Is It Safe to Take Allergy Medicine Every Day?

Allergy symptoms can be debilitating, and while some allergies only strike seasonally, others can cause year-round suffering. But is it safe or effective for children, teens and adults to take a daily allergy pill for prevention and protection?

The answer is nuanced. Cedars-Sinai experts say you can take over-the-counter allergy medications every day for the treatment of mild to moderate allergies as long as they are “second-generation” antihistamines that do not contain a decongestant. Decongestant allergy pills and nasal sprays are only safe when used intermittently for no more than three days in a row.

The gold-standard treatment for people who routinely experience allergy symptoms are steroid nasal sprays, which are also safe and effective for daily, year-round use. These sprays can be even more effective when combined with modifications to your environment and sometimes an antihistamine pill, said Lyne Scott, MD, an allergy specialist in the Cedars-Sinai Medical Network.

"Seasonal and perennial allergies aren’t usually life-threatening, but they can really hurt quality of life in terms of missing work or school when symptoms are severe,” Scott said. “Doctors can advise you about daily allergy medications and other steps you can take to get allergies under control.”

What Causes Seasonal and Year-Round Allergies?

Both seasonal and perennial (year-round) allergens can cause a runny, stuffed up or itchy nose as well as watery eyes, postnasal drip, cough, skin irritation and fatigue. Many people are immune to common allergens, but some people experience an exaggerated immune response that results in inflammation of the nasal passage and throat.

• Perennial allergens like dust mites, cockroaches, mold spores and pet dander are present year-round.
• Seasonal allergens from trees, pollens and grasses usually are produced in the spring, but warming trends are extending the allergy season for some patients.

Chronic allergy sufferers are prone to frequent sinus infections, and allergies can also trigger or inflame asthma symptoms, so getting control over them is important for your overall health, Scott said.

Seasonal and perennial allergies can be treated with daily over-the-counter medications, which block the chemicals released by your immune system in response to allergens.

Is It Safe to Take a Daily Antihistamine?

For patients with year-round allergies, doctors and pharmacists recommend second-generation antihistamines such as levocetirizine (Xyzal), cetirizine (Zyrtec), loratadine (Claritin) and fexofenadine (Allegra), which are generally safe for daily use, said Audry Ortiz, PharmD.

The medication that works best is based on individual preference, Ortiz said. There is no data that one type is more effective, though they vary in cost and availability of generic formulations.

Avoid first-generation antihistamines, including diphenhydramine (Benadryl) and hydroxyzine, which cross the blood-brain barrier and can cause drowsiness. They also can cause slowing in the gut and cognitive side effects, which can be dangerous, especially in patients aged 70 and older.

“It is not safe to take first-generation antihistamines every day,” Ortiz said. “If someone is having extremely severe allergies, maybe they want to take one dose at night. For everyday use, either as a sleep aid or for allergy control, definitely do not take this type of medication.”

Medications with decongestants (sometimes indicated by including a “D” at the end of the drug name) should not be used for more than two or three days in a row, Ortiz said. These drugs are only safe for short-term use during an exacerbation period—for example, for a few days when seasons change.

Intranasal Sprays or Daily Pills: What Works Better?

For people with persistent allergy symptoms, especially sneezing and a runny nose, daily use of an intranasal steroid spray like fluticasone (Flonase) or mometasone (Nasonex) can be very effective, Scott said. Steroid nasal sprays can control congestion by reducing inflammation and hyperreactivity of the nasal passages.

Scott notes two important facts about nasal sprays:

• They don’t take immediate effect, and it can take up to two weeks of consistent use to achieve the peak effects.
• Make sure you’re using proper technique to avoid side effects such as nosebleeds.

“When people start nasal steroids, they often think they’re not working, because they use them for three to four days and then stop,” she said. “You have to give the nasal spray the full seven to 10 days in order to evaluate its effectiveness.”

Make sure to insert the spray upward and away from the center of your face, not toward the middle of the nose, which can cause nosebleeds, Scott said.

Just like with allergy pills, use decongestant sprays such as oxymetazoline (Afrin) with caution, Ortiz said.

"Using a nasal spray that contains a decongestant for more than three days can lead to rebound congestion. So, if you’re going to use it, use it as briefly as possible to relieve your symptoms and then move on to a spray that does not contain a decongestant,” she said.

When Should You Get Tested for Allergies?

If you’re experiencing allergy symptoms most days of the year and your over-the-counter medications are not helping, see a doctor.

“It’s always good to know what you’re sensitized to, because there are things you can do in your environment to reduce your exposure and risk,” Scott said. “An allergist or a primary care doctor can help evaluate what you’re allergic to with a blood or skin test.”

Doctors can prescribe immunomodulatory therapies that are specific to your allergies.

“Allergy shots, sublingual tablets and drops can be effective for patients with really bad allergies,” Scott said. “It’s a three- to five-year commitment, but after the treatment course, a large portion of patients are no longer sensitized to what they’ve been treated for.”

How Can You Reduce Your Exposure?

Knowing your sensitivities can help you take steps to adjust your home environment and your outdoor exposure to reduce allergies. After just two to three weeks of small changes, patients often feel a major difference in their symptoms, Scott said.

“You’ll achieve the most success in allergy control when you address environmental measures in combination with medication treatments,” she said. “Even simple things matter. For example, if the Santa Ana winds are blowing and you know you have pollen allergies, wear a face cover when you go outside.”

A doctor will make specific recommendations based on your allergies, such as:

• If you’re allergic to pollen, don’t wear shoes in your house, and sleep with the windows closed, because many trees pollinate between 2 and 6 a.m. Also, air purifiers with HEPA filters and MERV 11 filters for your air conditioner can reduce the amount of pollen entering your house from outside.
• If you’re allergic to your cat or dog, bathe them regularly, wipe their paws when they come in from outside and keep them out of your bedroom.
• If you’re allergic to dust mites, keep the humidity in your house low.

When Should You Connect With a Doctor?

If your antihistamines are not working, talk to a doctor to learn about evidence-backed treatment methods.

Doctors can advise you about alternative therapies or dosages or whether you should combine an antihistamine with a steroid nasal spray. Patients should always be comfortable consulting their healthcare providers, including pharmacists, who are medication specialists, Ortiz said.

“AI and search engines are going to give you the same information that’s on the medication label, but the pharmacist knows what’s actually relevant for you as a patient,” she said. “We can talk you through how to select the best medications, what side effects to look out for and when you should seek help from your doctor.”