By Karen L. Kier
Pharmacist on behalf of the ONU Healthwise Team 

A recent commercial uses the saying “it’s faster bro” to promote an over the counter product for seasonal allergy symptoms. There has been negative feedback about the commercial on social media because of the phrase. Did you know the term “bro” dates back to the 1830s-1840s as an abbreviation for brother? Only in the last decade did bro become a slang term for a male friend.  

When it comes to allergy symptom relief, is the advertised Astepro® Allergy nasal spray really faster bro?

The short answer is yes! It has a faster onset of action in relieving allergy symptoms. However, there is more to the story. 

There are five common categories to treat and/or prevent allergies including prescription and over the counter drugs. These categories include antihistamines, decongestants, corticosteroids, mast cell stabilizers and leukotriene inhibitors.  

Montelukast (Singular®), a leukotriene inhibitor, is prescription only and has a major warning for potential mental health effects. The FDA warning contains language to reserve this medication for when other drugs may fail to manage symptoms. 

The decongestant category includes oral and nasal spray products. These agents do not suppress the reaction to the allergen, but treat congestion or a runny nose.  The decongestants dry up and relieve pressure. They should not be used longer than three days. The most common agents in this group are pseudoephedrine (Sudafed®) and oxymetazoline (Afrin®).  

The mast cell stabilizing group includes over the counter cromolyn sodium known as NasalCrom®. This product takes 1-2 weeks to see the beneficial effects of blocking allergy symptoms. This is a maintenance medication taken daily to prevent allergies. It works very effectively, but needs to be started a few weeks before major allergy season.  

The corticosteroids include over the counter fluticasone (Flonase®), triamcinolone (Nasacort®), mometasone (NasonexTM), and budesonide (Rhinocort®). These agents are beneficial in blocking allergy symptoms before they start. They take 3-4 days of daily use to see an effect and need to be started at least a week before allergy season.  

In individuals who have seasonal allergies and know their triggers or when their season starts, using either a nasal corticosteroid nasal or a mast cell stabilizer is considered the best way to control allergies. Evidence from studies and national guidelines recommend using a corticosteroid nasal spray as first-line therapy in managing and preventing allergy symptoms.  

Where mast cell stabilizers and corticosteroids help prevent allergy symptoms from occurring, the antihistamine group can be used to prevent symptoms and manage allergic reactions once they occur. When an allergen enters the body, it causes histamine release and this results in the sneezing, runny nose, sleepiness, and eye watering. The antihistamines block histamine release and manage symptoms already occurring. 

Azelastine (Astepro® Allergy) is an over the counter nasal antihistamine for managing symptoms. It indeed is faster, resulting in a benefit in about 2 hours from administration. This is faster than the oral second-generation antihistamines such as loratadine (Claritin®), fexofenadine (Allegra®), cetirizine (Zyrtec®) and levocetirizine (Xyzal®). The second-generation antihistamines do not cause as much drowsiness as the first-generation antihistamines such as diphenhydramine (Benadryl®).  Cetirizine and levocetirizine cause more drowsiness than fexofenadine or loratadine.  

Azelastine nasal spray is absorbed into the bloodstream and can cause drowsiness, headache and a bitter taste.  The usual dose is two sprays into each nostril once daily or every 12 hours. It is indeed faster than the oral antihistamines, but it could have more drowsiness than with some of the oral agents. 

The important takeaway is although it is faster, it is not the recommended first-line agent to prevent allergy symptoms. Talk to your pharmacist for advice on allergy management. 

Get advice, bro!

Contact ONU HealthWise Pharmacy (419-772-3784) for more information. ONU Healthwise is offering flu and COVID-19 vaccines. Vaccine clinics occur Monday - Friday from 4:00 - 6:00 p.m.

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