Although the best way to treat hay fever is to minimize exposure to the allergens, it is almost impossible to completely avoid airborne allergens such as pollen. There are many medicines, both prescription and nonprescription, to treat hay fever and its symptoms. Nonprescription decongestant pills, such as pseudoephedrine (Sudafed, Afrin and other brand names), can be used to relieve nasal congestion. Decongestant nasal sprays can give relief for a few days but they can cause congestion to get worse if they are used for more than three days.
Another nonprescription nasal spray, cromolyn sodium, prevents allergy symptoms by blocking the release of an irritating substance called histamine. Antihistamines are also available in pill form. Some can make you drowsy, but newer antihistamines, such as fexofenadine (Allegra) and loratadine (Claritin), usually are less sedating. You may need to work with your doctor to find the specific antihistamine that best relieves your symptoms with the fewest side effects.
Corticosteroid nasal sprays, such as beclomethasone (Beconase, Vancenase), budesonide (Nasonex) and fluticasone (Flonase), are probably the most effective treatment for hay fever and perennial allergic rhinitis. People with seasonal allergies should start the nasal corticosteroid spray a week or two before an expected rise in pollen counts.
Montelukast (Singular) can be used alone or in combination with other medications to treat allergic rhinitis. It is a leukotriene receptor antagonist, which decreases the allergic response in a different way than either antihistamines or corticosteroids. It is taken by mouth once a day. It is as effective as antihistamines in controlling symptoms of allergic rhinitis. But montelukast is not as effective as corticosteroid nasal sprays.
If steroid sprays and antihistamines fail, or if you have perennial symptoms, your doctor may recommend trying allergy shots (immunotherapy), a treatment aimed at desensitizing your body's immune reaction to a particular allergen. In immunotherapy, increasing concentrations of the allergen are injected under your skin either weekly or biweekly. If immunotherapy is effective, allergy symptoms usually subside within six months to a year. Treatment often is continued for three to five years.