Are You Overmedicating Your Allergies? Risks of Long-Term OTC Use

Are You Overmedicating Your Allergies? Risks of Long-Term OTC Use

Between 15 and 20 common active ingredients are found in the dozens of allergy medications on the market. With so many options for treating allergies, it’s not surprising that people turn to over-the-counter (OTC) allergy remedies for relief. Decongestants, antihistamines, and anti-inflammatory medications all provide relief. However, at what cost?

Long-term OTC allergy medications can create problems down the road. Explore some of the risks of long-term OTC allergy med use and what you can do to feel better without putting other areas of your health at risk.

Explore the Risks of Using OTC Allergy Medications for Long Periods

More than 80 million Americans have been medically diagnosed with allergies, and they miss almost four days per year from work because of their symptoms. OTC allergy medications help people live a normal daily life by calming the sneezing, itching, and congestion.

Being sold to the public doesn’t mean these medications are risk-free. Medical research has found that the long-term use of these medications leads to significant health complications, ranging from cognitive decline and cardiovascular strain to addiction. Understanding these risks is essential before you take another dose.

To understand the risks, you must first learn more about the two primary classes of oral antihistamines: First-Generation and Second-Generation. You also have nasal sprays.

1. First-Generation Antihistamines

First-generation antihistamines are medications containing diphenhydramine, such as Benadryl, or chlorpheniramine, such as Allerest or Chlor-Trimeton. They work by blocking histamine receptors.

The problem with them is that they don’t stay in your nose. They travel through your bloodstream and bind to histamine receptors. Because of this, they can block acetylcholine, which is a neurotransmitter for your learning and memory skills.

Research finds that chronic use of first-generation antihistamines affects your cognitive health. It increases your risk of developing dementia, particularly Alzheimer’s disease.

2. Second-Generation Antihistamines

Second-generation antihistamines were designed to be safer and not impact the brain. Instead, cetirizine (Zyrtec), fexofenadine (Allegra), and loratadine (Claritin) create a withdrawal symptom that causes full-body itching when trying to stop the medication. 

The itching is so severe that many people decide to keep taking it instead of trying to quit and deal with withdrawal symptoms. You try to stop, but full-body itching resumes, so you take more, and the cycle continues.

3. Nasal Sprays

Nasal treatments are often preferred because they deliver medication directly to the source of the allergies – the nose. However, these medications can worsen your health. It depends on the type of spray.

Newer nasal medications, such as budesonide (Rhinocort), fluticasone (Flonase), and triamcinolone (Nasacort), are corticosteroids used to ease congestion and inflammation. There’s a steroid-free option (Astepro). Afrin and Sudafed PE are other options that contain oxymetazoline or phenylephrine.

Steroid sprays are considered a safer option, but they still pose risks. They can cause irritation that triggers nosebleeds. There’s also ongoing research into a potential link between long-term use of nasal corticosteroids and eye health issues such as cataracts and glaucoma.

Oxymetazoline and phenylephrine shrink the blood vessels in the nose. They provide instant relief, but they come with warnings not to use them for more than three days due to the risk of Rhinitis Medicamentosa, in which the blood vessels swell when you stop using them. They can also damage the tissue, affecting your sense of smell. In rare cases, excessive use has caused a perforated septum.

The Link Between Long-Term OTC Allergy Medications and Cardiovascular Health

Pseudoephedrine is found in several allergy medications, including Allegra-D, Claritin-D, and Zyrtec-D. They’re long-lasting medications that are only taken once or twice a day. They do have problematic side effects.

• High Blood Pressure – The medication constricts blood vessels throughout the body. This increases blood pressure. In people with diagnosed high blood pressure, it can cause dangerous spikes.
• Tachycardia – As the blood pressure rises, it can make the heart beat faster. If you have an underlying heart condition, it can be dangerous and trigger a cardiac event. 

Stay Healthy by Being Proactive

When you have year-round allergies, make sure you’re being strategic about your allergy medication use. 

• Rely on Second-Generation Medications: Choose second-generation medications that don’t cross the blood-brain barrier. Itching isn’t fun, but it’s better than a chronic condition where there’s no cure.
• Stick to a Low Dose: Take the lowest dose possible to help ease your symptoms. Try one pill to start, even if the recommended dose is two. See if one helps enough. If it does, great! If not, add the second pill, but try to avoid taking more until well after the recommended time limit.
• Use Nasal Sprays for Emergencies: If you must use a nasal spray, limit its use to emergencies and, when possible, don’t exceed three days. Make sure you see an eye doctor yearly to check for early signs of cataracts or glaucoma.

Immunotherapy Is Effective and Safer

While OTC medications ease allergy symptoms, immunotherapy is the only way to potentially cure your allergies. It works by retraining your immune system to respond properly.

1. Intralymphatic Immunotherapy

This form of immunotherapy is a bit more involved but requires fewer allergy shots. Instead of injecting the allergens beneath the skin, they’re injected into a lymph node. An ultrasound is required during treatment to ensure the needle is placed correctly. 

Over three months, you receive one injection per month for long-term relief from your allergies. Your body learns to respond properly to the allergen through a series of three shots.

There are slight side effects, but you have a doctor nearby during the shot in case you have a severe reaction to the allergen. Plan to remain in the doctor’s office after the shot while you’re monitored for any potential reaction. You might also experience some injection-site pain and bruising.

2. Subcutaneous (SCIT)

SCIT, or allergy shots, are administered under your skin, helping your immune system learn to respond properly to allergens such as pollen, pet dander, or dust. It’s a very safe treatment given once a week or so for up to five years. 

Bruising and pain at the injection site are the most common side effects. You may also find that the area around the injection site itches for a short while. In time, your allergy symptoms fade, and the need for additional shots is discussed yearly during a check-in with your allergy doctor.

3. Sublingual (SLIT)

SLIT is a great choice for people who get anxious with shots or needles. Instead of a shot, you use a dissolvable tablet or drops that contain small amounts of the allergens that trigger your allergies. Your body slowly builds a healthy response to exposure to those allergens.

Side effects are minimal. Your throat may become mildly irritated. Your mouth might itch. Because the doctor needs to see how your body responds, you take the drops or pill in the office for a few days. After that, you use them at home when it’s convenient to you.

A professional allergy diagnosis goes a long way toward helping you regain your life. You don’t have to go through every day with a runny nose, itchy or watery eyes, and congestion that drags you down. 

Premium Allergy & Respiratory Center specializes in immunotherapy options. Make an appointment to gain lasting relief without putting your health at risk of complications from long-term OTC medication use.