Within nasal sprays, the most effective tend to be corticosteroids, followed by antihistamines. But the best option, developed in the last decade or so, packs a one-two punch: a combined corticosteroid-antihistamine spray – which has proven most effective of all, with no worse side effects.
Nasal sprays will often clear eye symptoms on their own. However, if itchy eyes persist, eyedrops with olopatadine can be helpful, says Stephen Durham, emeritus professor of allergy and respiratory medicine at Imperial College London and Royal Brompton Hospital in the UK.
2. Avoid nasal decongestants
Not all nasal sprays are the same – and while many of us turn to decongestant sprays for relief from a blocked nose, this can backfire.
Decongestant sprays (which use ingredients like oxymetazoline, phenylephrine or xylometazoline) work by constricting the blood vessels, shrinking nasal tissue so you can breathe better. But with prolonged use – generally speaking, more than five days – blood vessels can become dependent on this effect and, when the drug isn’t applied, swell too much. That leads to even more congestion (“rebound congestion”) and, often, the unsuspecting patient starts using even more. There is even a danger of long-term damage and dependence.
3. If you do take an oral antihistamine, make sure it’s a ‘second-generation’ version
If you decide to take a pill, opt for a “second-generation” option like certirizine (Zyrtec), loratadine (Claritin) or fexofenadine (Allegra). These newer medications work better and have less of a sedative effect than first-generation options like diphenhydramine (Benadryl), chlorpheniramine or doxylamine.
