claritin zyrtec allegra or...

April 4, 2021 10:31 AM

Have you had better results with one (or its generic equivalent), especially to ease breathing at night? My partner is having respiratory troubles that wake them up in the wee hours and the current theory is allergies to tree pollen. They've started taking a 24-hour antihistamine right before bed and it seems to help the severity of the symptoms but not eliminate them. Any other advice on managing sleep, and improving air supply especially, while dealing with allergies is much appreciated.
posted by spamandkimchi to Health & Fitness (30 answers total)

Tree pollen where I am has definitely been a factor. Showering before bed, and using some sort of saline sinus flush (e.g., a neti pot) helps. If you DIY the sinus flush, use distilled water.
posted by dws at 10:37 AM on April 4, 2021 [3 favorites]

Apparently hair picks up a lot of pollen throughout the day, so washing my hair at night and changing pillowcases several times a week seems to cut down on the pollen load that I breathe in bed. I also use an air filter in my room at night. It wasn’t cheap but it does help.
posted by corey flood at 10:45 AM on April 4, 2021 [4 favorites]

My mother - who is so allergic to everything that she has to be admitted to the hospital to get antibiotics - swears by Allerest, Chlorpheniramine. Neither she nor I can get it in our local drugstores, so we order it online. It seems like the only people recommending it anymore are veterinarians, so you often find it in the pet care section. I only just got some, for my dog, and haven't switched to it myself yet.

The other things we do are:
- run a humidifier if at all possible, it just seems to keep things from floating around so much AND improves dry airways
- frequent bedding changes, daily pillowcase changes if possible, and if you have pets use an oversheet/bedspread/some kind of coverlet during the day that you CAREFULLY fold into itself and remove from the room before bed
- hepa filter in the room
- neti pot/nasal rinse, also keep a bottle of saline nose spray by the bed for

You need to vacuum the room frequently, but not right at bedtime because it will kick up a lot of dust. Ideally you'd do that around dinnertime and then let the hepa filter take care of the dust before you go in for sleeptime.
posted by Lyn Never at 10:55 AM on April 4, 2021 [3 favorites]

I've used zyrtec for years.

Also seconding the above - shower before bed, neti pot, air filter, and fresh bedding. Additionally, I put allergy covers on the foam pillows that can't be washed and began washing my down pillows more frequently on the theory that cutting down the reactions I have other allergens like pet hair and dust mites will lessen my seasonal misery as well.
posted by minervous at 10:57 AM on April 4, 2021 [2 favorites]

If it’s mucus/postnasal drip, flonase (spray) did for me what none of the three pills could do. It takes like a week to build up, it’s not an as-needed.

If it feels like an asthma-type thing, see a doctor and get better meds. Sleep and being able to breathe are both so, so important and it seems there have been a lot of new options in the past 10-20 years.
posted by needs more cowbell at 11:15 AM on April 4, 2021 [7 favorites]

I hated the idea of using a sinus rinse and avoided it for years, and they're not super pleasant to do*, but I hate to admit they make a big difference during allergy season. I use the NielMed Sinus Rinse bottle.

*you do get used to it though
posted by EndsOfInvention at 11:15 AM on April 4, 2021 [4 favorites]

Best answer: Singulair (montelukast) is still prescription but this is exactly its purpose— help with allergic breathing symptoms. If a prescription is an option, that’s one worth considering.

Personally, I take Singulair as well as ceterezine (Zyrtec) every day, plus an Allegra (fexofenadine) on the really bad days. I used to take Benadryl on the bad nights, because who cares if you get knocked out when you are trying to sleep anyhow. If you are going to combine antihistamines though you really should talk to a doc about which combos are ok, because some have similar action mechanisms and shouldn’t be combined.

Also— which drug is best is going to depend on the person. Claritin doesn’t work for me at all, but for many people it is a huge improvement. So unfortunately you’ll have to experiment yourself to find what works best. And keep in mind that things can change over time; if a regimen stops working it might be time for some new drugs.

And there are always allergy shots. Not cheap, although insurance may cover them well. Much less annoying than I expected and infinitely less so than waking up with an asthma response. Some people get great relief, others (like me) moderate relief.

Asthma issues at night are still my worst symptom, but greatly improved through the following:
1) no carpet in bedroom. I use a swiffer on our wood floor twice a week, and Mr Nat is responsible for removing the reusable cloths so I don’t get extra dust/pollen exposure.
2) a stack of twenty pillowcases. A new one any time I wake up with allergic response.
3) shower before bed and wash hair every shower.
4) no stuffed animals or other plush items in bedroom.
5) no books or other dusty things in bedroom (no curtains or soft surfaces). Everything in the bedroom can be wiped down or dusted or washed on high heat.
6) bed and pillow encased in dust mite covers.
7) bed made every day (this is easy if your bed cover is a duvet) so dust/pollen only accumulates on the outside of the top cover.
8) all bedding replaced weekly and washed on high heat. I had to stop using the wonderful handmade quilts from my mom, because they aren’t high heat tolerant. I like the duvets with cover, because then duvet can be washed just once every two weeks, and by having an extra duvet cover, I still get to replace at least the outer layer of the bedding once/week while only doing laundry once every two.

And for symptom control, I’ve found my lung symptoms get better when I manage my other symptoms well. So, Neti pot, plus the pills mentioned above. Sudafed if I am congested. I don’t take Nasocort or Flonase because I have a weird anomalous reaction, but they are OTC now and many people find them helpful. Also recently OTC is a strong dose of opatalidine, eye drops which for me seem to reduce nasal symptoms too, which in turn helps the lungs (less drainage).

Allergies are no fun, lung allergies doubly so, but there are lots of tricks, medical and non, to mitigate them.
posted by nat at 11:19 AM on April 4, 2021 [4 favorites]

Oh I forgot, I also sleep on my stomach. My lungs are a lot happier that way.
posted by nat at 11:29 AM on April 4, 2021 [2 favorites]

I take Singulair and Flovent for my asthma daily. At this time of year, I take Allegra most days as well. At night, I sometimes take Benadryl. And I second the suggestions above for putting an air purifier and humidifier in your bedroom. My wife also frequently uses a neti pot; I sometimes do during pollen season.
posted by Artifice_Eternity at 12:05 PM on April 4, 2021 [1 favorite]

Best answer: Allegra and claritin didn't do it for me. (claritin dry and sleepy, Allegra didn't do anything). Zyrtec is great for me. My partner uses Zyrtec but finally tried Flonase and absolutely swears by it. I can vouch that her symptoms go away in 2 days and don't come back. She only use sit about 4 or 5 days (once a day) and that usually gets her through a pollen outbreak. It worked well for me too but it has a.... Peculiar side effect that is rare and I got.

Be sure if you try Flonase to get the regular Flonase NOT THE SENSIMIST which doesn't work as well and is more focused on red itchy eyes.
posted by chasles at 12:23 PM on April 4, 2021 [1 favorite]

I live in one of the most allergenic places in America, and Fluticasone is the only thing that makes it bearable. I've tried the others, but this is what has changed my life. Instead of sneezing fifty times a day, I sneeze–maybe–once, and this is only on the worst pollen days, as noted by the weather person on TV.
posted by ivanthenotsoterrible at 12:59 PM on April 4, 2021 [1 favorite]

Nasalcrom nose spray has made a huge difference for me. It can be a little drying but I also use saline nose spray and a humidifier. I also use Chlorpheniramine as needed; most other allergy meds I've tried make me too groggy or twitchy, and as a side bonus it's dirt cheap.
posted by gennessee at 1:09 PM on April 4, 2021 [1 favorite]

Tangential reminder: use sterile water for the neti pot. People have died by ignoring that rule.
posted by aramaic at 1:09 PM on April 4, 2021 [6 favorites]

Costco sells generic Flonase and that's what works for me when Zyrtec or Claritin generics don't
posted by anadem at 1:20 PM on April 4, 2021 [1 favorite]

Just in case, test your home air for mold and other airborne stuff.
posted by kschang at 1:22 PM on April 4, 2021 [1 favorite]

I've found muscinex useful, although it has no effect on allergy. It makes your mucus more liquid so it's less likely to catch in your throat.
posted by tmdonahue at 1:32 PM on April 4, 2021 [1 favorite]

Make sure all windows are closed, AC running, and change your bedding so often.
posted by heathrowga at 1:56 PM on April 4, 2021 [1 favorite]

Of those three choices, Zyrtec worked best for me. However, when I tried to stop taking it (after taking it for years), i got this horrible rebound itching (not a skin rash). If you Google it, apparently it's a thing. So just, something to keep in mind if you take it year round.

I've had the best results from a combination of Flonase + mucinex. And sinus rinse as needed.
posted by litera scripta manet at 2:02 PM on April 4, 2021 [1 favorite]

I have bad birch allergies in an area where the birch pollen count can be in the thousands in the spring. What works for me is generic Zyrtec BUT I have friends who find that the thing that works for them is Allegra or Claritin (both of which had me still wanting to claw my eyes out). I also recommend showering just before bed and keeping the bedroom closed up and free of outside unfiltered air if you can.

Benadryl works GREAT but also absolutely turns me into a zombie. If I am feeling really bad, taking a Benadryl at night (while still taking a Zyrtec in the morning) can allow me to sleep.
posted by charmedimsure at 2:48 PM on April 4, 2021 [1 favorite]

Flonase paired with Zyrtec plus controlling indoor sources of pollen (running an air purifier, changing clothes and showering at end of day) has made life in our new exceedingly allergenic midwestern climate much more livable.
posted by Wavelet at 4:40 PM on April 4, 2021 [1 favorite]

Best answer: Tangentially helpful: During this time of year I have a 20" x 20" x 1" MERV 11 or better filter taped to the back of a 20" x 20" box fan. I run this in my bedroom for 30 to 40 minutes before bed (or overnight if I fall asleep), combined with the other suggestions might provide some additional relief. Disclaimer: When I tested years ago the filter on the "intake" side of a box fan resulted in almost no additional power draw and no unusual heat build up on the motor windings, but I'd give it a supervised test for a few hours before leaving it on overnight.
posted by token-ring at 5:09 PM on April 4, 2021 [2 favorites]

Speaking of filters, do make sure you are using a high-quality filter on your air system (heating and/or cooling). And make sure you've replaced it recently. (In high allergy season we have to replace 1/ month; in low times we can go a lot longer).
posted by nat at 5:23 PM on April 4, 2021 [1 favorite]

In addition to the great advice above, a nasal strip, like Breathe Right, can help a lot if nasal congestion is causing part or all of the breathing problems.
posted by quince at 8:14 PM on April 4, 2021 [2 favorites]

Side note about Flonase/fluticasone if it’s a strain on the budget—many insurances (including my state’s Medicaid) will cover it if you get a prescription rather than buying it OTC, even though you can buy an OTC version that is identical to the prescription version. Also, personally I need two sprays per nostril per day during hard allergy seasons to manage symptoms—there is a variation in recommended dosage, with a trend toward just one spray per nostril per day.
posted by needs more cowbell at 2:48 AM on April 5, 2021 [1 favorite]

came in to say singulair, which i have been getting generic for a few years now.
posted by misanthropicsarah at 6:42 AM on April 5, 2021 [1 favorite]

If affordability is a factor, and no insurance, GoodRX often has coupons and/or can point you at the cheapest retailer in your area, or online pharmacy if need be. And FWIW, Amazon has started offering pharmacy services (check your Amazon website to see if it's available in your area)
posted by kschang at 7:02 AM on April 5, 2021 [1 favorite]

Camp wood floors, HEPA filter. I also have long hair, and having my hair recently washed or covered helps a lot in high pollen season.

I get allergy shots, and my allergist says many people stop responding as well if they take the same allergy med for longer periods (i.e. more than 2-3 months at a time) so it can be worth switching it up. Lots of people also find one or two of the OTC ones work better for them.

(Also, my allergies got hugely better once I started using a CPAP machine - breathing humid filtered air all night is great. If that might be in the mix, there's some additional incentive on the allergy front. Otherwise, humidifying and filtering the air in the bed is great.)
posted by jenettsilver at 12:02 PM on April 5, 2021 [1 favorite]

singulair for asthma at night when needed (prescribed), Zyrtec for seasonal allergies, Claritin 12 hour redi tab for "I went jogging next to the orchard and i'm regretting it." ++ for air filter recommendations as well. i've spent most of my life on at least two pills, an inhaler, and 1-2 nasal sprays. Singulair and Zyrtec really only work for me when i've been on them for a week...just taking them every once in a while doesn't help--but a claritin does. A burly air filter has me down to occasional pills and inhaler, and I live in between orchards, and the nasal strip trick works better than any of those for helping me actually sleep.

also, it can change. My allergies as an adult are better than when I was a teen, but dusk/nighttime is still the worst.
posted by th3ph17 at 4:37 PM on April 5, 2021 [1 favorite]

Best answer: Lots of really good suggestions here. I would break it down to this (which is my strategy):
Reduce Pollen Contact
Don't leave windows open (at night), wash areas of contact (bedding, hair), air purifier, clear air conditioning filters, etc..
I use a nasal rinse with saline AND alkalol (a mucus solvent?). So far, no major issues. I have found with some steroids and sinus rinses that I'll get a nose bleed, but this seems to have worked well.
Steroids
Usually nasal sprays. Flonase or Nasacort. Pick only 1, I don't think combining is a good idea. It takes time (as others have mentioned) to build up in your system. You can start now, but I put an annual reminder on a calendar to start up in mid/end of March. If one doesn't work, you can switch because they manage different allergy aspects. I believe that you can use these year round (but I do not)
Antihistamines
The three big ones are claritin, zyrtec and allegra. My doctor said that you can combine them if you get really bad, but it still seems like a questionable idea in my mind. However, some work better than others for some people. The generics of all three work (wallitin, waltec, etc...). I do combine steroids with antihistamine, but I can never remember which combination works for me (and I should probably add it to my calendar reminder). You may have to try one for a few days to a week and then switch over to a different antihistamine if it isn't helping (or overlap them and then discontinue the first one).
posted by kookywon at 12:39 PM on April 6, 2021 [1 favorite]

Response by poster: Thank you everyone! These are all great, just marking best answer for the ones that have new things to buy (shopping list) or organize multiple possible solutions.
posted by spamandkimchi at 12:41 PM on April 6, 2021