OTC counseling - antihistamines

Patient arrived at pharmacy seeking OTC recommendation for allergies. Patient had tried Allegra (fexofenadine) for 7 years before and then it stopped working after her surgery so she switched to Claritin (loratidine) which worked well and then stopped working as well.  She wanted to know if she should switch back to Allegra or try something else.

We confirmed that the patient does not have closed angle glaucoma because antihistamines dilate the pupil and causes angle closures.  We recommended that the patient try Zyrtec (cetirizine) 14 day box to see if it helps her symptoms of drainage and sinus pressure.  Allegra, Claritin, and Zyrtec are less sedating antihistamines. We also recommended nasal corticosteroids (Nasacort, Flonase) as an add therapy on if relief with Zyrtec was inadequate.