It's Ragweed Season

Yesterday morning I woke up feeling under the weather. Stuffy nose? Check. Runny nose? Check. Sinus pressure? Check. Sneezing? Check. I’m allergic to ragweed, and although it isn't yet August, ragweed is already blooming with our hot summer weather.

I have allergic rhinitis, which is inflammation of my nose from exposure to something I’m allergic to. Airborne pollens that stick to the inside of your nose and throat trigger allergic reactions. These episodes used to be called "hay fever" because doctors associated it with plant pollens like hay.

Allergic rhinitis can be either seasonal or perennial (year-round). Seasonal allergic rhinitis is usually triggered by plant-based pollens, which bloom at different times of the year. Perennial allergy symptoms are often from molds and pet dander.

Grasses and trees like birch, oak, elm, and maple release their pollens in the spring and early summer, while weeds like ragweed produce their pollen in late summer and early fall.

Ragweed is related to marigolds, chrysanthemums, and daisies. One of the most common seasonal allergies, ragweed creates powdery pollen, which can be carried by the wind for hundreds of miles.

Sometimes ragweed pollen makes my eyes itch and water. Other times, my nose runs, called rhinorrhea. The allergy symptom I suffer from the most is a stuffy nose. This year my allergic rhinitis symptoms include sneezing, nasal congestion, rhinorrhea, and sinus pressure.

Allergic rhinitis is triggered by a chemical called histamine. Your body stores histamine in special cells called mast cells. Suppose your body recognizes pollen or cat dander as something you are allergic to, called an allergen. Coming in contact with allergens will trigger mast cells in your nose to open up. The mast cells release their stored histamine, creating the misery of an allergic reaction. 

Medicines called mast cell stabilizers can block this chain reaction from starting by keeping histamine safely locked up inside your mast cells.

For itchy or watery eyes, I prefer prescription-strength over-the-counter (OTC) ketotifen or olopatadine eye drops. Olopatadine and ketotifen work not only as mast cell stabilizers but also as antihistamines. This allows them to both prevent and relieve an allergic reaction.

Once sold as the prescription drug Zatidor®, ketotifen is available as a generic and Alaway® eye drops. Olopatadine was the prescription eye drop Pataday®, now OTC.

Steroid nose spray decreases inflammation and is the most effective way to treat allergic symptoms like sneezing, sniffling, and stuffiness. There are several agents available without a prescription.

Oral antihistamines can be used either with or without eye drops or steroid nasal sprays. They can relieve all of your allergic rhinitis symptoms. Diphenhydramine (Benadryl® is one of the most effective antihistamines available OTC. Benadryl® is most effective when taken every 6 hours. It also causes drowsiness. If you need an antihistamine that doesn't cause drowsiness, try loratadine (Claritin®) or cetirizine (Zyrtec®), each only needing to be taken once daily.

When I have a stuffy and runny nose simultaneously, a steroid nose spray will help. I prefer taking an older combination of antihistamine and decongestant called Actifed®. Actifed® contains triprolidine plus pseudoephedrine (the original formulation of Sudafed®) and is available as a generic. Triprolidine dries up my watery eyes and runny nose without causing drowsiness, and the pseudoephedrine eases my stuffy nose. 

5 Tips on Taking Allergy Medicine:

1.Try an OTC steroid nose spray first.

Nasacort Allergy 24-Hr,® (triamcinolone), Flonase Allergy Relief® (fluticasone), and Rhinocort® (budesonide) help relieve runny nose, stuffy nose, and sneezing. Be patient because it may take several days to get complete relief. Until then, try taking an oral antihistamine along with the nasal spray.

2. Ketotifen or olopatadine eye drops work well for itchy or watery eyes. Ketotifen (Alaway®) and olopatadine (Pataday®) work both as antihistamines and mast cell stabilizers. They are available without a prescription and can be used safely in children as young as 2 or 3 years old.

3. If you have a runny nose, avoid oral decongestants.

A decongestant relieves a stuffy nose but often makes a runny nose even worse. Try an antihistamine instead, a combination antihistamine/decongestant purchased from the pharmacy counter, or a steroid nasal spray.

4. Don’t waste your money on phenylephrine.

Phenylephrine is only available as 1/3 the effective dose of pseudoephedrine due to its side effects, including stroke. Pseudoephedrine is available from the pharmacy counter, either alone or with an antihistamine.

5. Use decongestant nose sprays sparingly.

Avoid using any decongestant nasal sprays for more than 2-3 days at a time to avoid triggering rebound (worsening of your stuffy nose) symptoms.

Dr. Louise Achey, Doctor of Pharmacy, is a 40-year veteran of pharmacology and author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Get clear answers to your medication questions at her website and blog TheMedicationInsider.com.®2021 Louise Achey