Hayfever treatments

by | Pharmacy Care

General Information

Hayfever (allergic rhinitis) can be seasonal, such as during spring, or happen all year round (perennial). It is important to prevent and treat hayfever because it can affect your sleep, work or learning.

Hayfever is mostly associated with triggers or allergens, such as pollens, grasses, pet hair and dust mites. Seasonal hayfever can appear when there are higher pollen levels, such as in the morning or evening, or in hot and humid weather. Hayfever can also be occupation based, from using certain chemicals at work that trigger symptoms.

If you or family members suffer from allergies, asthma or eczema you may be more prone to hayfever. Adolescents are more likely to have hayfever but it tends to improve with age.

Symptoms can be like those of a cold and they include an itchy nose, roof of the mouth or eyes, sneezing, a blocked or runny nose, a sore or tickly throat and red, watery eyes. Talk to your pharmacist or doctor if you are not sure.

Symptoms can also become worse even though allergen levels are the same; this is why most people will complain of worsening symptoms throughout hayfever season.

See Your Pharmacist or Medical Professional

  • if you have shortness of breath, coughing or wheezing, this could be asthma
  • if you have swollen glands, a fever and/or a persistent headache, you may have an infection
  • if you have yellow discharge coming from your eyes or nose, or a bloody nose
  • if only one side of your nose or one eye is affected
  • if you have persistent nasal obstruction
  • if your ears or sinuses (around your cheekbones) are painful
  • if you are pregnant or breastfeeding; some hayfever medicines may not be suitable
  • if you have other medical conditions, such as asthma, or take other medicines
  • if you have allergies to any medicines
  • if hayfever medicines do not seem to work after five days

Treatment Tips

  • continuous exposure to triggers can make hayfever worse
  • identifying triggers and avoiding them is important in treating hayfever
  • try to stay indoors when pollen counts are high and avoid grassy areas; wearing wrap-around sunglasses can help keep pollen out of your eyes
  • keep windows closed and re-circulate air in the car
  • reduce exposure to dust and pet hair by removing or shampooing carpets, removing soft toys from bedrooms, washing bed linen in hot water and limiting contact with pets
  • have a shower after pollen exposure
  • start treatment early and take it regularly, especially if you know you will be exposed to triggers
  • if you have eye and nasal symptoms, controlling nasal symptoms often improves the eye symptoms
  • sodium chloride nasal irrigation (e.g. Flo or Fess) may help clear nasal passages by washing out allergens and sticky mucus, and reducing congestion and irritation.

Treatment Options

  • there are two main types of medicines to treat hayfever:
    • medicines that treat or prevent an allergic reaction, such as corticosteroid nasal sprays and antihistamines
    • medicines that relieve the symptoms rather than treat the allergic reaction, such as decongestants
  • it is better to treat or prevent the allergic reaction, so the treatment choice depends on what your main symptoms are, when they happen and how severe they are
  • some medicines need to be taken before you have symptoms and need to be used regularly to be effective
  • there are also many tablet and syrup products available that combine an antihistamine with a decongestant, and sometimes a pain reliever as well
  • these options are not included here, but your pharmacist can tell you if one may be suitable

Nasal corticosteroid sprays

[PHARMACY ONLY]
e.g. beclometasone (Beconase Allergy & Hayfever 12 hour), budesonide (Rhinocort Hayfever), fluticasone (Flixonase Allergy & Hayfever 24 hour), mometasone (Nasonex Allergy Aqueous Nasal Spray, Azonaire Hayfever and Allergy Prevention & Relief Nasal Spray, Sensease Nasal Allergy Relief Nasal Spray)

  • nasal corticosteroid sprays work by suppressing the body’s response to allergens or triggers
  • use the spray every day throughout the hayfever season to prevent hayfever
  • you can begin the spray a few weeks before the hayfever season starts
  • these sprays begin to work within a few days but may take a few weeks to reach their full effect
  • you might also need to use a nasal decongestant or an antihistamine to start with
  • these sprays are particularly effective for more severe or persistent hayfever, particularly for nasal symptoms
  • they are not appropriate if you have a sinus infection
  • nasal corticosteroids are considered safe, but some minor side effects include irritation, unpleasant taste, headache, coughing and nasal dryness

Nasal decongestant sprays

[GENERAL SALE]

e.g. phenylephrine (Nyal Decongestant Nasal Spray)

[PHARMACY ONLY]
e.g. oxymetazoline (Dimetapp 12 Hour Nasal Spray, Drixine, Logicin Rapid Relief Nasal Spray, Vicks Sinex Nasal Spray), xylometazoline (FLO Rapid Relief Nasal Spray, Otrivin), tramazoline (Spray-Tish, Spray-Tish Menthol),

  • these decongestants unblock your nose and make breathing easier
  • nasal drops, rather than sprays, are recommended for young children
  • use only for up to five days, otherwise their effect is lost and a blocked nose from rebound congestion is likely

Oral antihistamines (tablets and syrups)

  • when you have an allergic reaction your body releases histamine, which leads to hayfever. Antihistamines block this reaction. There are two types:
    • newer, less sedating antihistamines, which do not typically cause drowsiness
    • older sedating antihistamines that cause drowsiness
  • antihistamines are good for treating hayfever symptoms as they occur, especially if you have a lot of different symptoms. You can also take them in advance if you know you are going to be exposed to allergens or triggers

Newer less-sedating antihistamines

[GENERAL SALE]
cetirizine (Zyrtec packs of 5), fexofenadine (Fexotabs, Pharmacy Action Fexorelief, Telfast), loratadine (Allereze – pack size up to 10, Claratyne – packs up to 10, Lorano)

[PHARMACY ONLY]
e.g. cetirizine (Alzene, APOHealth Cetirizine Hayfever & Allergy Relief, Zilarex, Zyrtec – larger packs), desloratadine (Aerius), loratadine (Allereze – packs 30 or 50, Claratyne – pack above 10 tablets), fexofenadine (Fexo, Fexotabs – larger packs, Pharmacy Action Fexorelief – larger packs, Tefodine, Telfast – larger pack size or stronger dose, Xergic)

  • cetirizine and loratadine are available as syrups for children; check correct doses for different age groups
  • newer antihistamines may rarely cause drowsiness; do not drive or operate machinery if you are affected.

Older sedating antihistamines

[PHARMACIST ONLY]
e.g. chlorpheniramine (Demazin 6 Hour Relief Tablets), dexchlorpheniramine (Polaramine), promethazine (Phenergan, Sandoz Fenezal, Allersoothe)

  • these medicines are not available without a prescription for children under two years old
  • these medicines can cause drowsiness, sometimes the next day; it is important you do not drive or operate machinery
  • do not drink alcohol with medicines that make you drowsy
  • sedating antihistamines are not suitable for everyone; check with your pharmacist.
  • if you have other medical conditions, such as glaucoma, epilepsy or prostate problems, or you take antidepressants, check with your pharmacist before taking these medicines

Anti-allergy nasal sprays and eye drops

[PHARMACY ONLY]
e.g. azelastine (Azep Nasal Spray, Eyezep Eye Drops), ketotifen (Zaditen Eye Drops), levocabastine (Livostin Eye Drops, Livostin Nasal Spray, Zyrtec Levocabastine Eye Drops, Zyrtec Levocabastine Nasal Spray), lodoxamide (Lomide Eye Drops 0.1%), pheniramine + naphazoline (Naphcon-A Eye Drops, Visine Allergy with Antihistamine Eye Drops), naphazoline + antazoline (Albalon-A)

  • anti-allergy drops and sprays can relieve symptoms such as itching, sneezing and watery eyes
  • azelastine works quickly
  • some eye drops combine an antihistamine with a decongestant (e.g. naphazoline) which reduces redness; these are for short term use only (no more than five days)
  • you may need to remove contact lenses before using; check instructions
  • throw drops away one month after opening; mark the opening date on the bottle
  • some eye drops cause temporary stinging

Preventative eye drops/nasal sprays

[PHARMACY ONLY]
e.g. cromoglycate (Opticrom Eye Drops, Rynacrom Metered Dose Nasal Spray)

  • cromoglycate should be used to prevent symptoms of hayfever
  • start treatment before hayfever season starts, as it may take a few weeks to work
  • may cause temporary stinging
  • throw away eye drops one month after opening

More Information

Availability of medicines

  • GENERAL SALE available through pharmacies and possibly other retail outlets.
  • PHARMACY ONLY available for sale through pharmacies only.
  • PHARMACIST ONLY may only be sold by a pharmacist.

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