As allergies attack, you have several weapons to choose from


April 26, 1994|By Joe Graedon and Dr. Teresa Graedon | Joe Graedon and Dr. Teresa Graedon,King Features Syndicate

It's that time of year again. The grass is growing, the birds are singing and the noses . . . they're sneezing. Spring pollen is back, and people with allergies are suffering.

The meteorologists tell us this spring will be worse than usual. All the moisture that came down in the form of snow and ice last winter will give trees and grass a great head start. Pollen is flying everywhere.

It used to be that allergy victims had to choose between sneezing and snoozing. Conventional antihistamines combat stuffiness, but they make many people feel drowsy and spaced-out. Driving, working, even thinking can be difficult.

The active ingredient in popular over-the-counter products such as Benadryl is diphenhydramine. This compound is also found in many over-the-counter sleeping pills, including Nytol, Sleep-Eze 3, Sominex 2, Bayer Select Maximum Strength Night Time Pain Relief and Extra Strength Tylenol PM.

Nonprescription decongestant nasal sprays such as Afrin or Neo-Synephrine don't make people sleepy, but they carry a clear warning not to use them for more than three days. Otherwise, people can develop a nasal spray habit, with stuffiness getting worse when they try to stop. Allergies have a nasty habit of lasting longer than three days.

This makes the situation tricky for those trying to cope with sniffles and sneezes on their own. There is an alternative, though. Seeing the doctor for prescription-strength help in managing allergies makes sense. Such medications are safer as well as more effective than those available over the counter.

Physicians now have three antihistamines to choose from that don't make people feel sedated. Seldane (terfenadine) and Hismanal (astemizole) have been joined by Claritin (loratadine). All three are effective in forestalling allergy symptoms and have relatively few side effects.

Claritin has a slight advantage, though, because at high doses both Seldane and Hismanal can cause potentially dangerous heart rhythm disturbances. Drugs such as Nizoral for fungus or erythromycin for infection can boost blood levels of Seldane and Hismanal. Even grapefruit juice could be hazardous with these two antihistamines.

Prescription nasal sprays are another option. Nasalcrom (cromolyn) is a cell stabilizer that can keep histamine where it belongs. Steroid sprays such as Beconase AQ, Nasalide, Nasacort and Vancenase AQ can control symptoms without causing side effects associated with oral cortisone.

For those who choose not to see a doctor, there are several options worth trying. Disposable pollen masks can cut your exposure to allergens while you are outside. Newer products such as Tavist-1 (clemastine) may be a little less sedating than other over-the-counter antihistamines. Oral decongestants such as Sudafed (pseudoephedrine) are unlikely to cause drowsiness.

You can survive the next few weeks without suffering from allergies. To avoid unpleasant side effects, though, you'll need to choose your medicine wisely.

Q. My daughter is allergic to cats. Whenever we visit her grandma she suffers unless I give her Actifed. But I think this medicine makes her hyper. Is that possible?

A. Although antihistamines often make adults drowsy, they can sometimes stimulate kids. The Actifed label warns: "May cause excitability, especially in children."

Joe Graedon is a pharmacologist. Dr. Teresa Graedon is a medical anthropologist and nutrition expert.

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