Make us your home page

Today’s top headlines delivered to you daily.

(View our Privacy Policy)

feeling fine

New treatments available for allergy season

If you are suffering with runny nose, sneezing, cough, itchy-watery-eyes and nasal congestion then you already know that allergy season is here. Allergy sufferers today have a lot of options to help control and even "cure" their symptoms.

The vast majority of allergy symptoms seen in hay fever are related to the release of histamine from immune cells in the body. That is why the mainstay of over-the-counter (OTC) treatment remains antihistamines. Antihistamine medications are great for treating runny, sneezy, itchy symptoms. The older antihistamines (such as Benadryl and Chlor-Trimeton) work well but tend to cause drowsiness.

Newer drugs such as Claritin (loratadine), Zyrtec (cetirizine) and Allegra (fexofenadine) offer similar benefits without the sedation. We now have generic equivalents available over the counter.

If itchy, watery, red eyes are the primary complaint there are newer OTC eye drops such as Zaditor that contain antihistamines that act locally.

Decongestants are added on to address nasal congestion and sinus pressure, but must be used cautiously in people with hypertension. Over the counter nasal sprays can offer some relief, but patients often become dependent on them so they can be used for only limited amounts of time.

When allergy symptoms are just too severe to be handled through lifestyle changes and over-the-counter remedies then you should consider seeing an allergist, who can identify the source of your symptoms and better target your treatment. When allergen avoidance is ineffective and medications are inadequate, immunotherapy may be a viable treatment option.

Allergy shots (medically known as subcutaneous immunotherapy, or SCIT) are a very effective form of treatment. Increasing doses of the allergy serum are given weekly over a period of months until a target dose or maintenance dose is achieved. Allergy injections have been used since 1911 with proven efficacy and long-term benefits but many patients find the time investment impossible to make and they continue to suffer through allergy seasons.

For those patients, we may have new therapies to offer.

Recently, there has been a growing interest in "allergy drops" (medically known as sublingual immunotherapy, or SLIT). Instead of allergy shots, allergens are placed in liquid or tablet form under the tongue. Increasing amounts of allergens are administered through this route on a daily basis. This treatment has been widely used in Europe for decades but has only recently been FDA approved in the United States. A large review of the data on SLIT shows that it is better than over-the-counter meds in improving symptoms but not as effective at SCIT. It is important to note that the only FDA-approved materials for SLIT are in a pill form. There are some practitioners using or offering allergy drops (SLIT). The same allergen extracts used for allergy shots are being used for SLIT. These allergens are FDA approved to be used for allergy shots only so the use of these allergens in drop form is not FDA approved and considered "off-label" use. This is why this treatment is typically not covered by insurance companies. There are no standard guidelines in terms of dosage and schedule when using the serum in this fashion. Therefore, those offering this type of treatment are making educated guesses on the correct dose and course of therapy.

SLIT has the potential to make allergy treatment easier and less painful but comes with its own inherent concerns. The tablet has to be taken every day and could have frequent side effects of mouth or tongue itching. If even one day is missed, the subsequent dose could lead to more severe side effects. There is also still a risk for severe allergic reaction with these tablets. If one of these reactions occurred at home that could lead to a dangerous situation for patients. Also, the studies have shown these pills to be helpful in patients who are allergic only to grass pollen. It is quite rare for patients to be allergic to grass pollen alone, especially in Florida.

It is exciting to know that there are many new treatments being studied to help patients who suffer with allergies. With so many options, it is best to talk with your allergist about which treatment options are a right for you and your lifestyle.

Dr. Mona V. Mangat is an allergist and immunologist in St. Petersburg at Bay Area Allergy & Asthma.

New treatments available for allergy season 02/19/14 [Last modified: Thursday, February 20, 2014 1:56pm]
Photo reprints | Article reprints

© 2017 Tampa Bay Times


Join the discussion: Click to view comments, add yours

  1. Prosecutors tried to delay a trial because of the eclipse. Florida judge cited 'Star Trek' in ruling


    The wheels of justice may grind slowly, but they cannot be stopped by Monday's total eclipse, a judge has ruled.

    Schweta Kulkarni, from left, Rhea Kulkarni and Saanvi Kulkarni, from Seattle, try out their eclipse glasses on the sun at a gathering of eclipse viewers in Salem, Ore., early Monday, Aug. 21, 2017. (AP Photo/Don Ryan) ORDR102
  2. Top 5 at Noon: Mayoral race affects ballpark decision; stream the eclipse live


    Here are the latest headlines and updates on

    Looking east at Tropicana Field and downtown St. Petersburg.  SCOTT KEELER    |    Times

  3. Full disclosure: My AP Top 25 ballot


    Now that you've seen the preseason AP Top 25, here's what I submitted in my first year as a voter. The AP doesn't give us many guidelines in the preseason. I didn't try to predict how …

  4. AP Top 25: Alabama first, FSU, UF, Miami and USF all in top 20


    As expected, Alabama will start the season at No. 1 in the AP Top 25.

  5. Hollywood lost a serious filmmaker in Jerry Lewis


    The day the clown died, Hollywood lost a serious filmmaker in Jerry Lewis.

    Jerry Lewis in 2005. Lewis, the comedian and filmmaker who was adored by many, disdained by others, but unquestionably a defining figure of American entertainment in the 20th century, died on the morning of Sunday, Aug. 20, 2017, at his home in Las Vegas. He was 91 (New York Times)