Ask the Pharmacist: Hay fever

By Dominic Kelly RPh, pharmacy manager at Pharmasave James Bay

Allergic rhinitis, also called hay fever or pollinosis, literally means "allergic nose inflammation," where rhino means "to do with the nose" and the ending -itis simply refers to inflammation.

Allergic rhinitis can either be seasonal or year-round. In most people, an allergen - something that triggers an allergy - sets their symptoms off at about the same time each year. Spring attacks are usually due to tree pollen, while grass pollens dominate in the summer and weed pollens in the autumn. Most people with allergic rhinitis are sensitive to more than one allergen.

Perennial allergic rhinitis appears year-round. This condition is most common in people with allergies to allergens that are present all year. Naturally, people who are allergic to house dust mites or to their own pets tend to suffer no matter the season. Allergic rhinitis affects about 20% of Canadians.

Allergic rhinitis is an allergic condition like asthma, meaning that the body tends to overreact to certain types of outside substances. One way it overreacts is by producing antibodies that signal your immune system to release histamine and other chemicals. These chemicals cause the symptoms of allergic rhinitis including sneezing, runny nose, itchy or watery eyes, and even coughing.

Allergic rhinitis can be inherited, but you probably don't inherit particular allergies, such as to cat dander or ragweed. Instead, you just inherit the tendency to be allergic. Children have a 30% to 60% chance of developing allergic rhinitis if one of their parents is affected and a 50% to 70% chance if both parents have allergic rhinitis.

Most people with allergic rhinitis know they have it, although it can sometimes be confused with the common cold.

Symptoms include runny nose; sneezing; itchy nose, mouth, throat, or eyes; and congestion. Other symptoms can also occur, such as tearing of the eyes, coughing, sore throat, wheezing, and headache.

The best way to prevent allergic rhinitis is to avoid the allergen. This may mean changing your habits, or even giving away a pet or moving to another house if the symptoms are unbearable and don't respond to medications.

Stay indoors during high pollen times.

Keep in mind that it is not always possible to control the environment or to eliminate or avoid allergens, especially those that are airborne. Many people need medication treatment for relief. Fortunately, most people respond well to medications. The therapy of choice will depend on your symptoms, the severity of your symptoms, your past response to medications, and other medical conditions that you have, if any.

Treatment for mild symptoms is usually antihistamines taken orally (eg, chlorpheniramine*, diphenhydramine, cetirizine, loratadine, fexofenadine, desloratadine), as a nose spray (eg, levocabastine), or as an eye drop (eg, olopatadine). Your doctor or pharmacist can help you choose the medication best suited to your needs. For example, many oral antihistamines are now "non-drowsy." People with certain medical conditions (eg, glaucoma, prostate problems) should consult their doctor before using certain antihistamines.

It is important to know that some products contain antihistamines plus decongestants for symptom relief. Again, seeking advice from a health professional is recommended as those with medical conditions such as high blood pressure and diabetes must use caution with these types of medications.

A corticosteroid nose spray (eg, budesonide, ciclesonide, fluticasone, flunisolide, mometasone) can be tried if antihistamines aren't working. Corticosteroid sprays can be used if rhinitis symptoms are chronic or if symptoms are moderate to severe. For seasonal allergies, some people may find that nasal sprays, eye drops, and inhalations containing sodium cromoglycate are effective in preventing allergic rhinitis if treatment is started before allergy season and used on a regular basis.

An anticholinergic nose spray (eg, ipratropium) may also be used to help reduce runny nose symptoms. Another medication that may be tried when other medications have not worked or have not been tolerated is called montelukast. Saline nose sprays and lubricant eye drops may also help with nose and eye symptoms.

Women who are pregnant or breast-feeding should consult their doctor or pharmacist before beginning treatment for allergic rhinitis.

All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (eg, Aerius). The common name is the medical name for the medication (eg, desloratadine.) A medication may have many brand names, but only one common name.

For more information and advice for your condition see our pharmacists at James Bay Pharmasave.