Best Allergy Medications Explained by an ENT Doctor | Antihistamines, Nasal Sprays & More!

Dr Madeleine S. Herman, MD, MPH, FAAOA

Relieve sneezing, congestion, and itchy eyes—fast.

If you suffer from seasonal allergies, dust sensitivity, or chronic sinus issues, you’re not alone. Millions of people deal with allergy symptoms every year, and the key to relief often starts with the right allergy medication.

As an ENT (Ear, Nose, and Throat) specialist, I get asked all the time:

“Which allergy meds actually work?”“Should I be taking a pill or using a nasal spray?”“What’s safe to use daily?”

In this post, I’ll break down the most effective over-the-counter (OTC) and prescription allergy medications—how they work, when to take them, and which ones may be right for you.

1. Antihistamines: First Line of Defense for Sneezing & Itching

Best for: Sneezing, runny nose, itchy eyes/throat, hives

Examples: Claritin (loratadine), Zyrtec (cetirizine), Allegra (fexofenadine), Benadryl (diphenhydramine)

Antihistamines block histamine, the chemical your body releases during an allergic reaction. Modern non-drowsy antihistamines like Zyrtec and Allegra are usually the best choice for daytime use. Benadryl can be effective but causes sedation, so it’s typically used at night or for short-term flare-ups.

ENT Tip: Take antihistamines before your allergies usually hit—especially during peak pollen seasons.

2. Nasal Corticosteroid Sprays: Best for Nasal Congestion

Best for: Stuffy nose, post-nasal drip, chronic sinus pressure

Examples: Flonase (fluticasone), Nasonex (mometasone), Rhinocort (budesonide), Nasacort (triamcinolone)

Steroid nasal sprays are incredibly effective for reducing inflammation inside your nasal passages. Unlike antihistamines, they directly treat nasal congestion—often the most frustrating allergy symptom.

ENT Tip: Use these daily, not just when symptoms appear. Consistency is key for full effectiveness.

3. Decongestants: For Short-Term Nasal Relief

Best for: Severe nasal congestion or sinus pressure

Examples: Sudafed (pseudoephedrine), Afrin (oxymetazoline)

Decongestants shrink swollen blood vessels in the nasal passages, providing fast relief. However, oral decongestants like Sudafed can raise blood pressure and cause jitteriness. Nasal sprays like Afrin work quickly but should never be used for more than 3 days to avoid “rebound congestion.”

ENT Warning: If you have high blood pressure, heart issues, or take daily medication, consult your doctor before using decongestants.

4. Leukotriene Receptor Antagonists (LTRAs): A Prescription Option

Best for: People with asthma and allergies, nighttime symptoms

Example: Singulair (montelukast)

This prescription-only medication works differently by blocking leukotrienes—chemicals involved in inflammation. It’s often used in combination with other allergy treatments, especially for patients who also have asthma or nighttime coughing.

ENT Insight: Singulair can be a great add-on for stubborn allergy cases but comes with rare mood-related side effects. Use with supervision.

5. Natural Remedies & Lifestyle Tips (Bonus!)

While not medications, certain lifestyle changes and supplements may help manage mild allergy symptoms:

• Saline nasal rinses or neti pots

• Limiting outdoor exposure during high pollen days or wearing a mask

  
  

ENT Tip: Always consult with your ENT or primary care provider before mixing natural remedies with prescription meds.

So, Which Allergy Medicine Is Right for You?

Symptom	Recommended Treatment
Sneezing, Itching	Non-drowsy antihistamines (Zyrtec, Claritin)
Nasal Congestion	Nasal steroid spray (Flonase, Nasonex)
Severe Sinus Pressure	Short-term decongestants (Sudafed, Afrin)
Nighttime Allergies	Prescription meds like Singulair
Chronic Sinus Issues	Combination therapy + ENT evaluation

When to See an ENT Specialist

If your symptoms don’t improve with OTC medications or you're dealing with year-round allergies, chronic sinusitis, or frequent sinus infections, it's time to see an ENT doctor. You may benefit from allergy testing, prescription treatment, or advanced solutions like immunotherapy or even sinus surgery.

👃 Breathe Easier, Live Better.

Allergy relief isn’t one-size-fits-all, but with the right plan, it’s absolutely possible to manage your symptoms and improve your quality of life.

Want personalized advice from an ENT expert?📅 Schedule your consultation today and get the relief you deserve.