Should you use Flonase or Nasacort for your allergies?

Both are good options. Research suggests that nasal steroid sprays such as fluticasone (Flonase Allergy Relief) and triamcinolone (Nasacort Allergy 24HR) are the most effective stand-alone medications available for relieving congestion, sneezing, postnasal drip and other allergy symptoms. For that reason, many experts consider them the best first option for allergy sufferers. In addition, Flonase and Nasacort are now available as over-the-counter medications.

One drawback with using Flonase and Nasacort is that it can take several hours before you begin to feel some relief. And it may take several days before you get the full benefit of the drug. This means that to get the best results, you should use them every day during the allergy season and not just when you have a flare-up.

To get the most benefit, it’s important to make sure that the medication stays in your nose and doesn’t run down the back of your throat.

The technique

First, keep your head upright and don’t tilt it backward. Insert the tip of the spray device into your nose, aiming to the outside of your nasal passage (away from the cartilage that divides the two sides of your nose). A gentle sniff after you spray is enough. A powerful sniff could make it drain down your throat. If that happens, spit it out.

The steroid sprays are usually well tolerated, but some people may experience nosebleeds and nasal dryness and irritation.

If your child uses one of these sprays, another potential side effect is a slightly reduced rate of growth. To reduce the risk of that, don’t allow the child to use it for longer than two months a year. If allergy symptoms last longer than that, talk to your doctor about other options.

And tell your doctor if your child also uses inhaled steroids to treat asthma or a topical steroid for itchy skin: Using those drugs along with a steroid spray could increase the risk of slowed growth. Another option is to try a cromolyn spray instead. It’s not as effective, but it is not associated with growth problems and is very safe for children.

If the steroid sprays don’t provide enough relief, consider adding an antihistamine spray (such as azelastine or olopatadine, which are available only by prescription). Another option is an antihistamine pill, such as fexofenadine (Allegra and generic), loratadine (Claritin and generic) or cetirizine (Zyrtec and generic).

It’s not a good idea to take Benadryl every day to treat allergies. Benadryl Allergy (diphenhydramine and generic) and similar first-generation antihistamines used to treat allergy symptoms, including chlorpheniramine (Chlor-Trimeton Allergy and generic), shouldn’t be taken for long periods.

About Benadryl

Besides having such side effects as drowsiness, confusion and urinary retention, the frequent, long-term use of older antihistamines is associated with an increased risk of dementia and Alzheimer’s disease, a recent study showed.

The study found that was also true for certain drugs, called anticholinergics, which are used to treat depression, asthma, overactive bladder and Parkinson’s disease. These drugs block the substance acetylcholine, which is involved in learning, memory and muscle contractions.

The study, published online in the Journal of the American Medical Association (JAMA) in January, looked at 10 years’ worth of pharmacy data, including prescription and over-the-counter drugs taken by 3,434 people age 65 or older who didn’t have dementia at the beginning of the study. Researchers at the University of Washington School of Pharmacy then tracked them for about seven years. During that time, 797 participants (23 percent) developed dementia.

Researchers found that people who had regularly taken any type of anticholinergic, including the older antihistamines such as chlorpheniramine and diphenhydramine, were more likely to develop the disease than those who had not, and those who had taken the drugs for three years or more had an even higher risk.

Warning for older adults

While additional research is needed, the study’s findings and several previous studies suggest an association between taking older antihistamines over a period of time and cognitive decline, particularly in older adults.

If you need an allergy medicine, consider a newer, “second-generation” antihistamine such as loratadine (Claritin and generic) or cetirizine (Zyrtec and generic) — though you shouldn’t take either for longer than you need to. Those newer antihistamines, Consumer Reports’ analysis shows, are equally effective at reducing allergy symptoms as the older ones and have fewer side effects. They also appear to have a lower risk of causing memory problems.

Some people respond better to one of the newer antihistamines than to others, so some trial and error may be necessary. Preventive measures, such as staying indoors when the pollen count is high and washing your hands and face after spending time outdoors, can also help.

Copyright 2015. Consumers Union of United States Inc.

For further guidance, go to www.ConsumerReports.org/Health, where more detailed information, including CR’s ratings of prescription drugs, treatments, hospitals and healthy-living products, is available to subscribers.