What to do when your allergy medicine stops working?

Key Points

• If your allergy medicine stops working, you might have a new allergy. A new environment, stress and using the wrong medicine can also cause problems.
• You might need a different treatment plan if your over-the-counter medicine stops working. Lifestyle changes can also help relieve symptoms.
• Prescription medication can sometimes help when over-the-counter medications aren’t enough to manage symptoms.

As we get deep into allergy season, sneezes and sniffles may have you reaching for a familiar bottle or box that’s always done right by you. But if it doesn’t stop the congestion and watery eyes?

Allergy medications stop working for many reasons. Sometimes, a change in environment introduces new triggers. Some people develop new triggers, which can require a different treatment approach. Or you might be using the wrong medicine for your symptoms.

If you’re suffering, read on for a medicine explainer, symptom-reduction tips and medication shifts.

And if you’re still not sure how to treat your environmental or seasonal allergies? Start a $15 online health consultation with Dr. B, and we’ll connect you with a licensed provider who can guide you through prescription allergy treatment options.

What causes allergies?

When your body detects a threat, the immune system starts releasing histamines. Histamines trigger all sorts of reactions to try to get the invader out—like sneezing, watery eyes and coughing.

Histamines also cause swelling (inflammation). Swelling is uncomfortable, but it can be helpful in some situations.

Swelling happens when blood vessel walls thin out. This allows special immune cells to move in and start doing repair work. For example, if a snake has bitten you, swelling allows your body to fight that poison and get it out of your system.

People with allergies have overactive immune systems. That means their bodies start producing histamines in response to everyday substances like pet dander or dust.

How do allergy medicines work?

Several types of medications treat allergies. Some can be purchased over the counter, and others require a prescription. Three of the most common types of allergy treatments include antihistamines, corticosteroids and decongestants.

• Antihistamines are medications that block—you guessed it—histamines. Blocking histamines stops the cycle of itching, sneezing, watery eyes, and coughing that can make you miserable. Diphenhydramine (Benadryl) and Cetirizine (Zyrtec) are types of antihistamines.
• Corticosteroids stop inflammation. Fluticasone is a corticosteroid found in many nasal sprays and inhalers.
• Decongestants help stop congestion in your nose or throat. Pseudoephedrine (Sudafed) is a type of decongestant. Some medicines combine decongestants and other allergy medicines to tackle symptoms from two sides.
• Allergy shots (immunotherapy) help your body slowly get used to an allergen so it doesn’t react so strongly.
• Epinephrine helps stop life-threatening allergy reactions. This comes as the “Epi-pen” many people with severe allergic reactions carry with them in anticipation of such an extreme reaction.

A licensed provider can help you decide which medicine is best for you.

What to do when allergy medicine doesn’t work

It can be super frustrating when an allergy medicine doesn’t work. It might mean you’ve developed a new allergy trigger or you may need a stronger medication.

You might also be using a medicine for too long. For example, if you take decongestants for too long, you can develop rebound congestion, which makes stuffiness worse.

It’s also important to take your medicine as prescribed. Some people stop taking their medicine when symptoms get better. But most allergy medicine is meant to be taken regularly, even if your symptoms improve. If you stop, symptoms can come back.

Smoking can also make allergies worse. And some kinds of alcohol contain histamines that can trigger symptoms, too. One study found that women who drank more than two glasses of wine a day almost doubled their risk of allergy symptoms.

How to get rid of allergy triggers

Here are some simple ways to avoid allergy triggers at home:

• Clean your house with a HEPA-filter vacuum
• Remove carpets where possible
• Change your HVAC system filter regularly
• Wear a mask while working in the yard
• Wash sheets in hot water
• Use a HEPA-filter air purifier in your bedroom

If you have a pet-related trigger, managing symptoms can be extra challenging. Try bathing your pet regularly to keep dander down. If possible, keep pets off furniture. At a minimum, keep them out of your bedroom.

Cat allergies can be extra tricky, though. Even if the pet is removed, it can take up to 20 weeks to get rid of cat dander. And some people aren’t willing to give up their pets (we get it!). In that case, something like immunotherapy might help.

How to manage long-term allergies

Avoiding triggers is the first step to managing chronic allergy symptoms. But if lifestyle changes and OTC medications aren’t cutting it, prescription medicines can provide allergy relief.

Azelastine and Cetirizine drops are used to treat itchy, watery eyes. Oral medications, including Cetirizine and Montelukast, may help reduce symptoms like sneezing and runny nose.

Allergy symptoms can really slow you down. If you’re suffering from chronic allergies, it’s important to talk to a medical expert who can help you manage your symptoms.

Dr. B offers convenient online allergy consultations to help you get the relief you need. After filling out a short health questionnaire, a licensed health provider will review your answers within three business hours. If appropriate, they’ll send a prescription to the pharmacy of your choice. It only takes a few minutes, and the cost is just $15—less than most copays!

Sources

Akhouri, S., et al. (2023). Allergic rhinitis. StatPearls Publishing.

Bendtsen P, et al. (2008). Alcohol consumption and the risk of self-reported perennial and seasonal allergic rhinitis in young adult women in a population-based cohort study. Clinical & Experimental Allergy.

​​Chen, L., et al. (2017). Inflammatory responses and inflammation-associated diseases in organs. Oncotarget.

Corren, J., et al. (2023). Effects of combination treatment with Tezepelumab and allergen immunotherapy on nasal responses to allergen: A randomized controlled trial. The Journal of Allergy and Clinical Immunology.

Farzam. K., et al. (2023). Antihistamines. StatPearls Publishing.

Wahid, N.W., et al. (2024). Rhinitis Medicamentosa. StatPearls Publishing.