Patient Information Leaflet : Treating your Hayfever with over-the- counter medicines

The attached leaflet contains some basic information about hayfever and how you can treat it yourself using over the counter (OTC) medicines.

Hayfever is an allergic reaction to pollen. It can start at any age and at any time in your life and lasts for weeks or months, unlike a cold which goes away after 1-2 weeks.

Symptoms are usually worse between late March and September especially when it’s warm, humid and windy. This is when the pollen count is at its highest.

It is best to start using medicines such as nasal sprays or tablets before your symptoms start.

Symptoms include:

Sneezing and coughing
A runny or blocked nose
Red, itchy, watery eyes
Itchy throat, mouth, nose and ears
Headaches and sinus pain
Feeling tired

Your local community pharmacy can help with hayfever

Prescriptions are not routinely provided for treating mild to moderate symptoms of hayfever, but you can buy medicines for adults and children to help with the symptoms. A wide range of medicines can be purchased from community pharmacies and supermarkets without seeing a doctor. These medicines are often cheaper than medicines on prescription.

Your pharmacist can give you advice and suggest treatments to help with your symptoms. These include:

antihistamine tablets or liquids
nasal drops or sprays e.g. antihistamine, decongestant or steroid preparations
eye drops
simple pain relief (paracetamol or ibuprofen) for headaches and sinus pain
salt water nasal sprays/ nasal douching

For general hayfever symptoms such as sneezing, itchy throat, coughing, you can use antihistamine tablets, capsules or liquid. Loratadine and cetirizine are available both as tablets and as liquid (syrup) and are taken usually once a day for those aged 12 yrs and over, or twice a day for younger children (see table on the next page for age ranges). Fexofenadine tablets, in some strengths are also available. Acrivastine is available as a capsule and can be taken up to three times a day. The above antihistamines are referred to as “second generation” antihistamines as they are less likely to cause drowsiness than older antihistamines.

Chlorphenamine is available as a tablet and a liquid and is taken up to four times a day. It may cause drowsiness.

Do not take two antihistamines together unless recommended by your doctor.

For nasal symptoms – such as runny nose, sneezing and congestion –those aged 18yrs and over may use a steroid nasal spray. This works by reducing inflammation in the nose and helps control allergic symptoms associated with hayfever. This will not produce immediate relief and can take 23 weeks of regular use before full benefit is seen. For best results start using the spray 2-3 weeks before the likely onset of symptoms and make sure you use it every day. A pharmacist can check your technique to help make sure you are using it correctly.

A steroid nasal spray can also ease eye symptoms. Beclometasone, budesonide, fluticasone, mometasone and triamcinolone are steroid nasal sprays available to purchase over the counter for adults only (18 years and above). These sprays should be discarded three months after first opening.

Saltwater nasal sprays may also help. The aim of saltwater sprays is to wash pollen out of the nostrils. This can sometimes help to reduce the need for steroid nasal sprays.

For eye symptoms i.e., red watery itchy eyes – use eye drops. Eye drops containing sodium cromoglycate can stop the release of histamine from cells to stop the watering and provide relief from itchiness. The drops need to be used regularly in both eyes to prevent symptoms. Sometimes they can make the vision blurry when first put in the eyes, but this will clear. Sodium cromoglycate eye drops can be used throughout the hayfever season if needed. Check how long the product can be used after the bottle has been opened. In many cases the eye drops need to be discarded 4 weeks after opening to reduce the risk of infection.

Frequently asked questions

My symptoms are not controlled

If your hayfever symptoms are not controlled after 2-4 weeks, you may need to try a different treatment or add another treatment. Some trial and error may be required to find the best combination of tablet/nasal spray/eye drops to suit you.

How long do I need to take hayfever medication for?

If you are taking hayfever medication regularly and your hayfever is well controlled on your current treatment, continue this treatment until the end of the pollen season.

When should I seek further advice from my GP?

In the first instance speak to your community pharmacist to ensure you have explored all suitable options. Seek advice from your GP if:

your child is under 2 years of age
you are pregnant or breastfeeding
symptoms do not improve after using different types of over the counter medicines or if you are experiencing troublesome side effects caused by the medication.
If the pattern of your symptoms is unusual, such as occurring during the winter or only at your workplace. It is likely that a substance other than pollen is responsible and further testing may be required to confirm this.
Symptoms include wheezing, shortness of breath or worsening of asthma