blood vessels in the sinus cavities (thus drying up the mucous membranes). It's common knowledge that decreased blood flow often causes headaches. I'm very much inclined towards headaches for one reason or another. And since I've discovered that Chlor-Trimeton restores free-er breathing simply by arresting the allergy attack, I won't be using this decongestant again.

Oxymetazoline Hydrochloride
Brand Name: Sinex Nasal Spray
Function: Nasal Decongestant Spray In Progress

Corticosteroids

Beclomethasone Dipropionate, Monohydrate
Brand Name: Vancenase
Function: Nasal Corticosteroid Spray In the past, doctors have given me sprays to accompany sinus infections without telling me what the spray targets. So I take the stuff home and shoot the (awful tasting) sprays up my nose, and expect some kind of relief. Not. Gonna. Happen. And so I give up using the (awful tasting) stuff and wind up with another irritation-infection-fever on my hands a few months down the line. So when my doctor sent me home with a Vancenase mister back in '99, I used it dutifully without paying attention to its effects. Antibiotics and Claritin brought me relief, and I gave up on this spray when my prescription ran out. I currently have a sample from a more recent doctor's visit, and when my Flonase sample (below) runs out, I'll have a chance to see if Vancenase (an anti-inflammatory just like Flonase) delivers the same top-notch results.

Fluticasone Propionate
Brand Name: Cutivate
Function: Topical Corticosteroid Cream In Progress

Fluticasone Propionate
Brand Name: Flonase
Function: Nasal Corticosteroid Spray Flonase is the most recent weapon in the war on allergies. All the commercials rave about it "pollution, pet dander, perfume, pollen, blah, blah, blah". And as much as I hate buying all that hype... The stuff certainly does get the job done. This summer, has been really hard for me allergy-wise. Environment leads to allergic irritation and sneezing/itching, constant irritation leads to infection, and infection creates pain and pressure 'til I'm driven to the doctor by an explosive headache and fever. This time (August 2003) around I got a 'script for Omnicef (antibiotic), a handful of Clarinex samples (these are just Desloratidine, a variation on Claritin and I haven't tried 'em yet) and 50 metered sprays of Flonase. Instead of expecting decongestion, all the commercial hype gave me a clue about what it does, and I fleshed that out by reading the insert. Flonase hasn't brought me any relief - actually when I started using it I was still so congested I could barely inhale the fine mist. This is because Flonase is a corticosteroid, an anti-inflammatory that targets rhinitis. And it doesn't have immediate effects. After about a week of twice daily sprays, I noticed a dramatic difference in my general levels of irritation. Sneezing is minimal now, my face doesn't ache, and I don't have sympathetic itchy eyes (which is brilliant considering I'm in gas perm contacts). The insert says that Flonase is most effective with consistent daily use, which suggests that it's a long term treatment. And while I don't like the idea of being on medication for the rest of my life (even seasonally), I'm much more comfortable using a preventative spray daily than taking an antihistamine orally. So far I haven't experienced any of the potential side effects (e.g. headache, sore throat, nose bleed), and've only got leftover congestion from my last sinus infection.