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Which is better - an allergy pill or an allergy spray?

By August 8, 2008 - 2:38pm
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I am wondering if pills are better for allergies or are sprays like Flonasse or Nasonex?

Has anyone tried both kinds of allergy relief and found one better than the other?

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Depends what type of nasal spray, as there are nasal antihistamines and nasal corticosteroids, which each act differently in your body. The most common forms of allergy medication are (pills) oral antihistamines and nasal corticosteroid sprays (both sprays you mentioned are in the steroid family).

Spray (my example: ciclesonide or "Omnaris")
- This is a corticosteroid used for inflammation and "nose symptoms" related to allergies. There are side effects if used for more than several months non-stop, which includes a possibility for increased chance of infection. So, I use this on my really bad allergy days and it works great!
- "Flonase" is a fluticasone which is also a corticosteroids
- "Nasonex" is a mometasone in a class of medications called topical steroids

Pill (my example: levocetirizne or "Xyzal")
- This is an antihistamine used for all allergy symptoms, and blocks the natural histamines in your body (that are the culprits for the allergic "symptoms"). Side effects are primarily drowsiness, which is why it is recommended to take in the evening before bedtime.
- I assume this brand is similar to cetirizine ("Zyrtec"), which is more heavily advertised

More info from FDA and MedlinePlus:


According to the American Academy of Allergy, Asmtha and Immunology patient page:
Antihistamine pills and nasal antihistamine sprays "block histamine, one of the most important mediators of the allergic response. The release of histamine during allergic reactions leads to many rhinitis symptoms, including itching, sneezing and runny nose. Antihistamines are not as effective for nasal congestion."

Nasal corticosteroid sprays "reduce and control the impact of many of the mediators that can cause inflammation in the nose. These medications improve all symptoms of allergic rhinitis, including itching, sneezing, runny nose, and congestion. Nasal corticosteroids are the strongest medications available for the treatment of allergic rhinitis."

How I interpret the above information from AAAAI:
- Nasal corticosteroid sprays are strongest treatment for seasonal allergy sufferers, but we know that they come with some (possible) side effects.
- Oral antihistamines work on your body's histamines, the most important "mediator" (or, "interferes") in the allergic response (symptoms).

This is more GREAT information for all allergy sufferers to read:

This website also offers information on other types of medication for allergy, as well as immunotherapy ("allergy shots") -which I am now undertaking!

Does this help? I have obviously tried both kinds and am also doing the long-term prevention allergy shots (immunotherapy, with the goal that I do not need to take these medications after a few more years). For me, the antihistamine needs to be taken every day, same time each night for the best overall relief. Then, the nasal steroid-type spray is for really bad days (windy, high pollen count or if I will be outside for long periods of time). My allergist also said that it is a trial to find which medications work best, as there are slightly different formulas in each.

August 10, 2008 - 7:11am

My husband prefers nasal sprays, while I'd rather take a sublingual dissolving Loratidine tablet. I think your doctor would be a better person to consult for what would be best for you and whether there would be damage to your nasal passages by overuse of sprays.

August 8, 2008 - 6:09pm
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