Allergies and Oralair

Feb 4, 2013

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

I like cold weather. However, it is not helping my dog or son. Cold weather means neither Eric nor Sheldon get outside enough. My dog has turned into a collector. He collects shoes, hair brushes, toys, and whatever else he can find. He then chews them at the front door so we will see him and chase him. Eric has set a new record. He had two different teachers write us notes in his agenda on the same day. These werent good notes. They were notes saying he was having behavior issues, and being sneaky and causing disruptions in class. Im not saying Eric is an angel by any stretch, but two notes from two teachers in one day is new. I blame indoor recesses. I think without outdoor recess Eric doesnt burn off enough energy. Then we have trouble getting him to go to bed on time. Then the next day at school, we get behavior issues. Thank goodness for hockey twice a week. At least that tires him out so he will go to sleep on time. We are thinking fondly of spring and warmer temperatures at our house.


What do you think of when you think about spring? For many people spring time means allergies. When most people say allergies, they are probably talking about allergic rhinitis. That is when your nose runs, you sneeze, and your eyes get scratchy and red.


What can you do about allergic rhinitis? Well, if youve never had any of these symptoms before, get assessed by your doctor. They will want to rule out other illnesses, and possibly have you sent to a specialist to find out exactly what substances are your triggers. If you and your doctor are sure your problems are just allergies and the symptoms arent too severe, you can start with trigger avoidance and over the counter antihistamines.


To avoid your allergy triggers, you have to know what they are. Allergy testing can determine your triggers, and you can help yourself by keeping an allergy diary. In an allergy diary you list what you did and what you were exposed to and how your symptoms were in a given day. If it turns out you are allergic to pollen or outdoor molds try to remain inside during pollen season. Watch the pollen counts on the Weather Station and avoid outdoor activities on high pollen count days. Shower or bathe after outdoor activity to remove pollen from hair and skin and to prevent contamination of bedding. If you have indoor allergies like dust mites, then try to avoid carpeting. The less carpeting in the house, the better, especially the bedroom. A central vacuum system that exhausts outside is best, and the allergic person shouldnt even be in the home when the vacuuming is done, if possible. Encase all mattresses, box springs and pillows in zippered, allergen-proof casings. Keep indoor humidity under 50%.


Allergen avoidance isnt always possible or sometimes even desirable. While getting people to not smoke in the house is probably attainable, getting rid of the family cat is probably not. If the persons symptoms are not too severe, over the counter antihistamines can be effective. Oral antihistamines work best if they are taken before exposure to the allergy trigger and taken consistently. So if you suffer from spring fever due to pollens, you would start taking the antihistamine before the snow finished melting and take them daily for the first month or two of spring until the pollen count drops.


Antihistamines are divided into two major classes: the first and second generation. All are equally effective. The major differences between them are the side effects. First generation antihistamines like chlorpheniramine (Chlor-Tripilon), and diphenhydramine (Benadryl) can cause dry mouth, trouble passing urine, and drowsiness. They should be avoided in narrow-angle glaucoma, urinary problems, thyroid and heart problems. Second generation antihistamines like loratadine (Claritin), fexofenadine (Allegra), and cetirizine (Reactine) generally dont cause those side effects, especially not the drowsiness.


This year there will be a new option if your allergies include grass pollen. It is completely different than the antihistamines. It is called oralair and it contains extracts of five different grass pollens. The idea is that if we expose the immune system to small amounts of the allergen, it will get used to it. Then when the immune system sees the allergen, it wont overreact and cause allergy symptoms. So we say oralair desensitizes the immune system to grass pollen allergens. Oralair is indicated for patients between 5 and 50 years old who have had allergies for at least two pollen seasons. The patient will also have to get an allergy skin test to confirm the allergy to grass pollen before they are prescribed oralair.


Oralair are tablets that you dissolve under the tongue. A patient should start them 4 months before their allergy season and continue to take them throughout their whole allergy season. The company reports allergy sufferers should have 27% less symptoms during their first allergy season on oralair. Hopefully the patient will also need less antihistamines. The first treatment of oralair will be given in a doctors office and you will have to remain there for 30 minutes to make sure you dont have a severe allergic reaction. Side effects from oralair are reported to be mild such as mild allergy symptoms, minor mouth swelling or discomfort. However, please report any more serious reactions to your doctor immediately. Oralair shouldnt be used by people taking beta-blockers like metoprolol and propranolol. Finally, oralair is expensive. It will be more than $130 per month.


So heres to dreams of spring! Hopefully yours will be allergy free. Im just hoping for a little bit warmer weather so my dog and son can go outside. That way Sheldon will stop collecting and chewing on my daughters socks and shoes and Eric can stop being a thorn in the side of his teachers.




The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

As always if you have any questions or concerns about these or other products, ask your pharmacist.

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