Allergy medications that can have dangerous side effects

“Any decongestant will raise blood pressure, possibly causing an increase in cardiac arrhythmias,” says Kevin McGrath, MD, an allergist in Wethersfield, Connecticut, and spokesperson for the American College of Allergy, Asthma & Immunology. People with glaucoma or hyperthyroidism should also avoid decongestants, according to the Mayo Clinic.

Taken too late in the day, decongestants can make it difficult to fall asleep. They can also lead to jitters and feeling jittery or shaky, McGrath says.

Although commonly found in cold medicines, phenylephrine and pseudoephedrine are also found in some allergy products. “In general, avoid anything that has a D in its name, like Zyrtec-D, because it contains a decongestant,” Niznik says. Allegra-D and Claritin-D are two other examples of allergy medications that contain both a decongestant and an antihistamine.

Decongestant nasal sprays such as Afrin do not carry the same risks as their pill counterparts, but you should limit their use as they can cause rebound congestion or constant stuffiness, if used too often.

What to take instead

Nasal steroid sprays. These are actually the first line of treatment for people with seasonal allergies, and studies show they can be even more effective than oral antihistamines. Three that McGrath recommends are Nasacort AQ and Rhinocort Aqua (both require a prescription) and Flonase Sensimist, an over-the-counter product.

To maximize effectiveness, use them the right way: be sure to spray slightly outward from the nostril. “Use the right hand to spray the left nostril and the left hand to spray the right nostril,” says McGrath. “You don’t want to spray in the middle of your nose, the septum, because that increases the risk of nosebleeds and irritation.”

Certain over-the-counter oral antihistamines. If a steroid nasal spray isn’t enough, you can combine it with an over-the-counter antihistamine. McGrath’s top pick for seniors is Allegra 180 mg. “It’s non-sedating because it doesn’t cross the blood-brain barrier, so it doesn’t cause drowsiness,” he explains. If you don’t have it on hand, he suggests Xyzal, which he says is less sedating than other brands.

Allergic immunotherapy. These are regular injections over a period of time – usually three to five years – to stop or reduce allergy attacks. Each allergy shot contains a tiny amount of what you are allergic to, to boost your immune system.

Over time, your doctor increases the dose of allergens with each injection to help your body get used to the allergens so your symptoms lessen. Although it is normally considered a treatment for children, it can also be extremely effective in older people. In reality, a 2016 study published in the Annals of Allergy, Asthma and Immunology found that immunotherapy reduced symptoms by 55% in adults aged 65 to 75 after three years of treatment and reduced the amount of medication patients had to take by almost two-thirds.

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