Nasal Sprays vs Oral Medications for Allergies | Buoy (2024)

Oral Medications

Oral medications, such as antihistamines, target the histamine response triggered by allergens. They come in various forms, including:

  • Tablets
  • Capsules
  • Liquids

Antihistamines like cetirizine, loratadine, and fexofenadine block the effects of histamine, relieving symptoms like sneezing, itching, and runny nose.

Types of Antihistamines:

  • First Generation (Older): Brompheniramine, chlorpheniramine, diphenhydramine. These are known to cause more drowsiness.
  • Second Generation (Newer): Cetirizine, loratadine, fexofenadine. These are known to have fewer side effects.

2. Advantages

Nasal sprays and oral medications have unique advantages that make them suitable for managing allergies. Here are some of the key benefits of each method.

Nasal Sprays

Nasal sprays provide fast, targeted relief by delivering medication to the source of allergic reactions. They are an excellent option for controlling nasal allergy symptoms. To break it down, here’s what you need to know:

  • Localized Action: Nasal sprays deliver medication directly to the nasal lining, targeting symptoms at the site of the allergic reaction. This localized action ensures efficient relief where it's needed.
  • Reduced Systemic Absorption: Nasal sprays often require smaller doses than oral medications since they act directly on the affected area. This can reduce the risk of systemic side effects.
  • Effective for Nasal Symptoms: Nasal sprays, particularly intranasal corticosteroids, are highly effective in treating nasal symptoms such as congestion, runny nose, itching, and allergy sneezing.
  • Combination Options: Some nasal sprays come in combination formulations containing a mixture of steroids, antihistamines, or mast cell inhibitors. These combination sprays provide comprehensive relief for multiple symptoms.
  • Prevention of Rebound Congestion: Unlike decongestant nasal sprays, which can lead to rebound congestion if used for an extended period, other types of nasal sprays, like corticosteroids and antihistamines, are less likely to cause this issue.

Oral Medication

Oral allergy medications offer convenience and flexibility in managing various allergy symptoms. Their ease of use makes them a popular choice for many. Here are more advantages:

  • Convenience of Administration: Oral medications are generally more convenient than nasal sprays. They come in various forms, including tablets, capsules, and liquids, making them easy to take on-the-go.
  • Broad Symptom Coverage: Antihistamines taken orally can address allergy symptoms, including sneezing, itching, runny nose, and watery eyes. This broad coverage makes them suitable for individuals with multiple symptoms.
  • Ease of Use: Oral medications are typically easy to use and do not involve the application of a spray directly into the nasal passages. This simplicity makes them accessible to a wide range of individuals.
  • Variety of Options: There is a wide variety of oral antihistamines available, both over-the-counter and prescription, allowing individuals to choose based on their preferences, tolerance, and specific allergy symptoms.
  • Less Irritation Risk: Some individuals may find nasal sprays irritating or uncomfortable. Oral medications, being ingested, avoid any potential discomfort associated with direct application to the nasal passages.

3. Effectiveness

Numerous clinical trials have assessed the effectiveness of nasal sprays and oral medications in treating various types of allergies. Here's an overview of the evidence.

Nasal Sprays

In a study on a nasal spray-type allergen blocker combined with oral antihistamines for dust mite allergic rhinitis, 90 patients were randomly divided into experimental and control groups. The experimental group used a nasal spray allergen barrier agent with citrate tablets, while the control group used physiological seawater with a citrate sheet.

The experimental group showed significantly better symptoms, signs, and quality of life scores than the control group. No obvious adverse reactions were observed, indicating the remarkable effect of the nasal spray-type allergen blocker combined with antihistamine in treating dust mite allergic rhinitis.

A trial for the drug-free, barrier-forming nasal spray (AM-301) involved 36 participants. The study found that AM-301 demonstrated noninferiority to hydroxypropyl methylcellulose (HPMC) in reducing grass pollen-induced allergic rhinitis symptoms. The mean total nasal symptom score during exposure without protection was 5.91, reduced to 4.82 with AM-301.

The study emphasized the noninferiority, efficacy, and safety of AM-301, with 31% of subjects rating its efficacy as good or very good.

A comparative clinical study for the fixed-dose combination of Fluticasone Furoate and Oxymetazoline Hydrochloride Nasal Spray included 250 patients randomized into two groups. The results demonstrated a significant reduction in the night-time Total Nasal Symptom Score with the combination compared to Fluticasone alone at various time points, starting as early as day 3 and sustained until the end of treatment (Day 28).

Additionally, a significantly greater number of patients experienced complete relief in Nasal Congestion with the combination. Both treatments were well-tolerated, with no significant difference in adverse events between the groups.

For Fluticasone furoate nasal spray (FFNS) in perennial allergic rhinitis, a study involved 315 participants in a randomized, double-blind, placebo-controlled trial. FFNS, administered once daily for 4 weeks, showed significant improvement over placebo in daily reflective total nasal symptoms, morning and evening reflective total nasal symptoms, daily reflective individual nasal symptoms, and quality of life scores. Adverse events reported with FFNS included epistaxis (15%) and nasopharyngitis (5%), higher than the placebo group.

In a study on FFNS for seasonal allergic rhinitis caused by grass pollen, involving 285 participants, FFNS significantly improved the mean change from baseline in daily reflective total nasal symptoms compared with placebo. The treatment difference was -1.757, establishing its effectiveness. FFNS was well-tolerated, with a significant improvement observed in various efficacy measures as early as day 1.

These studies provide robust data supporting the efficacy and safety of nasal sprays, especially those containing corticosteroids, in treating different forms of allergic rhinitis.

Oral Medications

The efficacy of oral medications in treating allergic rhinitis has been extensively studied, focusing on oral H1 antihistamines and other therapeutic approaches.

A systematic review and network meta-analysis of randomized controlled trials evaluated various oral H1 antihistamines for allergic rhinitis, highlighting that rupatadine, especially at a dosage of 20 mg, demonstrated the highest efficacy in reducing total symptom scores, nasal congestion, rhinorrhea, and ocular symptoms. In contrast, loratadine 10 mg exhibited inferior efficacy compared to other antihistamine treatments.

This suggests that oral antihistamines can significantly impact symptom relief, with rupatadine emerging as a particularly effective option.

The evaluation of montelukast's effectiveness in treating allergic rhinitis through a systematic review and meta-analysis highlighted its superiority over placebo in improving daytime and nighttime nasal symptom scores, composite nasal symptom scores, daytime eye symptom scores, and rhinoconjunctivitis quality-of-life questionnaires. However, oral antihistamines were more effective than montelukast in certain aspects.

Furthermore, combining montelukast and oral antihistamine showed superior efficacy compared to either treatment alone, emphasizing the potential benefits of combination therapies in allergic rhinitis management.

Overall, oral medications, particularly oral H1 antihistamines and montelukast, have effectively alleviated symptoms associated with allergic rhinitis and food allergies. The choice of drugs and potential combination therapies should be tailored to individual patient needs, considering efficacy, safety, and the specific characteristics of the allergic condition.

Ongoing research aims to refine these treatment approaches further and explore additional options, such as oral desensitization and immunotherapy, to enhance the management of allergic rhinitis and food allergies.

4. Side Effects

While generally safe when used as directed, both nasal sprays and oral allergy medications can potentially cause side effects.

Nasal Sprays (Antihistamines, Decongestants, Corticosteroids)

Common side effects

  • Dryness
  • Stinging
  • Burning
  • Irritation in the nose

Serious side effects

  • Thick nasal discharge
  • Fever
  • Sore throat
  • Signs of infection
  • Whistling sound from the nose
  • Hives
  • Rash
  • Itching
  • Swelling of face or throat
  • Difficulty breathing or swallowing
  • Wheezing
  • Severe or frequent nosebleeds

Oral Medication

Common side effects

  • Headache
  • Cough
  • Tiredness
  • Sore throat
  • Abdominal pain or discomfort
  • Nausea or vomiting

Potential serious side effects

  • Vary depending on the specific type of medication (e.g., corticosteroids may have long-term effects like osteoporosis, high blood pressure, weight gain)

5. Cost

The costs of prescription and over-the-counter nasal sprays and oral allergy medications can vary. Let’s break them down below.

Nasal Sprays

The cost of nasal sprays and oral medications for allergies can vary depending on factors like the specific brand, generic versions, and discounts available.

For the 12 Hour Nasal Decongestant Spray (oxymetazoline nasal), the price is around $12 for 30 milliliters, or you can opt for the generic version starting from $10.60 for 15 milliliters.

Nasal Sprays vs Oral Medications for Allergies | Buoy (2024)

FAQs

Nasal Sprays vs Oral Medications for Allergies | Buoy? ›

Nasal spray options should work within about 10 minutes, and oral options work within 30 to 60 minutes. Oral antihistamines: These are another quick-relief option. Many work within about 1 to 2 hours. Nasal steroids: These take longer to start working — a few days to 2 weeks for full effects.

What works better for allergies, nasal spray or pills? ›

Intranasal corticosteroids are considered the most effective treatment for symptoms of seasonal allergies and are less likely than corticosteroid pills to cause significant side effects, because they're not directly absorbed into the bloodstream.

Is Flonase better than allergy pills? ›

Single-ingredient oral antihistamines don't relieve nasal congestion, and some, like Zyrtec, may even cause drowsiness. FLONASE nasal sprays are non-drowsy, anti-inflammatory allergy relief nasal sprays that provide more complete relief* than a single-ingredient antihistamine.

What's the most effective allergy medicine? ›

Allergists recommend long-acting, non-sedating antihistamines — ones that won't make you sleepy — for everyday use. Though you may know them by their brand names, the generic versions tackle the same problems: Cetirizine (Zyrtec®, Aller-Tec®, Wall-Zyr®). Fexofenadine (Allegra®, Aller-ease®, Aller-Fex®, Wal-Fex®).

What is the safest antihistamine for long term use? ›

Non-drowsy options like loratadine and cetirizine are among the safest choices for long-term allergy relief. Both medications work by blocking the effects of histamine, and people generally tolerate them well.

Why is nasal spray better than pills? ›

Nasal sprays operate more quickly than antihistamine pills to relieve allergy symptoms. In particular, research has shown that steroid sprays are more effective than antihistamine pills for improving nasal obstruction, itching, sneezing, and overall quality of life when managing allergic rhinitis.

How did I cured my allergies naturally? ›

8 Natural Remedies for Allergies
  1. Dehumidifier.
  2. Essential Oils.
  3. HEPA Filters.
  4. Herbs and Supplements.
  5. Nasal Spray.
  6. Neti Pot.
  7. Showering.
  8. Steam.
Dec 31, 2023

What is the downside of Flonase? ›

Common Flonase side effects include headache and sore throat. Nasal side effects — such as nosebleeds, irritation, and burning — can happen, too. Most side effects are generally mild and can be managed at home. Serious Flonase side effects include vision changes, asthma symptoms, and thrush.

Is Flonase alone enough for allergies? ›

When using FLONASE, no other allergy medicines are needed for symptom relief. FLONASE is not indicated for use with other allergy medicines.

Is it better to take Flonase at night or in the morning? ›

Is it better to use FLONASE at night? In short, no. One daily dose of FLONASE Allergy Relief delivers 24-hour relief from your worst allergy symptoms. So, even if you take it in the morning, you're still covered for all night long, without pesky allergy symptoms.

What do doctors prescribe for really bad allergies? ›

  • Beclomethasone (Beconase AQ, Qnasl)
  • Budesonide (generic)
  • Ciclesonide (Omnaris, Zetonna)
  • Flunisolide (generic)
  • Fluticasone furoate (Flonase Sensimist)
  • Fluticasone propionate (Flonase Allergy Relief)
  • Mometasone (Nasonex 24HR Allergy)
  • Triamcinolone (GoodSense Nasal Allergy, Nasacort Allergy 24HR)

What is the strongest natural antihistamine? ›

What is the most powerful natural antihistamine? Researchers haven't yet established any natural product as the “best” or “most powerful.” Natural antihistamines with the most research backing their use include stinging nettle, vitamin C, quercetin, butterbur, bromelain, and probiotics.

Is it better to take allergy meds or not? ›

"Antihistamines are really effective for treating allergies," says Dr. Hays. "They need to be taken every day while you're experiencing symptoms, and people with seasonal allergies should proactively take them throughout both the fall and spring allergy seasons."

What is the best antihistamine for people over 65? ›

Astepro (azelastine) nasal spray, and non-drowsy oral antihistamines, such as Allegra (fexofenadine) are also first-choice options. All of these allergy medications are safe for older adults. Nasalcrom (cromolyn) and antihistamine eye drops, such as Zatidor (ketotifen), are also safe but may be less effective.

Is there a downside to take antihistamines every day? ›

It's important to note that long-term use of first-generation antihistamines, like Benadryl, may increase the risk of dementia and cognitive decline, research suggests. And there's always a risk of taking too much of an antihistamine, especially with long-term use.

What is the new allergy medicine? ›

Xolair is the first FDA-approved medication to reduce allergic reactions to more than one type of food after accidental exposure.

Is nasal decongestant tablet better than spray? ›

What are the benefits of using a spray? As sprays are applied directly to your nasal passage, they begin to work in the affected area instead of travelling around your body, like a tablet does1. That's why sprays begin to work within 5-10 minutes, whereas tablets can take up to thirty minutes2 to begin working3.

Is nasal spray the best for allergies? ›

Nasal steroid sprays work best for treating allergy symptoms. They're considered a first-choice treatment since they generally work better than antihistamines for congestion and reducing mucus. Antihistamine nasal sprays can also be an effective choice.

Which medicine is best for nose allergy? ›

Nonsedating oral antihistamines — Commonly used oral antihistamines include loratadine (sample brand names: Claritin, Alavert), desloratadine (brand name: Clarinex), cetirizine (sample brand name: Zyrtec), levocetirizine (brand name: Xyzal), and fexofenadine (sample brand name: Allegra) (table 1).

Do allergy pills clear your sinuses? ›

Antihistamines and decongestants don't cure your allergies, but they'll give you much-needed relief for a runny or congested nose.

References

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