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December 10, 2006 2:32 PM   Subscribe

MedicalFilter: What allergy medications work best against cat dander?

I'm hauling the family to Mom's house for Christmas, like always. She has three longhair cats, though, and every year it turns into a game of "how much of this can I stand." Most years I endure, with a mix of bloodshot eyes, runny nose, wheezing, and a lot of standing outside in the cat-free air. It's only a week, though, and then I'm back to my pet-free house.

But now, I've had it. I want to be able to breathe again. I can't make her get rid of the cats (she couldn't have any while I was in the house growing up), we can't afford a hotel room, we have no place for her to stay in our tiny house, and I'd never hear the end of it if Grandma didn't see the grandchild.

I've decided that this year, I'm going to my on-again off-again doctor and asking for an allergy medication that works against cat dander. The problem is that I don't necessarily trust said doctor with having a clue. Last time around I ended up with Allegra... which is not indicated for pet dander. So, I need to know what to ask for (and check to see if it's on my insurance's formulary) so I know where to steer him.

This previous AskMe comment mentions Clarinex and Singulair. Are those the preferred remedies? What about an over-the-counter med like Claritin? Seldane used to work really well, but that's off the market now. Benadryl and Actifed are right out, since they both literally put me to sleep. Any ideas what the right option might be?
posted by dw to Health & Fitness (20 answers total) 4 users marked this as a favorite
I just got the Kenalog allergy shot - no side effects that I've felt, it lasts 6 weeks to 3 months (starts wearing off after 6 weeks, by the time you get really bad again it's been 3 months, the doc told me), and costs about $45. I've only had it a week, but my neighbor that I babysit for has a cat, and so far since I got the shot I haven't had to take Benadryl.
posted by IndigoRain at 2:44 PM on December 10, 2006

(I'm allergic to cats and was taking a Benadryl every day I was there.)
posted by IndigoRain at 2:46 PM on December 10, 2006

Best answer: I live with someone who is terribly allergic to cats. A number of his friends have cats, and in stead of just avoiding those places altogether, he uses Loratadine (the generic form of Claritin) daily with stellar results.
posted by numinous at 2:51 PM on December 10, 2006

I'd like to second Claritin or's what my husband took when he was sensitive to my cats' dander. I also take it for my seasonal and environmental allergies and it works better than anything I've ever tried.
posted by christinetheslp at 3:03 PM on December 10, 2006

One Claritin a day worked for me with a cat in the house. I found I was fine for the first day, but if I didn't take one within 24 hours my nose and eyes would act up. With it, my sinuses feel almost too dry, but that's a far better feeling than all-out frontal assault on cat allergens.
posted by A dead Quaker at 3:13 PM on December 10, 2006

Claritin, Claritin, Claritin. I have severe cat allergies and Claritin is practically a wonder drug. If I experience any side effects I don't notice them.
posted by nev at 3:19 PM on December 10, 2006

I am terribly allergic to cats, and Claritin saves my ass every. Single. Time.
posted by rhapsodie at 3:21 PM on December 10, 2006

Singulair 10 mg might work. Unlike antihistamines, it is supposed to prevent the histamines from forming. Ask your doctor---it's prescription, but s/he may have samples. (It's pretty new, I think.)
posted by LeisureGuy at 3:27 PM on December 10, 2006

I've heard of people having success with Claritin, but when a dear friend (who is pretty tremendously allergic to kitties) visited for Thanksgiving, it wasn't even close to enough for her. She was okay for the first 12 or so hours, but by the second night, she was a real mess. I've been led to believe that Zyrtec can help with pet dander, as can the various steroid nasal sprays. When my summer allergies are really in full, miserable swing, I find a combination of a pill and a spray can be very effective, so that might be an angle to pursue.
posted by mostlymartha at 3:28 PM on December 10, 2006

Claritin didn't work for me with the cat. Hence the reason I was taking Benadryl.
posted by IndigoRain at 3:39 PM on December 10, 2006

I found that with multiple cats, Claritin-D works better than regular Claritin. That plus an albuterol inhaler got me through a week long visit with my friend who was 4 long-haired, adorable little monsters.
posted by Space Kitty at 3:40 PM on December 10, 2006

Heh. "has"
posted by Space Kitty at 3:40 PM on December 10, 2006

Best answer: A quick summary: Claritin, Clarinex, Allegra and Zyrtec are about equal in terms of efficacy. Zyrtec might make you sleepy. All four suck rocks compared to Benadryl and Chlopheniramine. Singulair might work for you. Consider an inhaler. Consider nasal sprays. Be clean.

Don't discount your physician on the basis of being prescribed Allegra for your allergies. Pharmaceutical companies seek approval for various indications from the FDA, but this requires trials which specifically include or are designed around said indication. Allegra works just fine for many people with pet allergies.

There's no clear winner in terms of the second-generation allergy meds. Different drugs work better for different people. Many of the trials demonstrating one drug's superiority over another futz around with the dosages of both in order to make it look like one drug is better.

That said, Zyrtec has been shown to induce sedation more often than Allegra and Claritin. This isn't to say that everyone suffers from this side effect. All three of these drugs are greatly inferior to Benadryl in terms of efficacy, though, of course, many people get pooped out from Benadryl use.

(Interestingly enough, I remember reading a meta-analysis that couldn't find a link between Benadryl and sedation, though most of the comparison trials are designed to demonstrate the lack of sedative effect from the newer antihistamines.)

At any rate, it sounds like you need multiple meds based on your symptoms. You'll likely need:
- an antihistamine. Again, it's a toss-up between Allegra, Claritin, Zyrtec and Clarinex. I haven't come across anything conclusive demonstrating the effectiveness of one over another. I think Clarinex is an attempt to sucker people into buying a non-generic version of Claritin (it being simply an enantiomer of Claritin-- and yeah, I know, sometimes this is better if the other enantiomer is causing problems).
- some sort of lung med. If you're wheezing or have a history of asthma, get an albuterol inhaler and have someone show you how to use it properly. If your wheezing is persistent, you might want to consider something like Advair, which is a combination of a long-acting bronchodilator (versus albuterol, which is a short-acting one) and a corticosteroid. Note that Advair does not replace albuterol for acute exacerbations.
- maybe Singulair. For some asthmatics and allergy sufferers, Singulair works well. It's typically not considered to be first line treatment for either, and I rarely prescribe it. But it works for a handful of my patients (most say it didn't do squat).
- maybe a nasal corticosteroid. If your nasal symptoms persist despite the other meds, think about this. Flonase is generic, and pretty cheap.

Most importantly, do what you can to avoid exposure. I do not believe that you will be able to pick up a cat, hold it up to your face and inhale deeply without adverse reactions, even after taking any or all of the above. See if you can have a "clean room" to sleep in. One which was vacuumed well, has a door you can close, possibly a HEPA filter, and clean linens.
posted by herrdoktor at 4:31 PM on December 10, 2006 [2 favorites]

Claritin-D (24 hour) works wonders for me, but at roughly $1 a pill it's a big investment. Now I'm wondering about this shot mentioned in the first comment.
posted by Brittanie at 6:02 PM on December 10, 2006

For people near the border, many of these allergy meds (e.g. Claratin, Allegra, and Zyrtec is called Reactine here) are available without prescription in Canada at much lower prices. e.g. the store-brand loratadine (generic Claratin) at Zellers is $3.99 for a 12-day supply (no prescription).
posted by winston at 6:21 PM on December 10, 2006

Response by poster: I've had mixed results with Claritin. It's my drug of choice for hay fever, but with cats it's a crapshoot.

(Interestingly enough, I remember reading a meta-analysis that couldn't find a link between Benadryl and sedation, though most of the comparison trials are designed to demonstrate the lack of sedative effect from the newer antihistamines.)

If I take Benadryl, I will either fall asleep or be a zombie until it's metabolized. It's been this way since I was a kid, when Benadryl for kids was prescription and peppermint-flavored. I don't think it's psychosomatic.

At any rate, it sounds like you need multiple meds based on your symptoms.

That's what I was hoping to avoid. But at least this gives me enough to have a conversation with the doctor, rather than the usual "You have allergies? Here's some Flonase/Allegra" bit. (I really need a better doctor.) Thanks herrdoktor.

See if you can have a "clean room" to sleep in. One which was vacuumed well, has a door you can close, possibly a HEPA filter, and clean linens.

Heh. Did I mention they were longhairs? When I come back home from her house, I usually have to clean the luggage because they're covered in hair -- even after the 2-3 flights and the jostling around in the luggage system.
posted by dw at 6:26 PM on December 10, 2006

The main reason why I mentioned multiple meds is because of your wheezing (as if the misery of a runny nose and itchy eyes isn't bad enough). Wheezing -> asthma -> trouble.

Personally, Benadryl knocks me out, too. The meta-analysis I mentioned is funny because it just defies what I think to be common sense. But hey, data is data, which isn't to say that metanalyses aren't without faults.

When my allergies act up, I find Allegra and Zyrtec work well. Claritin/Clarinex don't do squat. I own cats, and I'm allergic to them. Ah, this reminds me: my brother is allergic to cats as well. On one occasion, when he was in town, he slept with a dust mask. Seemed to work, though I wouldn't recommend it for you: would seem kinda silly to be the only one wearing one in the family photos.

Good luck!
posted by herrdoktor at 6:54 PM on December 10, 2006

Different drugs work for different people, so take all of this with a grain of salt. Singular didn't work for me (my allergist said maybe 40% of the population doesn't find it helpful), but my mother and brother love it.

What I will recommend is a combination of Sudafed (if you can still find it, what with the Drug War and all) and Benadryl. Sudafed doesn't do much for my whole-body itching, but with it I can breath, and my face and eyes don't itch nearly as much. It keeps me awake, though, so then at night, Benadryl (for which the only side effect I notice is that same "right to sleep"-ness you describe). And I sometimes take a quarter of a pill of Benadryl during the day if the cats decide I'm interesting.

For some people, Sudafed isn't an option; it makes them too jittery, or anxious, or otherwise unfocused. It all depends on what side effects you're willing to put up with. For me, when I'm not working or studying, and I'm being exposed to cats, it's worth it to be not half-dead; YMMV.
posted by spaceman_spiff at 7:47 PM on December 10, 2006

There's a drug, acepromazine, you can put in a cat's food to make them stop producing the saliva protein that most people find causes an allergic reaction. It's a tranquilizer, but the dose used for this purpose doesn't actually knock the animal out. It does require a prescription from a vet.
posted by kindall at 1:59 AM on December 11, 2006 [1 favorite]

Response by poster: To follow up....

I took Claritin the whole trip. It helped a bit, but not nearly enough. I was miserable the whole trip. At least it's over for another year.

I'm planning on seeing an allergist in the spring to talk about shots (for all my allergies).
posted by dw at 2:28 PM on January 7, 2007

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