Most allergies (hay fever / allergic rhinitis, hives, and itchy, watery eyes from pollen, dust, mold, or pet dander) are managed with self-care and over-the-counter medicines. The mainstays are non-drowsy antihistamines for sneezing, itching, and runny nose, and steroid nasal sprays — which MedlinePlus calls the single most effective treatment for allergic rhinitis — for nasal congestion and stuffiness.
Available without a prescription — follow each label.
fluticasone (nasal spray) Flonase Nasal corticosteroid (steroid nasal spray) | MedlinePlus calls nasal corticosteroid sprays the most effective treatment for allergic rhinitis. Best for nasal congestion, stuffiness, runny nose, and sneezing. Works best when used daily and steadily — it may take two or more weeks to reach full effect. Available OTC; check the label and ask a pharmacist about use in children. |
triamcinolone (nasal spray) Nasacort Nasal corticosteroid (steroid nasal spray) | Another OTC steroid nasal spray, equivalent in role to fluticasone, for daily control of nasal allergy symptoms. Choose one steroid spray and use it consistently; relief builds over days to weeks rather than instantly. |
Claritin Second-generation (non-drowsy) oral antihistamine | Good for sneezing, runny nose, itching, hives, and itchy/watery eyes, especially when symptoms come and go. MedlinePlus lists it among antihistamines that cause less sleepiness. Once-daily; a sensible everyday choice when you need to stay alert. |
cetirizine Zyrtec Second-generation (non-drowsy) oral antihistamine | Same uses as loratadine — sneezing, itching, runny nose, hives, eye symptoms. Often felt to act quickly. Slightly more likely than loratadine to cause mild drowsiness in some people, so know how it affects you before driving. |
A doctor may prescribe these — not for self-treatment.
montelukast Singulair Leukotriene inhibitor | A doctor may prescribe this for allergic rhinitis (and overlapping asthma). The FDA boxed warning and MedlinePlus note it can cause serious mood and behavior side effects such as anxiety, depression, or suicidal thoughts, so it is used selectively and under medical supervision — not a first choice for most people. |
prescription-strength steroid treatment Corticosteroid (short oral course or stronger prescription nasal product) | For severe, poorly controlled hay fever a GP or doctor may prescribe a stronger steroid treatment, occasionally a short course of steroid tablets. Because of side effects these are kept short and clinician-directed — never something to source or dose on your own. |
allergen immunotherapy (allergy shots or sublingual tablets) Immunotherapy / desensitization | When symptoms stay hard to control, a specialist may offer immunotherapy — gradually escalating doses of the allergen as injections or under-the-tongue tablets, often started months before pollen season. This is a long-term, clinician-managed treatment, not symptom relief. |
Match the medicine to your main symptom. If sneezing, itching, a runny nose, hives, or itchy eyes dominate — especially intermittently — start with a non-drowsy oral antihistamine (loratadine, cetirizine, or fexofenadine). If a blocked, congested nose is the main problem, a daily steroid nasal spray (fluticasone or triamcinolone) is the most effective option, but give it one to two weeks of steady daily use to work. The two can be combined. An OTC antihistamine nasal spray (azelastine) is another option that acts faster on nasal symptoms. Add antihistamine eye drops for stubborn itchy eyes. Reach for an oral decongestant only for short-term congestion, and never use a decongestant nasal spray more than 3 days in a row to avoid rebound stuffiness. Prefer non-drowsy antihistamines if you drive or need to concentrate; sedating older antihistamines may help if symptoms wreck your sleep. Avoid alcohol with antihistamines, and check with a pharmacist or pediatrician before giving these to young children, or if you are pregnant, breastfeeding, older, or have high blood pressure or heart disease. A pharmacist can help you choose.
See a clinician if your symptoms are severe, keep getting worse, or don't improve after trying pharmacy treatments, or if a medicine that used to work stops working. Get medical advice for increased wheezing, coughing, chest tightness, or shortness of breath, which can signal asthma. Talk to a doctor before treating children under 2, and if you are pregnant, breastfeeding, older, or have high blood pressure or heart disease. Seek emergency care (call 911) for signs of a severe allergic reaction (anaphylaxis): trouble breathing or swallowing, swelling of the lips, tongue, throat, or face, widespread hives, dizziness or fainting, or a rapid drop in blood pressure — especially after a food, insect sting, or medication. Anaphylaxis is a life-threatening emergency; use an epinephrine auto-injector if one has been prescribed and still call 911.
General reference, not medical advice, and not a substitute for your doctor or pharmacist. The right choice depends on your symptoms, health conditions, age, and other medicines — always read each label and confirm before taking anything.
fexofenadine Allegra Second-generation (non-drowsy) oral antihistamine | Listed by MedlinePlus among the lower-sedation antihistamines. A strong choice if other non-drowsy options make you sleepy. Treats the full range of hay fever and hives symptoms. |
azelastine (nasal spray) Astepro Allergy Nasal antihistamine spray | An antihistamine you spray in the nose — now sold OTC in the US (Astepro Allergy). Works well for allergic rhinitis and acts faster on nasal symptoms than oral pills, so it is useful when oral antihistamines plus a steroid spray aren't enough. Can cause a bitter taste and some drowsiness; know how it affects you before driving. (Older prescription forms such as Astelin still require a doctor.) |
ketotifen (eye drops) Zaditor / Alaway Antihistamine eye drops | Best for itchy, red, watery eyes that oral medicines don't fully settle. Used as needed during allergy flares; works directly at the eye. |
pseudoephedrine Sudafed Oral decongestant | Targets nasal stuffiness and congestion specifically. Sold from behind the pharmacy counter (no prescription needed, ID required). Can raise blood pressure and disturb sleep — avoid if you have high blood pressure, heart disease, or take it late in the day. Decongestant NASAL sprays must not be used more than 3 days in a row, as MedlinePlus warns, or congestion rebounds. |