Medicines for hay fever

introduction

In addition to intervening in the mechanisms that trigger the allergy, the treatment of pollen allergy consists in administering medication to eliminate or alleviate the symptoms. This is what antihistamines, mast cell stabilizers such as disodium cromoglycate (trade name: Intal) and Nedocromil (trade name: Tilade), as well as inhalable and nasal steroids (cortisone) are available.

Administered early, the administration of antihistamines can prevent the later occurrence of allergic asthma as a complication of a longstanding hay fever disease.

You might also be interested in the following topics:

Antihistamines
Active ingredients antihistamines
asthma
Hay fever in children

Antihistamines for hay fever

The best-known antiallergic drugs from this group of antihistamines can be divided into two groups, each of which differ in terms of their side effect profile.
The first group (medical: 1st generation antihistamines, the development of which took place at the beginning of the 1960s)

Doxylamine (trade name: Mereprine®)
Diphenhydramine (trade name: Dormutil®) and
Dimetinden (trade name: Fenistil®).

However, since these substances are also effective in the brain, they have considerable sedative properties, so newer drugs have been developed.
For the treatment of allergic complaints, e.g. Dimetinden and Clemastin (trade name: Tavegil) related to the use of their local anesthetic (numbing) effect to combat severe itching; Doxylamine and diphenhydramine are sleeping pills available without a prescription (medical: hypnotics).
Diphenhydramine also has a blocking effect on the histamine receptors, which are located in the vomiting center of the brain, and is therefore used as an antiemetic (against nausea).
Examples of newer antihistamines with little or no sedation or anti-emetic effect (medical: 2nd generation antihistamines) are:

Cetirizine and levozetirizine
Loradatin and desloratadine.

These do not get through the blood-brain barrier into the brain because they are bound to protein substances in the blood: As charged particles, they are no longer able to cross the membranes, which are mainly made up of fat-soluble, uncharged particles.
The antihistamine fexofenadine (trade name: Telfast) is based on a different mechanism for the lack of sedative properties: It does get into the brain to be immediately detected by an enzyme that precisely this property is used to transport various drugs out of the brain was to be removed.
The enzyme is accordingly referred to as a “multi-drug resistance” transporter - a transport protein responsible for the ineffectiveness of several drugs (medical name for the enzyme: P -glycoprotein 450).
Unwanted side effects of antihistamines can occur (in addition to the already mentioned sedation that is extremely low or absent with newer drugs) in the form of loss of appetite, nausea and diarrhea (medical: diarrhea), but are rare.

Read more on the topic: Antihistamines

Mast cell stabilizers against hay fever

Mast cell stabilizers are no less important in the treatment of pollen allergies such as antihistamines, as they are used both preventively (medically: for prophylaxis) and for long-term therapy
It should be noted, however, that the full effectiveness only occurs with a delay of one to two weeks.
For the mast cell stabilizer disodium chromoglycate, different types of ingestion are available for local use:
It is available as a nasal spray, as an eye drop, and as an inhalable aerosol. In the case of food allergies, the drug can also be taken as a capsule or as a granular powder (so-called granules).

Learn more about: Nasal spray for an allergy or Livocab® eye drops against hay fever

For the treatment of asthmatic complaints, Nedocromil is preferred because it has an anti-inflammatory effect in the large lower airways (the bronchi) and also reduces the tendency of the bronchi, which is present in allergic asthma sufferers, to contract like an attack when they come into contact with pollen (or other allergens) (medical : Nedocromil causes a reduction in bronchial hyperreactivity).

The side effects of these two mast cell stabilizers are minor, as they only work on the spot and only very small amounts enter the body's circulation. Their high fat solubility is responsible for this.

Cortisone against hay fever

Topically administered, i. E., Are also of great importance in the treatment of asthma. Inhaled steroids (cortisone), whose mechanism of action is to reduce the formation of new inflammatory messenger substances and cell-damaging enzymes.

Steroids (cortisone) are among the most effective anti-inflammatory drugs ever; the price for this, however, are significantly more undesirable side effects, the strength of which depends on the dose administered, the type of intake and the duration of intake.

The following side effects are known after long-term use of steroids as tablets (i.e. orally) or intravenously, but practically never occur with inhalation or with cortisone nasal spray, as the absorption into the body's circulation is negligible and the steroids only have a local effect:

These include bone loss (medical: osteoporosis), in children a delay in length growth,
high blood pressure (medical: hypertension),
an increased blood sugar up to diabetes mellitus observed.
Somewhat less often occur psychological changes in the form of increased aggressiveness or depression as well
Opacity of the normally transparent cornea of the eye (medical: cornea).

Examples of inhaled steroids are:

Beclomethasone
Budesonide
Fluticasone

Read more on the subject at: Cortisone

These hay fever medications are available without a prescription

A widely used over-the-counter drug for hay fever is cetirizine. This is used for a variety of allergies. Cetirizine is the active ingredient that can be bought in pharmacies under different trade names.

In addition to cetirizine, drugs with the active ingredient loratadine can also be used against hay fever.

Another medicine is azelastine. This is often used in the form of eye drops.

Find out more about: Vividrin® acute nasal spray

Cromoglicic acid and levocabastine are also used in various eye or nasal sprays for therapy.

All drugs listed in this paragraph belong to the group of antihistamines. Histamine is a messenger substance in the body that mediates allergic reactions. Antihistamines prevent this from happening. They can be used as tablets, eye or nasal sprays.

Eye drops with an active ingredient from the group of antihistamines are used for hay fever to alleviate the discomfort in the eyes. These include Livocab® eye drops. Read more about this at: Livocab® eye drops against hay fever
If you are interested in homeopathic remedies for hay fever, then read on at: Formica rufa

Which hay fever medications require a prescription?

A prescription drug from the group of antihistamines or antiallergics is

Ebastine. Ebastine is used in tablet form.
The active ingredient fexofenadine hydrochloride also requires a prescription.
Another prescription drug from the group of antihistamines is olopatadine, which is used in the form of eye drops to treat allergic reactions.
The active ingredient budesonide is used for the local treatment of hay fever, for example as a nasal spray. This has an anti-inflammatory effect.
Other active ingredients from the group of glucocorticoids are also effective in treating hay fever, such as fluticasone.

However, drugs that contain glucocorticoids can also cause many side effects. Hence, these drugs require a prescription. Some sprays combine an antihistamine and a glucocorticoid. These drugs also require a prescription.

Specific immunotherapy can be carried out for several years for the causal treatment. Here, the controlled administration of the allergen takes place with increasing dosage. The immunotherapy must be carried out under the supervision or regular control of a doctor.

Find out more at:

Therapy of hay fever
Desensitization for hay fever

These hay fever medications don't make you tired

The drugs against hay fever are in the group of antihistamines. The antihistamines of the second, i.e. the more advanced generation, make you significantly less tired than those of the first generation.

However, some people may still feel tired after taking it. However, this often subsides in the course of therapy. This is due to the fact that second-generation drugs barely cross the blood-brain barrier and therefore have very little effect on brain cells.

Second generation antihistamines include drugs with the following active ingredients

Cetirizine,
Loratadine,
Levocabastine,
Cromoglicic acid and
Azelastine.

Also the prescription drugs

Ebastine,
Fexofenadine hydrochloride and
Olopatadin

belong to this group and hardly cause fatigue.

New drugs for hay fever

The latest developments in the drug treatment of allergies include a protein molecule specifically directed against IgE antibodies (i.e. an antibody against IgE antibodies); Omalizumab (trade name: Xolair®). It is supposed to prevent the development of allergies and is primarily used in the therapy of allergic asthma.