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Tell me about Allergies!

Asthma Medications

Many medications can be used to help control asthma.  Here are some of the most commonly used:


Singulair:  this blocks a body substance, leukotriene, that contributes to developing asthma symptoms.  Warning:  a small number of patients have developed depression or even suicidal thoughts while on Singulair.  Although this is very rare, be aware, and if you notice anything like this happening to you, stop taking the medication immediately and notify your doctor!

Antihistamines:  There are two main classes of antihistamines: First generation (sedating) and second generation (non-sedating).  Benadryl is a classic example of the first generation antihistamines that works very well and the generic form (diphenhydramine) is inexpensive.  Most people taking it report that it sedates them (makes them sleepy).  For many people this sleepiness only occurs when first taking the medication, and subsides over time of taking it regularly.  The second generation non-sedating (won't make you sleepy) mediations currently available in the US are Allegra, Clarinex, Claritin, Xyrtec and Xyzal.  Of these, Xyrtec and Xyzal still make some people sleepy.  Allegra is the least likely to make you sleepy.

Decongestants:  These pills don't directly treat allergies, but they do treat the swelling of the inside of your nose, sinuses, Eustachian tube that develop from allergies.  Sometimes these are combined with an antihistamine, such as Allegra D, Claritin D or Zyrtec D.  They can also be found alone, as in Sudafed.  Sudafed may be either phenylephrine or pseudoephedrine.  Both are available without a prescription, but the pseudoephedrine is Behind the Counter.  If you want this medication, you need to ask the pharmacist, have a drivers license for identification, and sign for the purchase. 


Controllers:  Controlling inhalers are ones that you take every day on a regular schedule.  Their purpose is to decrease the amount of inflammation in your lower airways, making you less likely to have allergy symptoms.  It is important to take these exactly as often as your doctor has prescribed.  All patients on a controller inhaler should be taking an inhaled corticosteroid (Flovent, Q-Var, Aerobid, Azmanex, Alvesco, and Pulmicort are examples).  For some, this will be combined with a long-acting bronchodilator such as Advair or Symbicort.  None of these medications give quick relief, and you should not use these to treat an asthma attack!
Always rememer to rinse your mouth and gargle thoroughly after using your corticosteroid-containing inhaler.  If you don't you may develop thrush (candida infection) which makes the inside of the mouth and the tongue sore and red. 

Rescue Inhalers:  These are inhalers used for quick relief from increased asthma symptoms.  They are usually used only as needed (when your chest is tight or you are wheezing) rather than on a regularly scheduled basis.  Albuterol is the most commonly used one, and Xopanex is another common one.  Usually these are prescribed for using one or two puffs every 4 to 6 hours for shortness of breath.  If you need to use the maximum amount, you may find yourself developing a headache or feeling jittery, like you've had too much coffee.  These are common side effects. 


Xolair (omalazumab) is an anti IgE medication.  It binds with free IgE in the blood stream in a way that makes it no longer able to cause histamine release from mast cells, so no allergic reaction.  It is presently approved for use for severe asthma not controlled with high dose inhaled corticosteroids.  It is only available as a shot, usually given twice a month.  There is some evidence that it is also helpful for other allergy symptoms and for hives.