Flonase, Zyrtec, and More: Choosing The Right Allergy Medication - GoodRx (2024)

Allergies affect millions of children and adults in the U.S. every year. Common symptoms of allergies include sneezing, congestion, and itchy eyes. But for some people, allergies can lead to skin reactions.

With pharmacies having a whole aisle for allergies, choosing an allergy medication can feel overwhelming. This makes it easy to buy any convenient, over-the-counter (OTC) allergy medication only to find out later that it didn’t provide enough relief.

So let’s walk through some common mistakes when it comes to choosing allergy medications and what to do instead.

1. Not starting with a nasal steroid spray.

For many allergy symptoms — including runny nose and itchy eyes — experts strongly recommend steroid nasal sprays. Flonase (fluticasone), Nasacort Allergy (triamcinolone), and Nasonex (mometasone) nasal sprays are all potential options.

Flonase and Nasacort are already available over the counter. And in March 2022, the FDA also approved Nasonex to become an OTC product. There are also prescription steroid nasal sprays. Talk with a healthcare provider to find out what type of steroid nasal spray might be best for you.

2. Giving up on Flonase too soon.

While Flonase and other nasal steroid sprays are effective, they might not work for everyone. For those who don’t find enough relief with steroid nasal sprays, adding in an antihistamine nasal spray might help. For example, in June 2021, the FDA approved an OTC version of Astepro, which contains the antihistamine azelastine.

There are also prescription combination nasal sprays — like Dymista (fluticasone/azelastine) and Ryaltris (mometasone/olopatadine). Dymista is available as an authorized generic medication. Ryaltris, on the other hand, is a brand-name nasal spray that was approved by the FDA in January 2022. Both of these nasal sprays contain a steroid (e.g., fluticasone or mometasone) and an antihistamine (e.g., azelastine or olopatadine).

When compared to steroid nasal sprays, antihistamine nasal sprays might work faster — but antihistamine sprays are not more effective at treating your allergies. However, the combination of medications may be slightly more effective than a nasal steroid spray by itself for some people.

3. Accidentally using a nasal decongestant spray and not a nasal steroid spray.

Do not overuse nasal decongestant sprays. Examples include Afrin and Mucinex Sinus Max, which contain the decongestant oxymetazoline.

If you use these sprays for more than 3 days in a row, you might notice that your symptoms are actually becoming worse (rebound congestion). This may make you think using more and more of the spray will help, when, in fact, it can lead to worse symptoms.

4. Not looking into a non-drowsy, OTC allergy medication next

If nasal sprays are not for you, consider an oral (by mouth) non-drowsy antihistamine. As the name suggests, non-drowsy medications shouldn’t make you sleepy. These include Claritin (loratadine) and Allegra (fexofenadine), which mainly help relieve symptoms, like sneezing and itching. These low-cost medications might also help with runny nose, stuffy nose, and eye-related symptoms.

When compared to steroid nasal sprays, oral antihistamines aren’t as effective. But they’re good at quickly relieving mild or moderate allergy symptoms.

5. Accidentally choosing an OTC medication with a sedating medication

Antihistamine allergy medications that can make you really sleepy are often mistaken for being non-drowsy. Medications in this class that cause drowsiness include Benadryl (diphenhydramine) and Chlorphen-12 (chlorpheniramine). Chlorpheniramine is also found in many Coricidin products. It’s best to stay away from these ingredients during the day.

Take our quiz: Allergy medications

6. Not knowing when to go for the allergy medicines ending with “-D,” like Claritin-D and Zyrtec-D

Sudafed (pseudoephedrine) is the extra ingredient in some allergy medications that give them the “-D” part of their names. For example, Claritin contains loratadine, but with the addition of pseudoephedrine, Claritin becomes Claritin-D (loratadine/pseudoephedrine). Similar medications include Zyrtec-D (cetirizine/pseudoephedrine) and Allegra-D (fexofenadine/pseudoephedrine).

Pseudoephedrine might make these medications even more effective for nasal congestion. Having said that, some people do experience jitteriness with pseudoephedrine. If that’s the case with you, go back to the options in point #4.

7. Not using eye drops for red, itchy eyes

For red and itchy allergic eyes, consider antihistamine eye drops. They quickly relieve eye symptoms, but their effects might not be long-lasting. Some examples of OTC antihistamine eye drops include:

• Zaditor (ketotifen)

• Alaway (ketotifen)

• Claritin Eye (ketotifen)

• Pataday (olopatadine)

• Lastacaft (alcaftadine)

Antihistamine eye drops are also available as prescription products, such as Zerviate (cetirizine) and Bepreve (bepotastine).

8. Going with just one allergy medicine

As discussed above, a combination of allergy medications may help some people more than one product alone. But many people wonder if taking both a steroid nasal spray and an oral antihistamine is safe or effective. More on this below.

Can you take Flonase and Zyrtec together?

Yes. You can take Flonase and Zyrtec (cetirizine) together. But this doesn’t always provide more allergy relief for everyone.

Regular use of a steroid nasal spray (e.g., Flonase) is more effective than an oral antihistamine (e.g., Zyrtec). So, if you’re already using a steroid nasal spray, there’s usually no benefit to adding on an oral antihistamine.

However, everyone reacts differently to medications. So if you’re using a steroid nasal spray and it’s not working well enough, your provider may suggest taking an oral antihistamine. This combination is safe, since the two medications work differently in the body.