Hay fever

Medical information

Written and reviewed by a team of doctors. Dr Fox is regulated by the CQC & GPhC.

Symptoms of hay fever

Symptoms of hay fever develop if the body is sensitive to pollen or dust. Symptoms usually affect:

• Eyes: itchy, sore, red.
• Nose: sneezing, blocked, watery.
• Throat: itchy.

Some people also get headache, earache, tiredness, sinus pains, and occasionally asthmatic wheeze, breathlessness, and cough can be triggered.

General information about hay fever at bottom of page.

Selecting hay fever treatment

Antihistamine tablets taken on their own or with eye drops and/or nasal sprays improve the symptoms of hay fever.

If you have just nasal or eye symptoms you could try nasal sprays or eye drops first, and then add antihistamine tablets on top if needed.

People's response to hay fever treatment varies greatly. One antihistamine, nose spray, or eye drop may work better for you than another. For this reason it is a good idea to try different hay fever treatments, or a new one if your existing one stops working.

For detailed information about each treatment - including cautions, how to take, and potential side effects - please read the manufacturer's patient information leaflets (links below).

Antihistamine tablets

Dr Fox provides a choice of cetirizine, loratadine, and fexofenadine (Telfast) antihistamine tablets.

How antihistamines work

Antihistamines work by blocking the inflammatory actions of histamine. They start to work within 30 minutes of being taken. The antihistamines we offer are all of the newer type, frequently called non-sedative.

Trying different tablets

Different people respond better to one antihistamine over another. It is therefore worth trying a different tablet if one doesn't seem to help or has stopped working.

Symptom control

In addition to preventing the sneezing, runny nose and the sore eyes of hay fever antihistamines can also be used for allergies to house dust, pets and to prevent and to treat the allergic skin reaction of hives.

Antihistamines side effects

Even with the newer antihistamines some people occasionally experience drowsiness as a side effect. If you feel sleepy with the tablets, then you should not drive or operate machinery. Other uncommon (1 in 100-1000) side effects which are usually not troublesome can include headache, dry mouth, difficulty passing urine, and blurred vision. For more details see the patient information leaflets (links below).

Nasal sprays

Steroid sprays: Beconase & Avamys

Beconase (beclometasone) aqueous and Avamys (fluticasone) contain steroid agents similar to hydrocortisone (often used to reduce skin inflammation). These steroid sprays control hay fever symptoms by reducing inflammation of the membranes inside the nose. Not to be used at the same time (concomitantly) as Dymista nasal spray.

Steroid sprays used regularly morning and night are effective in relieving the nasal symptoms of hay fever on a continuous basis. They start to work after 2-3 hours. They are therefore not for immediate relief of symptoms. Steroid sprays control symptoms only if they are used on a regular basis throughout the hay fever season. The odd spray now and then will not work. They should not be used continuously for more than 12 weeks.

Antihistamine spray: Rhinolast

Rhinolast contains the antihistamine azelastine. Rhinolast controls hay fever by stopping histamine from being released into the membranes inside the nose. For further details about each spray see the links below to manufacturer's patient information leaflet. NOT to be used at the same time (concomitantly) as Dymista nasal spray.

Rhinolast works within a few minutes of the spray being used. Symptom relief lasts about 12 hours. If hay fever is severe or has been present for many days Rhinolast will not immediately settle down inflammation that has built up. Used regularly morning and night, Rhinolast will provide continuous antihistamine action.

Steroid plus antihistamine spray: Dymista

Dymista combines two medicines in one treatment. It has a dual action. It contains a fast acting antihistamine called azelastine and a steroid called fluticasone.

Azelastine usually starts to work within 30 to 60 minutes. It takes a few days of regular use for the steroid part of the spray to reduce inflammation. Symptom control is likely to be fast and to improve over a few days providing Dymista is used regularly.

The antihistamine effect of Dymista wears off over 12 to 24 hours and the steroid effects usually wear off over a few days after use of the spray is stopped.

• Dymista should NOT be used with other nasal sprays for allergic rhinitis. These may contain the same or similar ingredients and you may get a double dose.
• Consult a doctor if allergic rhinitis symptoms are not controlled after using Dymista for 7 days.

Side effects of nasal sprays

Very little of the active ingredients of nasal sprays are absorbed into the body and as a result systemic side effects are minimal. There may be localised soreness and dry skin inside the nose and possibly taste disturbance.

Manufacturers recommend avoiding use of these sprays in pregnancy and whilst breastfeeding and also where there is known allergy or sensitivity to the ingredients.

Beconase, Avamys, and Dymista contain steroids which on rare occasions could damage the eye. Any vision problems or disturbances should be checked by an optician.

Eye drops

How eye drops work

Dr Fox supplies two different types of eye drop: Sodium cromoglicate which stops histamine release, and Optilast (azelastine) which blocks the inflammation caused by histamine.

One type of eye drop may work better for you than another. It can be useful to try different drops. It is advisable to use only one type of eye drop at a time but in severe cases both can safely be used together.

Using drops

Eye drops are effective if used prior to dust and pollen exposure or for control of symptoms once they have started. The drops will be most effective if used regularly throughout the hay fever season, although they can be used on an 'as required' basis.

Side effects

Very little of the active agents are absorbed into the body. Systemic side effects are unlikely. There may be short lived blurring of vision when drops are applied. Sensitivity reactions can lead to soreness and irritation in and around the eye. This is unusual.

For further details about each product see the links below to manufacturer's product leaflets.

Dr Fox supplies medication for hay fever on prescription – you are required to answer a short medical questionnaire before your order can be completed.

Product leaflets

Hay fever - general information

How a hay fever attack happens

Hay fever symptoms arise where the body is sensitive to pollen or dust. This sensitivity results in the release of histamine which in turn causes inflammation. The runny nose, sneezing, and sore eyes of hay fever are a result of this. The histamine comes from cells that normally fight infection. In hay fever these cells become abnormally sensitised to pollen, and so they release histamine and cause symptoms, when pollen levels rise.

Hay fever is usually treated with medication which prevents histamine release or prevents the inflammation caused by histamine. Other ways to prevent hay fever include avoiding pollen and dust, and in some cases, undergoing treatments aimed at desensitising the body.

Preventing hay fever

It is difficult to avoid pollen but it may be possible to reduce exposure.

• Use vaseline around your nostrils. This can trap pollen and stop it getting into your nose.
• Avoid grass cutting and places where pollen counts are high.
• Vacuum regularly.
• Keep pets out of the house during the hay fever season.
• Stay indoors when pollen counts are high. You can check the pollen forecast on the or there are many helpful apps available.
• Keep windows and doors closed.
• Wrap around sunglasses reduce pollen contacting the eyes.
• Shower after going outside.

Further information about hay fever

• NHS - Hay fever
• Allergy UK - Hay Fever (Allergic Rhinitis)

Raised dementia risk media scare

Dr Fox pharmacy supplies newer non-sedative antihistamines for hay fever which are of a different type to those that raised concern in a January 2015 US study.
Further information

Authored 12 July 2010 by Dr Tony Steele
MB ChB Sheffield University 1983. Former hospital doctor and GP.

Reviewed by Dr A. Wood, Dr B. Babor, Dr P. Hunt
Last reviewed 11 November 2020
Last updated 28 November 2020

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