Allergy season is here! Are you team Zyrtec, Allegra, Claritin, antihistamine?

[jeezifonly]

Who doesn’t love a hundred-dollar douche?

https://amzn.to/3yrydjm

[dbar123]

Went through 10 years of allergy shots in my 20’s. Now I rarely take anything. It was a hassle at the time but definitely no regrets. Was allergic to almost everything….

[ICTJOCK]

The only time I ever have an allergy problem is late spring as I am allergic to Hedge Tree (Osage Orange)  tree pollen.   I hate to take anything,   so I guess I'm team  "skip it".     It seems like the medications either makes me sleepy  (typically) or other small side effects.    I always just feel like I'm trading one issue for another.   Some years are rough,  some aren't bad at all (as was 2023).

[Guest]

On 6/28/2022 at 1:27 PM, bichiguy said:

Advil Sinus & Congestion works for me, doesn't make me feel loopy

I'm not sure whether you mean Advil Cold and Sinus or Advil Sinus Congestion and Pain (there is no med by the name "Advil Sinus & Congestion" that I know of), but neither contains any allergy meds. Both contain only decongestants and the pain reliever ibuprofen. The latter's decongestant is phenylephrine and the former's is pseudoephedrine. Pain is a fairly uncommon symptom with allergies (more common with colds), and ibuprofen carries a pretty high risk for GI and kidney complications for an OTC medication. Fine if you have pain, but best avoided if you don't. While adding a decongestant to an allergy medication such as antihistamines and/or steroid nasal sprays is reasonable if congestion persists notwithstanding the allergy meds, it's probably not routinely needed, either. 

Also, anyone who might be subject to urine drug screens at work should know that pseudoephedrine will show up as an amphetamine in the original screen. Yes, a secondary analysis will reveal what the actual chemical(s) involved is (i.e. via chromatography), but it helps to warn the person collecting the urine beforehand. False positives are so common with the original amphetamine screen (even blood pressure meds and antidepressants can throw that test off), that many (but definitely not all) labs automatically run the secondary tests on all positive amphetamines. More than once I had a laugh when I'd run across a patient who knew that Sudafed could cause a false positive on a screening test--but didn't know that I could find out exactly the responsible chemical with secondary analysis. The patient might claim he was taking Sudafed--but I already knew the secondary screen showed the presence of methamphetamine and absence of Sudafed. In other words, the patient would be lying to me twice: once when he said he wasn't taking amphetamines (which he was), and again when he said he was taking Sudafed (which he wasn't). 

In any case, if some antihistamines make you feel sleepy, or "loopy," and your problem is really allergies (not a cold), it would be safer and more efficacious to use topical (i.e. nasal) steroids (or antihistamines, though those sting), and/or non-sedating antihistamines. That and allergy eye drops if you need them. 

[rvwnsd]

25 minutes ago, Unicorn said:

...In any case, if some antihistamines make you feel sleepy, or "loopy," and your problem is really allergies (not a cold), it would be safer and more efficacious to use topical (i.e. nasal) steroids (or antihistamines, though those sting), and/or non-sedating antihistamines. That and allergy eye drops if you need them. 

You've described my allergy regime, plus some asthma meds to treat asthma. I'm currently using the OTC generic equivalents of Allegra (antihistamine tablet), Flonase (nasal spray), and Allaway (eye drops) plus allergy shots. For asthma, I take Advair and Spiriva respi-mat (not that spawn of Satan called the "handi-haler") 

Zyrtec made me very drowsy and Claritin didn't do much at all, hence Allegra. 

PS: @Unicorn, I know you don't need me to explain what each med is. It's for the benefit of folks who are unfamiliar with allergy and asthma meds.

[Rudynate]

9 hours ago, rvwnsd said:

You've described my allergy regime, plus some asthma meds to treat asthma. I'm currently using the OTC generic equivalents of Allegra (antihistamine tablet), Flonase (nasal spray), and Allaway (eye drops) plus allergy shots. For asthma, I take Advair and Spiriva respi-mat (not that spawn of Satan called the "handi-haler") 

Zyrtec made me very drowsy and Claritin didn't do much at all, hence Allegra. 

PS: @Unicorn, I know you don't need me to explain what each med is. It's for the benefit of folks who are unfamiliar with allergy and asthma meds.

Same for asthma, and abuterol as needed.  I have the generic for Advair:  Wixela

[Guest]

10 hours ago, rvwnsd said:

You've described my allergy regime, plus some asthma meds to treat asthma. I'm currently using the OTC generic equivalents of Allegra (antihistamine tablet), Flonase (nasal spray), and Allaway (eye drops) plus allergy shots. For asthma, I take Advair and Spiriva respi-mat (not that spawn of Satan called the "handi-haler") 

Zyrtec made me very drowsy and Claritin didn't do much at all, hence Allegra. 

PS: @Unicorn, I know you don't need me to explain what each med is. It's for the benefit of folks who are unfamiliar with allergy and asthma meds.

That sounds like an excellent regimen. Claritin/loratadine is a bit of a strange bird. Although it showed a tiny but statistically significant improvement in allergy symptoms, you're right in that it doesn't do much for most people. It barely mustered FDA approval, passing by one vote. It's mostly a placebo. Zyrtec is a mixture of the active levocetirizine and inactive dextrocetirizine (like a right and left glove). Levocetirizine can be purchased on its own (formerly sold under the brand name Xyzal, now only generic). Since the dose is half of the mixture (5 mg instead of 10 mg), it's half as likely to cause side-effects such as drowsiness. Among the sedating antihistamines, levocetirizine is perhaps the least likely to cause sedation, and it's also pretty effective. Montelukast is another non-sedating allergy pill alternative. The only advantage of levocetirizine over fexofenadine (Allegra) is that it's a bit better at treating hives (a type of skin allergy):

Just a moment...

WWW.ANNALLERGY.ORG

"... After treatment with levocetirizine, all 18 subjects had >95% inhibition of the wheal response at one timepoint. Fexofenadine, mizolastine, and ebastine were inhibitory in declining order. All treatments were considered safe and well tolerated. Levocetirizine, the active enantiomer of cetirizine, is more potent and consistent than other popular H1 antihistamines for blocking the cutaneous response to histamine."

 

Edited September 5, 2023 by Unicorn

[samhexum]

On 5/2/2022 at 4:44 PM, marylander1940 said:

I take Zyrtec but antihistamine also works for me and is way cheaper at Walmart.

 

On 5/2/2022 at 5:36 PM, keefer said:

team Zyrtec...  my dad was a Pharmacist, I talk to Pharmacists yearly about this, I know beyond the packaging the pills are almost identical;  but I'm convinced zyrtec works better (for me) than the others...

 

On 5/2/2022 at 6:04 PM, FrankR said:

Allegra every night before bed, during the month of May. 💊

 

On 5/2/2022 at 8:05 PM, sync said:

I have tried most of the OTCs and the only one that has ever worked for me is Benadryl.  Unfortunately, it makes me very drowsy... Climate change is a bitch.  I used to have allergy difficulties for only a short time in the fall of the year, now they're showing up all the time.

The FDA begs to differ. (Oh, please!  Please let us differ!)

Decongestant in Cold Medicines Found Ineffective
FDA advisory panel’s declaration paves way for removal of dozens of medicines in the U.S.

Read in The Wall Street Journal: https://apple.news/A0v6rsr0eQSi20SYLIdoRIg

[Guest]

11 minutes ago, samhexum said:

...

Decongestant in Cold Medicines Found Ineffective...

Phenylephrine is the decongestant found to be ineffective. Pseudoephedrine is still considered effective. Again, be aware that this can initially test positive on a rapid drug screen as amphetamine (although further testing will clear things up). 

[samhexum]

An advisory panel of the Food and Drug Administration stated today that virtually all over-the-counter decongestants simply don’t work.

The FDA panel found that phenylephrine — the active ingredient in Sudafed, Benadryl, Robitussin and other popular decongestants — is nearly useless at reducing nasal congestion.

The advisory panel’s ruling might soon lead to these oral products being pulled off store shelves nationwide. (Nasal sprays containing phenylephrine are unaffected by the ruling.)

“This drug and this oral dose should have been removed from the market a long time ago,” Jennifer Schwartzott, a patient advocate from New York, told NBC News.

“The patient community requires and deserves medications that treat their symptoms safely and effectively and I don’t believe that this medication does,” Schwartzott added.

Phenylephrine first came to prominence in 2006 after another decongestant, pseudoephedrine, was taken off drugstore shelves because it’s an ingredient in the illegal stimulant methamphetamine.

After the passage of the Combat Methamphetamine Epidemic Act of 2005, pseudoephedrine was available only behind the counter, so drugmakers replaced it with phenylephrine-based products.

The FDA panel analyzed the early documents and studies that were used to support phenylephrine’s OTC use. The agency found that study results were inconsistent, did not meet modern standards for study design or had flawed data integrity.

In contrast, several recent studies into phenylephrine found that the drug didn’t reduce nasal congestion much more than a placebo, even at doses as high as 40 milligrams.

“In conclusion, we do believe that the original studies were methodologically unsound and do not match today’s standard,” said Dr. Peter Starke, an FDA official who led the review of phenylephrine.

“By contrast, we believe the new data are credible and do not provide evidence that oral phenylephrine is effective as a nasal decongestant.”

The FDA first started investigating oral phenylephrine in 2007, according to MedPage Today, in response to a citizen petition, and an advisory committee meeting was held that same year.

In the meantime, there was some industry pushback against regulation of the drug, which remains the case today.

The Consumer Healthcare Products Association, an industry representative group, had argued for keeping the drug available, citing the “totality of the scientific evidence” with pre-existing studies to support efficacy.

They criticized the more recent clinical studies as having “important limitations” that were “conducted using a study population that is not appropriate to evaluate the efficacy of phenylephrine for OTC use.”

The group also shared a survey that found 1 in 2 households in the US used an oral decongestant over the past year. It also found that people prefer oral decongestant tablets over nasal sprays 3 to 1.

The market for decongestants is huge: A consumer study of 100,000 US households showed that about half purchased medications with phenylephrine over the course of the year, and most of those did so several times a year.

Though the findings of the FDA advisory panel are nonbinding, the FDA usually sides with the panel, which may lead to oral phenylephrine products being removed from store shelves in the near future.

 

Sudafed, Benadryl and most decongestants don't work: FDA advisory...

NYPOST.COM

---

"This drug should have been removed from the market a long time ago," said a patient advocate from New York.

 

[BuffaloKyle]

16 minutes ago, samhexum said:

An advisory panel of the Food and Drug Administration stated today that virtually all over-the-counter decongestants simply don’t work.

The FDA panel found that phenylephrine — the active ingredient in Sudafed, Benadryl, Robitussin and other popular decongestants — is nearly useless at reducing nasal congestion.

The advisory panel’s ruling might soon lead to these oral products being pulled off store shelves nationwide. (Nasal sprays containing phenylephrine are unaffected by the ruling.)

“This drug and this oral dose should have been removed from the market a long time ago,” Jennifer Schwartzott, a patient advocate from New York, told NBC News.

“The patient community requires and deserves medications that treat their symptoms safely and effectively and I don’t believe that this medication does,” Schwartzott added.

Phenylephrine first came to prominence in 2006 after another decongestant, pseudoephedrine, was taken off drugstore shelves because it’s an ingredient in the illegal stimulant methamphetamine.

After the passage of the Combat Methamphetamine Epidemic Act of 2005, pseudoephedrine was available only behind the counter, so drugmakers replaced it with phenylephrine-based products.

The FDA panel analyzed the early documents and studies that were used to support phenylephrine’s OTC use. The agency found that study results were inconsistent, did not meet modern standards for study design or had flawed data integrity.

In contrast, several recent studies into phenylephrine found that the drug didn’t reduce nasal congestion much more than a placebo, even at doses as high as 40 milligrams.

“In conclusion, we do believe that the original studies were methodologically unsound and do not match today’s standard,” said Dr. Peter Starke, an FDA official who led the review of phenylephrine.

“By contrast, we believe the new data are credible and do not provide evidence that oral phenylephrine is effective as a nasal decongestant.”

The FDA first started investigating oral phenylephrine in 2007, according to MedPage Today, in response to a citizen petition, and an advisory committee meeting was held that same year.

In the meantime, there was some industry pushback against regulation of the drug, which remains the case today.

The Consumer Healthcare Products Association, an industry representative group, had argued for keeping the drug available, citing the “totality of the scientific evidence” with pre-existing studies to support efficacy.

They criticized the more recent clinical studies as having “important limitations” that were “conducted using a study population that is not appropriate to evaluate the efficacy of phenylephrine for OTC use.”

The group also shared a survey that found 1 in 2 households in the US used an oral decongestant over the past year. It also found that people prefer oral decongestant tablets over nasal sprays 3 to 1.

The market for decongestants is huge: A consumer study of 100,000 US households showed that about half purchased medications with phenylephrine over the course of the year, and most of those did so several times a year.

Though the findings of the FDA advisory panel are nonbinding, the FDA usually sides with the panel, which may lead to oral phenylephrine products being removed from store shelves in the near future.

 

Sudafed, Benadryl and most decongestants don't work: FDA advisory...

NYPOST.COM

---

"This drug should have been removed from the market a long time ago," said a patient advocate from New York.

 

I'd like a refund please. 💰 💊

[Guest]

2 hours ago, samhexum said:

...

The FDA panel found that phenylephrine — the active ingredient in Sudafed, Benadryl, Robitussin and other popular decongestants ...

Yes, PE doesn't work, but they have the brand names all wrong. The active ingredient in Sudafed (as opposed to "Sudafed PE") is pseudoephedrine (that's why it's called Sudafed). The active ingredient in Benadryl is diphenhydramine, and the active ingredient in Robitussin is guaifenesin  (though some formulations may also contain PE). Getting pseudoephedrine isn't tough. You don't need an Rx (at least in California), you just have to sign for it, so that the G-men know how much everyone has. (Incidentally, the evidence on guaifenesin is rather weak, although Robitussin DM, which also has dextromethorphan, seems to work better)

[+ sync]

I have no credentials to validate the criticism or support of the findings.  I can only state that Benadryl works for me.  

[marylander1940]

Zyrtec before going to bed! 

 

[samhexum]

On 9/5/2023 at 12:30 PM, Rudynate said:

I have the generic for Advair:  Wixela

Asked my Dr for a prescription today.  Big savings over Advair.  Thanks.

[+ Charlie]

I didn't realize until after I used Sudafed the other day that the Sudafed one buys off the shelf contains phenylephrine, not the pseudoephedrine that one gets from the pharmacist counter. No wonder it wasn't effective for me.

[+ Lucky]

People were forced to buy phenylephrine so that drug dealers couldn't get pseudoephidrine so easily. A useless drug exchanged for one that actually works. Using Sudafed to make meth has been surpassed with other methods.

[+ nycman]

7 hours ago, Lucky said:

People were forced to buy phenylephrine

"Forced"?

I don’t ever remember pseudoephedrine ever being completely removed. At least not in the US. I mean yeah, they moved it behind the counter and you weren’t allowed to buy 5 lbs of it all at once, but I’d hardly call that being "forced to buy phenylephrine".

Btw, CVS is voluntarily removing phenylephrine from their shelves because the crap doesn’t work. 

[+ Lucky]

1 hour ago, nycman said:

"Forced"?

I don’t ever remember pseudoephedrine ever being completely removed. At least not in the US. I mean yeah, they moved it behind the counter and you weren’t allowed to buy 5 lbs of it all at once, but I’d hardly call that being "forced to buy phenylephrine".

Btw, CVS is voluntarily removing phenylephrine from their shelves because the crap doesn’t work. 

Who knew that you could get pseudoephedrine from the pharmacist? @Charliedidn't, and I'd say he is an otherwise informed consumer. Since he didn't know it, he was "forced" to buy the stuff that didn't work.

I agree, forced may be too strong of a word, but in an effort to stop a few drug dealers, a whole lot of people bought the stuff that didn't work.

Edited October 19, 2023 by Lucky
sp

[+ Charlie]

I wonder how many consumers are aware that the Sudafed they pull off the drugs shelf at the supermarket does not contain the same ingredient as the Sudafed they can get from the pharmacist at the same store, although the packaging looks very similar? And how many of them are aware that the ingredient in the pills on the shelf has been shown by tests to be much less effective than the one in the pharmacy? I wouldn't have wasted money on the former product while doing my grocery shopping last week if I had known they were different.

Edited October 20, 2023 by Charlie

[Rudynate]

I hadn’t taken Sudafed in a long while and tried to buy some recently and was surprised I had to ask for it.

[+ Charlie]

My doctor gave me a prednisone shot this morning, and the sneezing stopped completely--for about ten hours. I am up and online at this hour because now I am sneezing as badly as I was before.

[+ Lucky]

4 hours ago, Charlie said:

My doctor gave me a prednisone shot this morning, and the sneezing stopped completely--for about ten hours. I am up and online at this hour because now I am sneezing as badly as I was before.

"At this hour?" From what I can tell, you posted at 1:45 am. I hope that your sneezing has abated and that you are sound asleep now.

Edited October 24, 2023 by Lucky

[Rudynate]

6 hours ago, Charlie said:

My doctor gave me a prednisone shot this morning, and the sneezing stopped completely--for about ten hours. I am up and online at this hour because now I am sneezing as badly as I was before.

[Rudynate]

2 minutes ago, Rudynate said:

6 hours ago, Charlie said:

My doctor gave me a prednisone shot this morning, and the sneezing stopped completely--for about ten hours. I am up and online at this hour because now I am sneezing as badly as I was before.

Im sorry you feel so rotten.  Maybe he should try decadron. It's longer lasting and generally a stronger steroid.