WebMD Ask the Pharmacist

Spring Allergy Relief: Ask the Pharmacist

April 27, 2010. Pharmacist Heather Free, PharmD, answers questions about finding relief from spring allergies.

Question:

Can you take Zyrtec if you are using Mucinex DM?

Answer:

Yes, as long as both medications are for the correct symptoms. Zyrtec is an antihistamine, which will work for runny nose, itchy eyes, and sneezing symptoms that are associated with allergic reactions. Mucinex DM has two ingredients, guaifenesin and dextromethorphan. The guaifenesin is an expectorant, which will help to thin mucus found in the chest, making it more manageable to cough up and out of the body. Dextromethorphan helps with coughing.
The important take-home message is to not over-medicate yourself. While all these medications are readily available over the counter for self-treatment, only treat the symptoms that are present. Don’t over-medicate or make you body work harder than it needs to. And remember, taking more medication isn’t going to make you better quicker. There isn’t a quick fix. Hope this helps!

Question:

Can I give my 7-year-old Ceron DM syrup and Children’s Claritin tab at the same time?

Answer:

I would not recommend giving your child both medications. Ceron DM syrup contains chlorpheniramine, dextromethorphan, and phenylephrine. Dextromethorphan is the cough suppressant, while phenylephrine is the nasal decongestant. Chlorpheniramine is an antihistamine, very similar to Claritin. Therefore, your child is already getting allergy symptom coverage, and we would not want to double the dose of this medication. Doing so increases the risk of drowsiness, additive side effects, and possible toxicity issues. Use one or the other during this time and continue the Claritin once they have stopped using the Ceron DM.

Question:

My daughter’s ear and face are covered in poison oak. She is using an over-the-counter cream. Is there anything else that I can do for her?

Answer:

With poison oak involving the face, the child should be seen by a doctor and evaluated for the possible need for prescription medications.
Poison oak is a reaction from the oil found in the plant. The more contact you have with the oil, the more severe the rash. It is important to make sure you wash all clothing in hot water to eliminate all the oil from the plants and to prevent further contact or spreading to other people. Once the oil is off the clothing and the body, it is no longer contagious.
If it doesn’t involve the face, the first part of treatment for poison oak is to wash the body thoroughly with wet compresses or cool water. The sores or the rash can be treated with many different over-the-counter products. Antihistamines can help to decrease the swelling, itching and redness. The corticosteroid cream is also great to use to treat the rash.

Question:

If a 4 1/2-year-old child is taking Zyrtec daily, can he also take a dose of Benadryl for severe symptoms on the same day? Also, what dose of Zyrtec is appropriate for a 4 1/2-year-old, weighing about 36 pounds? Is one tablet okay, or only 1/2 a tablet?

Answer:

I do not recommend giving your child Benadryl on top of Zyrtec. They are both antihistamines and will individually have the coverage your child needs for allergy relief.
However, you need to partner with your pediatrician or other health care providers to make sure this dose is safe and effective for your child. Both medications are readily available over the counter, but for self-use the directions on the box/bottle/package must be followed.

Question:

I lost the instructions to my EpiPen and was wondering how do I use it?

Answer:

First, check the expiration of the pen to make sure it is within date. Store it in a dry space out of the sun and moisture from the bathroom or kitchen.
If a severe allergic reaction occurs, you want to pull off the gray or orange cap of the pen. Place it directly over the clothes on the outside area of the thigh. Push the black end in and count to 30, leaving the pen still in contact with the leg. Once you have finished releasing the medication, call 911 or have someone drive you to your doctor right away.

Question:

My granddaughter was prescribed Lodine for her seasonal allergies. Is this medication safe for her to take? She is 17 years old.

Answer:

Lodine is the brand name for etodolac, a nonsteroidal anti-inflammatory medication. This medication does not give allergy relief and I would find out more about why she is taking this medication.

Question:

What allergy medications can I take when I already take Norvasc for my blood pressure? I’m very afraid to take something that will make my blood pressure skyrocket!

Answer:

Antihistamine medications that are NOT combined with other medications are safe to take with blood pressure medications, and should not affect your blood pressure. We tend to be more concerned about nasal decongestants effecting blood pressure more than the antihistamines when treating allergy symptoms.
I suggest working with your local pharmacist to help select a product for the specific symptoms you are trying to treat that would not affect you blood pressure.

Question:

Can Allegra-D affect someone who is diabetic and has had a kidney transplant?

Answer:

With patients who have had kidney transplants, we tend to be more cautious so as not to make the body work harder, especially the kidneys. When you have received a new kidney the function is better if not as good as a normally functioning kidney. Transplant patients already take many medications to prevent transplant rejection. We need to look at the specifics of the medications you are taking to prevent overloading of the kidney.
Without further information I would not be able to answer the question completely. I would suggest working with your pharmacist and/or your health care professional to make sure it is all right to add this medication to your regimen, looking at drug-drug interactions and the specifics of each individual medication (elimination and kidney affects).

Question:

Can I put human allergy eye drops in my dog's eyes?

Answer:

Many human medications are used for animals. However, check with your veterinarian and have your dog evaluated to make sure that your dog does have allergies and could benefit from using an over-the-counter antihistamine eye drop.

Question:

I am taking Allegra for allergies. Is fexofenadine the same as Allegra?

Answer:

Yes, Allegra is the same as fexofenadine. Every medication has two names, a brand and a generic name. The original creators are the only ones who can use the brand name. Once the recipe becomes available to other drug manufacturers, they sell the product under the generic name. It usually takes approximately seven years for the brand to go generic. The main active ingredient has to remain the same in each recipe.
What differs from the brand and generic are the inactive ingredients that can hold the medication together and that give it its color. In addition, the generic can be much more affordable. Most generics are FDA approved to be equally effective. Therefore, if the generic works for you then there is no need to switch. Also, make sure to only take one and not both the brand and generic to prevent overdosing and additive side effects.

Question:

What are the side effects of prolonged using of Histazine antihistamine?

Answer:

Histazine is an international medication, not found in the USA, but rather in Israel. For a more clear answer you would have to check with the manufacturers or someone from Israel.
If you live here in the USA, I recommend letting your doctor and pharmacist know you are taking this medication. It is important to check for possible drug interactions and complications. If you continue to stay here, I recommend switching to a USA form of the medication.

Question:

If an 8-year-old has a cold, should she have Flumist flu prevention?

Answer:

Flumist is used for prevention of influenza. This doesn’t mean that a person who has had the Flumist cannot catch the flu. The Flumist delivers live, but weakened, flu virus to help your body build up immunity to the virus. This way, when or if you contact the real virus your body will have a better team of fighters to eliminate or prevent complications associated with the flu, such as death.
If the child has a cold without fever and does not have any of the other contraindications (egg allergy, asthma, altered immune-compromised persons, or less than 24 months of age), then they should be fine to take the Flumist.

Question:

I'm a nursing mother and would like to know if there is any OTC nasal allergy medication that is safe to take.

Answer:

There are three different types of nasal sprays used for allergy relief: corticosteroids, antihistamines, and decongestants. If you need relief, you would work with your ob-gyn to make sure one of these medications is right for you, especially the decongestants (the only group found over the counter).
Examples of corticosteroid nasal sprays include fluticasone (Flonase), mometasone (Nasonex), budesonide (Rhinocort Aqua), flunisolide (Nasarel), triamcinolone (Nasacort AQ), and beclomethasone (Beconase AQ). Side effects can include unpleasant smell or taste, nasal irritation, and nosebleeds. These medications are much less likely to cause any side effects than are oral corticosteroids.
Prescription antihistamine nasal sprays include azelastine (Astelin, Astepro) and olopatadine (Patanase). Side effects of antihistamine nasal spray may include bitter taste, dizziness, drowsiness or fatigue, dry mouth, headache, nasal burning, nosebleed, nausea, runny nose, sore throat, and sneezing.
Examples of nasal decongestant sprays include phenylephrine (Neo-Synephrine, others) and oxymetazoline (Afrin, others). Nasal decongestants can cause dryness, burning, or stinging inside the nose, runny nose, and sneezing. Taking too much of a nasal decongestant can cause irritability, fast or irregular heartbeat, dizziness, insomnia, headaches, anxiety, tremors, and increased blood pressure. Don't use a decongestant nasal spray for more than a week or so, or you may develop severe congestion as soon as you stop taking it (rebound congestion).

Question:

Is it wise to use a nebulizer for nasal congestion?

Answer:

Nebulizers are used to deliver vapors to the lungs. Nebulizers are also used to help deliver asthmatic medications to the lungs for infants and other patients that have a difficult time using inhalers with spacers. The medications used are not for nasal congestion, but for asthma. Nasal congestion medications should not be poured into the nebulizers without supervision or recommendation form you health care provider. Check with your health care providers prior to doing so.

Question:

What information can you provide about Coricidin HBP?

Answer:

There are many Coricidin HBP products to treat symptoms that will not affect blood pressure. The company has products for day and nighttime relief, cold and flu symptoms, nighttime only, cold and cough, and so on. These products are decongestant-free, taking out the medications that can cause a rise in blood pressure with long-term use.
Two common decongestants that can raise the blood pressure over a prolonged period of use are phenylephrine and pseudoephedrine. Work with your pharmacist and your health care provider to see if these decongestants could be helpful in your case.

Question:

What can I take to relieve the symptoms of a nonproductive cough?

Answer:

Typically a nonproductive cough is a secondary symptom. You need to evaluate all symptoms to see if the cough is associated with another primary symptom. If you treat the primary symptom it can elevate the secondary symptoms. Then, you wouldn’t be over-medicating, or taking more medication than needed. For example, if there is a postnasal drip going to the back of the throat, it could cause irritation and soreness or even a dry cough from the tickle to the throat. If we treat the postnasal drip, we will get rid of all symptoms.
Without knowing more about your situation, a recommendation would be difficult at this point. I suggestion going to you pharmacist so more questions could be asked to help find a better solution to relieving your symptoms.

Question:

My 8-year-old son is allergic to milk and milk products. Should I give him a calcium vitamin and what dosage? Also, he was just diagnosed with a hypothyroid and is on Synthroid medication.

Answer:

I agree that you should give your son a calcium product if he is not able to get it in his diet. Check with your allergist to see if he is able to consume products like soy milk. I would start by giving him one 500 milligram tablet of calcium, plus vitamin D twice daily with food. Check with your pediatrician to make sure that they approve and feel that this dose is necessary.

Question:

I have been using Nasonex. But because of the cost and the availability of generics, I want to switch to flunisolide spray (Nasarel) or fluticasone propionate spray (Flonase). Which is the better of the two? I also need one that will treat indoor allergies (dander) better.

Answer:

This is a very individualized answer. In general, one of these products is no more effective than the other. But one of these products could be more effective for me than for you, and vice versa.
I suggest working with you health care provider to see if they have samples of the medications that you would be able to try to see if the medication works for you. I also suggest going to each of the medications’ web sites to see if there are coupons available to help save money. Check with your insurance company to see what the preferred nasal decongestant medications are and bring that information back to you health care provider when choosing a product.
Keep in mind, if the Nasonex works you may not benefit from switching. Check for coupons to see if you can make it more affordable for yourself.

Question:

Can I give my almost 2-year-old a half teaspoon of Benadryl for allergies?

Answer:

Benadryl is safe and effective to use for 2-year-old children. However, the dosing for a pediatric patient depends on their weight. Without knowing your child’s weight I cannot give an exact answer. Check with your local pharmacist or pediatrician about the correct dose for your child.

Question:

I have a foot rash and it itches like crazy. What is better for me to use for the itching? Claritin or Zyrtec?

Answer:

Claritin and Zyrtec are not used to treat the itching associated with a foot rash. Without seeing the foot rash it is difficult to help in selecting an over-the-counter medication for treatment. The most common type of foot rash is athlete’s foot, which is caused by a fungus. Symptoms include red, itching, burning areas, and sometimes dry white flakes. The burning itch associated with the foot rash is treated with antifungal medication.
Please note, having an itch does not always mean that an allergy medication is going to alleviate your symptoms. Medications are intended to work for the cause of a specific condition. You need to use the appropriate medication for the actual condition. Seeking medical advice, informing another health care professional, and asking a pharmacist about all the symptoms that are involved can help to correctly identify and treat your condition.

Question:

I have a 7-month-old baby girl who weighs 17 pounds. Her doctor prescribed Singulair and an OTC of Zyrtec. However, I don’t know how much or how often to give the Zyrtec. What should her dose be?

Answer:

The directions on the box for Zyrtec list recommended doses for children 6 years of age through adults. Since it has not been listed on the bottle for infants, I recommend speaking to your doctor again to get the correct dose.

Question:

I have been taking Allegra-D for the past few years and the medication is not being covered any more by my health plan. What OTC medication can I take that is similar, or will have the same results? I take the Allegra-D tablets twice per day for about three weeks during the "blooming" season.

Answer:

Allegra-D is in the same drug class as Zyrtec-D, Claritin-D, and all its generics. All three of these medications used to be prescription strength. A few years ago, Claritin and all its products converted to over-the-counter status, which led other medications in its class to make the switch from prescription to over the counter, as well. Allegra and it products have not made that switch yet.
It is worth the cost savings to see if another one of the antihistamines found over the counter work as comparable to your usual Allegra-D. Monitor your symptoms to make sure they do not worsen. Both Claritin and Zyrtec products work relatively quickly. So you would see relief taking place on the same day you take the medication. If your symptoms do worsen, then switch to another antihistamine or pick up your prescription for Allegra-D.

Question:

I am breastfeeding and my allergies are killing me. I have a sore throat, congestion, and itchy eyes and ears. Can I take Tylenol allergy or anything else while breastfeeding?

Answer:

There are several over-the-counter medications to treat allergy symptoms. However, all of them would become evident in your breast milk. At this point, I would not take the Tylenol allergy. Consult your primary health care provider or your ob-gyn to see what options are best for you and your infant.

Question:

Can you take allergy medicine and cough medicine at the same time?

Answer:

This depends on the active ingredients found in both of the products. Many cough and cold medications include a first generation antihistamine (i.e. diphenhydramine, chlorpheniramine) for a runny nose and drowsiness. We typically see second generation antihistamines in allergy medications, such as Claritin, Zyrtec, and their generics (less side effects and more allergy focused).
Nevertheless, an antihistamine is an antihistamine. The more you take, the more you increase toxicity and the intensity of side effects. It is really important when selecting a product to make sure you do not double the ingredients or take more ingredients than your symptoms require. Read the product boxes carefully. If you have any questions or concerns, do not buy the product before consulting with a pharmacist.

Question:

What OTC eye drops can I take to reduce itchiness and redness caused by pollen allergies?

Answer:

There are several products that can be used for treatment of allergy eye symptoms (itchy, watery, or red eyes).
Opcon-A/Visine-A/Naphcon-A and all the generics. The active ingredients: naphazoline HCl, a decongestant/relieves redness, and pheniramine maleate, an antihistamine. They are recommended for short-term use only.
Zaditor/Alaway (ketotifen), a topical antihistamine and mast cell stabilizer eye drops. This medication used to be prescription strength and recently went over the counter a few years ago.
These products are the most commonly used to alleviate allergy eye symptoms and have been approved by the FDA. Stay clear of eye drops that can contain herbals. We do not know enough about the safety and efficacy of these medications. Choose the product that works best for your frequency, budget, and symptoms.

Question:

I just started having allergy symptoms a few weeks ago. I tried Allegra, but it doesn't seem to help much. I've heard of Zyrtec and Claritin, but I’m not sure which one I should try next.

Answer:

Zyrtec, Claritin, and their generics are all found over the counter to treat allergy symptoms. Allegra is in the same class of antihistamine medications as Zyrtec and Claritin, but is found as prescription strength. Although they are all antihistamines, one product may work better than another for you. It doesn’t hurt to try out the over-the-counter products to see if they relieve your symptoms and cut the costs from the prescription medications you’ve already tried.
If nothing works, seek medical advice to make sure your symptoms are actually from allergies and to get advice about any medication that may work better for you.

Question:

I have been using Nasonex for some time now. I have tried several oral medications and nothing seems to help with my nasal congestion. When my nose gets stuffed up I use the OTC nose sprays, which I know are not good to use. But it’s the only thing that gives me temporary relief. Do you have any other suggestions?

Answer:

Unfortunately, OTC nose sprays can cause rebound nasal congestion if used more that 3-5 days. They only work temporarily. There are plenty of other nasal sprays for relief that are prescription strength.
I suggest working with your health care provider to evaluate your symptoms and find the appropriate product, whether it is an OTC product or prescription medication. Be sure to inform them of what OTC nose sprays that have worked in the past, so that they can see if there is a similar product that may be better for you.

Question:

What does the PE in allergy medicine stand for?

Answer:

PE stands for the phenylephrine, the decongestant ingredient found in many over the counter products.

Question:

I am taking prednisone for a bad case of poison ivy. My sinuses are also bothering me. Can I take Nyquil sinus while taking prednisone?

Answer:

This combination of medication will not interfere with each other. However, Nyquil may not be the appropriate medication to help treat your sinuses. I would ask further questions about your sinuses to find the correct medication. To avoid overmedication, check with your local pharmacist to help select a product that pertains to the symptoms you are experiencing.

Question:

Are there any known issues with taking Claritin (loratadine) and naproxen sodium at same time?

Answer:

No, there are no known drug interactions with these medications at this time. However, this does not necessarily mean no interactions exist. Always consult with your health care provider or pharmacist to make sure that nothing new has developed.

Question:

Is there a generic medication that is similar to Veramyst nasal spray? I'm on spring break and lost my spray.

Answer:

Unfortunately, there isn’t an over-the-counter medication, nor a generic prescription medication equivalent to the Veramyst nasal spray. Many pharmacies are linked within the same corporation. I suggest going to a local pharmacy that is in the same company you use at home in order to see if you can transfer the medication locally and get a replacement.

Question:

I took Femara for fertility reasons. I am also on amoxicillin. Can I take Tylenol allergy multi-symptom?

Answer:

Yes, at this time there are no drug interactions between the combination of these three medications. However, this does not necessarily mean no interactions exist. Always consult with your health care provider or pharmacist to make sure that nothing new has developed.

Question:

What are the side effects of Zyrtec?

Answer:

Get emergency medical help if you have any of these signs of an allergic reaction: hives, difficulty breathing, and swelling of your face, lips, tongue, or throat.
Stop using Zyrtec and call your doctor at once if you have any of these serious side effects: fast, pounding, or uneven heartbeat, weakness, tremors (uncontrolled shaking), or sleep problems (insomnia), severe restless feeling, hyperactivity, confusion, problems with vision, or urinating less than usual or not at all.
Less serious Zyrtec side effects may include: dizziness, drowsiness, tired feeling, dry mouth, sore throat, cough, nausea, constipation, or headache.

Question:

I am taking a prescribed anti-inflammatory and antacids. I’m wondering if I can also take regular Claritin with these.

Answer:

Generally, Claritin does not interact with antacids and inflammatory medications. However, without knowing the exact medication it makes it a bit difficult to give a 100% yes or no answer. Check with your local pharmacist to make sure there are not interactions.

Question:

I have severe allergies; I have tried various medications, to no avail. I am presently taking Zyrtec, but my eyes constantly water and my nose is continually dripping. Is there anything else that I can try?

Answer:

I would try adding on an eye drop that helps with allergy relief. There are several products that can be used for treatment of allergy eye symptoms (itchy, watery, red eyes).
Opcon-A/Visine-A/Naphcon-A and all the generics. The active ingredients: naphazoline HCl, a decongestant/relieves redness, and pheniramine maleate, an antihistamine. They are recommended for short-term use only.
Zaditor/Alaway (ketotifen), a topical antihistamine and mast cell stabilizer eye drops. This medication used to be prescription strength and recently went over the counter a few years ago.
These products are the most commonly used to elevate allergy eye symptoms and have been approved by the FDA. Stay clear of eye drops that contain herbals. We do not know enough about the safety and efficacy of these medications. Choose the product that works best for your frequency, budget, and symptoms.

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