Which drugs can help?

In general, one must distinguish two groups of medications that can relieve hay fever: The first group mainly includes drugs in the form of nasal sprays, eye drops or inhalers. They relieve the acute symptoms with itching, sneezing, burning eyes or obstructed nasal breathing. The effect is limited to the mucosa directly wetted with the drug, leading to a reduction in swelling and possibly also to a locally reduced release of tissue hormones.

So-called sympathomimetics are contained as active ingredients. They have a vasoconstrictive effect in the mucous membranes, which leads to a reduction in swelling, and a bronchodilator effect in the lungs, which can facilitate breathing in acute cases.In principle, these drugs are the same as those used to treat a cold or asthma, but they are not effective against the allergy itself. Allergy-specific are locally and systemically applicable drugs such as antihistamines and mast cell stabilizers.

These two groups of active ingredients interrupt the reaction chain that takes place in the case of an allergy. Antihistamines prevent the release of the tissue hormone histamine, which leads to an inflammatory reaction with the typical symptoms. Mast cell stabilizers prevent the release of histamine from the cells themselves.

Their mechanism of action is therefore similar. They are used in the form of nasal sprays, tablets, drops or juices. Cortisone should only be used in cases of serious impairment.

It has an immunosuppressive effect and therefore hinders the ability of the immune system to eliminate the particles of grasses in the body that are recognized as foreign. However, the dangerous thing about this active ingredient is that it can also stop useful defensive reactions of the immune system with increasing doses.

On the one hand, there are drugs that only locally relieve the symptoms of hay fever.
On the other hand, there are drugs that address the cause of hay fever – the overreaction of the immune system

Antihistamines are preparations that are sometimes used to treat allergies.

Their effect on the hormone histamine relieves the allergy-specific symptoms. During an allergic reaction, cells of the immune system initiate an increased release of this hormone. The hormone itself in turn induces an inflammatory reaction, which should neutralize the allergen.

Normally this process is very useful to remove potentially dangerous foreign substances from the body or to render them harmless. This is because only through the inflammatory reaction do the required defence cells reach their place of action. In the case of an allergy, however, this reaction is exaggerated.

Antihistamines prevent the release of histamine by attaching themselves to the receptors for the hormone. In this way the hormone is released by the body, but can no longer trigger an inflammatory reaction. This is explained by the fact that its binding site is already occupied.

Well-known active ingredients of this group of preparations are cetirizine and loratidine. They are second generation active ingredients and thus further developed drugs with a lower side effect spectrum. The side effects can be manifold, whereby in the majority of cases a pronounced tiredness after taking antihistamines is complained about.

For the sake of completeness, it must be mentioned in conclusion that antihistamines, in addition to their allergy-specific effect, can also be used to treat nausea, as sleeping pills or to counteract increased stomach acid production. However, these preparations contain other active ingredients and are useless in the case of an allergy. Eye drops with an active ingredient from the group of antihistamines are used to relieve the symptoms of hay fever, including Livocab® eye drops.

Loratidine is another active ingredient of a second-generation anthistamine. It is currently only available in tablet form under the trade name Lorano. Like cetirizine, Loratidine promises to relieve allergic symptoms without many side effects such as fatigue.

Thus, it is an alternative in case of intolerance to the active ingredient of cetirizine. Cetirizine is a well known antihistamine, which is used especially for allergies like hay fever. In addition, it is also used for neurodermatitis, hives or itching.

It is available both in tablet form and as drops or juice. This enables a wide range of applications and makes it easy to dose even for children. Specifically, it is a second-generation antihistamine.

It is therefore a further developed preparation of this group of drugs. Its advantage is a lower spectrum of side effects. Above all, fatigue after taking the drug should be reduced.

Mast cell stabilizers are mainly used for the prophylaxis of allergies. This is due to the fact that they only develop their full effect after one to two weeks. If a sufficient level of the active ingredient is reached, they can reduce the symptoms of an allergic reaction.

They achieve their effect by stabilizing mast cells, as their name suggests.Mast cells are mainly found in tissue and contain a lot of histamine. If the immune system is activated in the course of an allergy, the mast cells release their histamine and initiate an inflammatory reaction. This helps the defense cells to reach their site of action and neutralize the allergen.

For mast cell stabilizers used against hay fever, this means that less histamine is released on contact with grasses in the area of the conjunctiva or nasal mucous membranes. Mast cell stabilizers can only be applied locally in the form of nasal sprays or eye drops. An application in capsule form is only effective against food allergies, but not against hay fever.

This limits the use of these preparations. However, a good effect has been observed in children. Known active ingredients of this group of drugs are cromoglicic acid and Nedocromil.

Cortisone is a drug that suppresses the immune system. In detail this means that it restricts the actual function of the immune system. In the context of an allergy, it thus prevents the immune system from further overreacting and leads to a decrease in symptoms.

Depending on the intensity of the symptoms, it can be given locally in solution form or systemically in the form of tablets or an injection. The application in syringe form works fastest and is therefore most effective in extreme cases. Leukotriene receptor antagonists are not normally a focal point in the treatment of hay fever.

Rather, they are used in asthma therapy. Their name already reveals their principle of action. The active ingredients of this group of drugs are in fact antagonists of leukotriene.

Leukotrienes are inflammation mediators, which lead to a narrowing of the bronchial tubes, especially in the respiratory tract. As active ingredients such as montelukast or zafirlukast act on the body’s own binding sites for leukotriene, the inflammation mediator can no longer cause symptoms. Thus, leukotriene receptor antagonists can only be considered in the treatment of hay fever if, in addition to characteristic symptoms such as reddened eyes and a runny nose, difficult breathing and shortness of breath occur.

The application then takes place in the form of an inhaler in order to bring the active substance directly to its site of action, the constricted bronchial tubes. These are drugs used for severe forms of hay fever, which include the form of allergic asthma. Bronchial asthma is in itself an inflammation of the bronchial tubes, which can be triggered by various factors.

However, the inflammation in the bronchial region is untypical of a commonly known hay fever allergy. This symptomatology then speaks for a severe course. You can find additional information on this topic at:

Medicines for asthma