Allergy Medicines: A Complete Guide for Indian Patients
Allergies are extremely common in India, affecting an estimated 20–30% of the population. Allergic conditions range from allergic rhinitis (hay fever) and eczema to asthma and food allergies. Understanding the different medicines used to manage allergies helps patients achieve better control with fewer side effects.
Types of Allergic Conditions and Their Medicines
Antihistamines — Medicines That Block Histamine
Histamine is the chemical released by the immune system during an allergic reaction. Antihistamines block its effects on the body.
First-Generation Antihistamines (Sedating)
Examples: Chlorpheniramine (CTM, Phenergan), Diphenhydramine, Promethazine
- Effective for allergic symptoms but cause significant drowsiness
- Impair driving ability and concentration
- Can cause dry mouth, urinary retention, constipation
- Avoid in elderly, men with prostate enlargement, glaucoma patients
- Still commonly prescribed in India; cheaper than newer antihistamines
Second-Generation Antihistamines (Non-Sedating or Low-Sedating)
Examples: Cetirizine (Zyrtec, Allercet), Loratadine, Fexofenadine (Allegra), Levocetirizine, Desloratadine, Bilastine
- Minimal or no drowsiness
- Safe for daytime use and driving
- Once-daily dosing for most
- Effective for: hay fever, allergic rhinitis, hives (urticaria), insect bite reactions, eczema itch
- Preferred over first-generation for most patients
Tip: Among second-generation antihistamines, fexofenadine causes the least sedation. Cetirizine and levocetirizine may cause mild drowsiness in some patients — useful when allergies disrupt sleep.
Nasal Corticosteroids — Best Medicine for Allergic Rhinitis
Examples: Fluticasone (Flixonase, Nasofan), Mometasone (Nasonex), Budesonide (Rhinocort), Beclomethasone
Nasal steroid sprays are the single most effective treatment for allergic rhinitis. Despite the word “steroid,” they are very safe because minimal medication is absorbed into the body.
- Reduce nasal congestion, runny nose, sneezing, and nasal itching
- Take 1–2 weeks for full effect — must be used consistently
- Safe for long-term daily use
- Proper technique: tilt head slightly forward, aim spray towards the outer wall of the nostril (not the middle septum)
- Occasional nosebleeds; switching to mometasone (less irritating) may help
Decongestants
Examples: Pseudoephedrine, Oxymetazoline nasal spray (Otrivin, Nasivion)
- Relieve nasal congestion rapidly
- Nasal sprays: Use maximum 3–5 days only. Longer use causes rebound congestion (rhinitis medicamentosa) — the nose becomes more congested than before when the spray wears off.
- Oral decongestants (pseudoephedrine) raise blood pressure — avoid in hypertension, heart disease, hyperthyroidism
Medicines for Asthma and Allergic Airways Disease
Bronchodilators (Relievers)
- Salbutamol/Albuterol (Asthalin, Ventorlin): Quick-relief inhaler for acute breathlessness. Use when needed, not regularly.
- Levosalbutamol (Levolin): Fewer side effects (tremor, palpitations) than salbutamol
Inhaled Corticosteroids (Controllers)
- Budesonide (Pulmicort, Budecort): Prevents inflammation; must be used daily even when feeling well
- Fluticasone (Flixotide): Potent inhaled steroid for moderate-severe asthma
- Combination inhalers (Seretide, Symbicort, Foracort): Inhaled steroid + long-acting bronchodilator — convenient and highly effective
Montelukast (Singulair, Montair)
A leukotriene receptor antagonist widely used in India for asthma and allergic rhinitis. Particularly useful in children and in aspirin-sensitive asthma. Recent FDA warnings about mood side effects (rare) — discuss with your doctor.
Antiallergic Eye Drops
- Ketotifen (Zaditen eye drops): Antihistamine eye drops for allergic conjunctivitis
- Olopatadine (Olopatadine eye drops): Mast cell stabiliser + antihistamine; very effective
- Sodium cromoglycate: Mast cell stabiliser; preventive for allergic eye disease
Allergy Immunotherapy
Also called “allergy shots” or “desensitisation,” immunotherapy gradually exposes the immune system to increasing amounts of allergen to reduce sensitivity. Available in India through allergists/immunologists for:
- Allergic rhinitis not controlled by medicines
- Allergic asthma triggered by specific allergens (dust mites, pollen, animal dander)
- Venom allergy (bee, wasp stings)
Sublingual immunotherapy (drops or tablets under the tongue) is becoming more available and convenient than injection immunotherapy.
Treating Severe Allergic Reactions (Anaphylaxis)
Anaphylaxis is a life-threatening allergic reaction requiring emergency treatment:
- Adrenaline (Epinephrine) auto-injector (EpiPen): First-line treatment — should be available to anyone with known severe allergy history
- Antihistamines and corticosteroids are secondary — do not replace adrenaline
- Call emergency services immediately
Allergy Testing and Treatment at Dashvanth Healthcare
Our diagnostic centre offers comprehensive allergy testing including skin prick tests and specific IgE blood tests to identify your exact allergen triggers. Our specialists can then develop personalised management plans combining medicines and avoidance strategies for maximum allergy control.
