Allergy Medications

Epinephrine

Epinephrine is a prescription medication for use in people at risk of serious allergic reactions. Please also ask for updated Allergy Action Plans for school or daycare each year if you need this.

Information about all the epinephrine devices that are available in the US can be found on Kids With Food Allergies.

• Auvi-Q information and videos
• Auvi-Q pdf
• Epi-Pen information and videos
• Epi-Pen pdf

Oral (by mouth) Antihistamines

Antihistamines can be used to treat seasonal allergies as well as acute allergic reactions, such as hives, and to control the itch associated with insect bites and contact dermatitis. Antihistamines are fast acting.

Antihistamines limit itching, but not congestion.

Generic brands are considered as effecitve as name brands.

Cetirizine (Zyrtec)

Adults and children 6 years and over: 5-10 mg per day.

• Tablets, Chewables, and Caplets: Each tablet equals 10mg. Start with 5mg (1/2 tablet) and increase to 10 mg (full tablet) if needed for symptom control.
• Liquid: 1 teaspoonful (5 mL) or 2 teaspoonfuls (10 mL) once daily depending upon severity of symptoms; do not take more than 2 teaspoonfuls (10 mL) in 24 hours.

Children 2 to under 6 years of age: 2.5-5mg per day.

• Syrup: ½ teaspoonful (2.5 mL) once daily. If needed, dose can be increased to a maximum of 1 teaspoonful (5 mL), once daily, or ½ teaspoonful (2.5 mL) every 12 hours. Do not give more than 1 teaspoonful (5 mL) in 24 hours.
• Chewable tablets: ½ chewable tablet once daily. May increase to a full tablet for severe symptoms.

Children 6 months to 23 months: 1.25 – 2.5 mg/day

• Syrup: 1/4 teaspoonful (1.25 mL) once daily. If needed, dose can be increased to a maximum of ½ tsp (2.5 ml) once daily or ¼ tsp (1.25ml) twice/day. Do not give more than ½ teaspoon (2.5 ml) in 24 hours unless directed by a physician.

Fexofenadine (Allegra)

Adults and children 12 years of age and older:

• Syrup: Take 2 teaspoonfuls (10 mL) every 12 hours; do not take more than 4 teaspoonfuls (20 mL) in 24 hours
• Tablets: One 180 mg tablet with water once a day; do not take more than 1 tablet in 24 hours
• Syrup: 1 teaspoonful (5 mL) every 12 hours; may increase to 2 teaspoonfuls (10 mL) in 24 hours for severe symptoms

Loratidine (Claritin, Alavert)

Adults and children 6 years and over: 5-10 mg per day.

• Tablets, Orally disintegrating, and Caplets: ½ to 1 once/day.
• Liquid: 1 teaspoonful (5 mL) or 2 teaspoonfuls (10 mL) once daily depending upon severity of symptoms; do not take more than 2 teaspoonfuls (10 mL) in 24 hours.

Children 2 to under 6 years of age: 2.5-5mg per day.

• Syrup: ½ teaspoonful (2.5 mL) once daily. If needed, dose can be increased to a maximum of 1 teaspoonful (5 mL), once daily, or ½ teaspoonful (2.5 mL) every 12 hours. Do not give more than 1 teaspoonful (5 mL) in 24 hours.
• Orally disintegrating tablets: ½ chewable tablet once daily. May increase to a full tablet for severe symptoms.

Children 6 months to 23 months: 1.25 – 2.5 mg/day

• Syrup: 1/4 teaspoonful (1.25 mL) once daily. If needed, dose can be increased to a maximum of ½ tsp (2.5 ml) once daily or ¼ tsp (1.25ml) twice/day. Do not give more than ½ teaspoon (2.5 ml) in 24 hours unless directed by a physician.

Diphenhydramine (Benadryl)

Safety Warning:

Diphenhydramine is not generally recommended due to the side effects and frequency of dosing required. The medications listed above are preferred. If it is used, the amounts listed in the table below can be given every 6 hours if needed.
When to Use Diphenhydramine: Treatment of allergic reactions, nasal allergies, hives and itching if long acting antihistamine is not available.

Table Notes:

• AGE LIMITS. For allergies, don't use under 1 year of age. For colds, not advised at any age. (Reason: no proven benefits). They should be not be given if under 4 years old. If under 6 years, don't give products with more than one ingredient in them. (Reason: FDA recommendations 10/2008).
• DOSE. Find the child's weight in the top row of the dose table. Look below the correct weight for the dose based on the product you have.
• MEASURE the DOSE. Syringes and droppers are more accurate than teaspoons. If possible, use the syringe or dropper that comes with the medicine. If not, you can get a med syringe at drug stores. If you use a teaspoon, it should be a measuring spoon. (Reason: regular spoons are not reliable.) Keep in mind 1 level teaspoon equals 5 mL and that ½ teaspoon equals 2.5 mL.
• ADULT DOSE. 50 mg
• HOW OFTEN. Repeat every 6 hours as needed.
• CHILDREN’S BENADRYL FASTMELTS. Each fastmelt tablet equals 12.5 mg. They are dosed the same as chewable tablets.

Nasal Sprays

Nasal sprays include saline (salt water), steroids, antihistamines, and decongestants.

To learn how to use nose sprays correctly, see How to Use Nose Sprays Correctly.

Saline

Nasal saline is commonly used to relieve dryness, help with nosebleeds, help loosen mucus, decrease swelling of the nasal passageways, and to help remove pollen. It can be used prior to medicated nasal sprays to improve the efficacy of the medication.

Saline is available as drops, sprays and irrigation systems. It is safe for all ages.

Infants generally tolerate drops best. Irrigation systems are most effective with proper use. See Nasopure for instructions.

Nasal steroids

Nasal steroids are the most effective medication for seasonal and perinnial (year round) allergy symptoms. They control the congestion more than any other medication.

Nasal steroids should be used daily and work best after at least a week of use. They can be combined with oral antihistamines.

Tables adapted from https://www.aaaai.org/Tools-for-the-Public/Drug-Guide/Nasal-Sprays

Nasal Antihistamines

Nasal antihistamines are an option to treat nasal itch. They do not help congestion and are generally not recommended as a primary treatment for allergies.