There are many new medications and treatments for allergies and asthma. Board-
certified allergists have the training and experience to help patients make the best choices.
* New antihistamines. Histamine is one of the major inflammatory chemicals released by cells in the body during allergic reactions, and antihistamines block its action. Older antihistamines, such as Benadryl or Chlortrimeton, caused drowsiness. The newer antihistamines are less sedating.
Some of the weaker antihistamines that were prescription-only are now available over-the-counter; these include Claritin (loratadine). Other antihistamines still require a prescription but are available as cost-saving generic medications (Allegra (fexofenadine) now and Zyrtec (ceterizine) at the end of 2007).
Astelin is a newer antihistamine nose spray which is effective for both allergic rhinitis and non-allergic (vasomotor) rhinitis. It is especially helpful for patients troubled by post-nasal drip and throat clearing.
Xyzal (levocetirizine) is a new prescription antihistamine that is more potent and less sedating than its predecessor Zyrtec. Clarinex (desloratidine) is a totally non-sedating antihistamine that is notable for its long duration of action.
* Nasal steroids. There are a variety of prescription nasal sprays available now containing anti-inflammatory steroids which work locally in the nose to reduce swelling and mucus production. They have negligible systemic absorption so they don’t cause the side effects of oral prednisone.
Flonase (fluticasone) is now available as a generic drug. Nasonex and Veramyst have been approved for pediatric use in children as young as 2 years old. Others include Rhinocort Aqua, Nasacort AQ, and Beconase AQ.
* Leukotriene blockers. Leukotrienes are another of the chemicals released in allergic reactions. They play a role in allergic rhinitis and especially in asthma. Singular (montelukast) is a once-a-day leukotriene blocker which is approved for asthma and hayfever in adults and children down to 6 months of age. It is especially effective in patients with exercise asthma, cold-induced asthma, and aspirin sensitivity and nasal polyps.
Other leukotriene blockers indicated for asthma are Accolate and Zileuton.
* Anti-IgE injections. Immunoglobulin E (IgE) are the allergic antibodies which initiate allergic reactions. Xolair (omalizumab) is a monthly injection which reduces IgE levels to very low levels. Xolair is indicated for steroid-dependent allergic asthma which is inadequately controlled by usual medications. It may also be effective in severe food allergies. The down-side to Xolair is that it is very expensive and rare allergic reactions to the shot have been reported.
Every patient reacts differently to medications, so it is important that an individualized treatment plan be prepared; allergists are the best physicians to judge what will work best for patients with allergies and asthma.