Helps prevent and relieve allergy symptoms
Pharmacists can be essential resources for patients seeking advice on the selection and use of over-the-counter medications.
In a few weeks, students and teachers across the country will start returning to class to start a new school year.
Although back to school is exciting, people returning to class who are prone to allergies often face many challenges. Symptoms come in varying degrees of severity and often negatively affect an individual’s quality of life by causing fatigue and sleep disturbances and impairing concentration. Allergy symptoms also often contribute to absences from school and work and loss of productivity.
For people who suffer from seasonal allergies, finding relief from common symptoms, such as headaches, itching and watery eyes, nasal congestion, and repetitive sneezing, is a top priority. Unfortunately, choosing an over-the-counter allergy product can be overwhelming, especially for people with other health conditions and / or taking other medications. Pharmacists can play a critical role in guiding patients in the selection and appropriate use of over-the-counter allergy products and in referring them to additional medical care when warranted. Before starting pharmacological treatment, the patient’s medical and drug history should be carefully evaluated to determine whether self-treatment is appropriate and to prevent contraindications and drug interactions.
During this time of year, ragweed pollen is responsible for most of the symptoms associated with fall allergies.1-4 With 17 species of ragweed pollen, peak concentrations typically occur in mid-September, affecting about 23 million individuals in the United States.2
Almost 75% of people allergic to spring plants also have allergic reactions to ragweed.1-3 Ragweed pollen can also worsen asthma symptoms, which can lead to coughing and wheezing.2 Other plant allergens that trigger allergy symptoms in the fall can include mugwort, mugwort, and tumbleweed.
Dust mites and molds are other possible causes of allergy symptoms in the fall.2.4.5
Additionally, the American College of Allergy, Asthma, & Immunology (ACAAI) reports that some students experience allergy symptoms in the fall due to exposure to allergens in the classroom, such as chalk dust and the domestic animals.6
A study published in Annals of Allergy, Asthma & Immunology, the scientific journal of the ACAAI, found that 75% of adults with asthma aged 20 to 40 and 65% of adults with asthma aged 55 and over have at least 1 allergy. .7
OTC products available for self-treatment and prevention of mild to moderate allergy symptoms include intranasal corticosteroids (INCS), mast cell stabilizers, eye and oral antihistamines, and oral and topical decongestants. INCS has been shown to be the most effective treatment for most symptoms associated with allergic rhinitis.8 Pharmacists can also help recommend convenient and easy-to-use dosage forms, such as long-acting, once-daily formulations and / or orally disintegrating tablets, especially for pediatric patients.
In June, the FDA approved Azelastine Hydrochloride 0.15% Nasal Spray (Astepro Allergy; Bayer) as an over-the-counter product for the temporary relief of itchy nose, nasal congestion, runny nose nasal and sneezing associated with upper respiratory allergies such as hay fever.9 Its recent approval makes it the first non-steroidal antihistamine nasal spray for indoor and outdoor allergies available over the counter in the United States.
OTC Astepro Allergy is indicated in patients 6 years of age and older.9 Each nasal spray delivers a volume of 0.137 ml solution containing 205.5
g of azelastine hydrochloride. The product can be administered as a dosage regimen once or twice a day. The OTC formulation includes a flexible dosage that provides up to 24 hours of relief from itchy nose, nasal congestion, runny nose and sneezing caused by indoor and outdoor allergies.
Due to the risk of drowsiness associated with the use of azelastine, the Astepro Allergy label warns consumers to avoid alcoholic beverages and to be careful while driving a motor vehicle or operating machinery.9 Additionally, consumers should avoid sedatives or tranquilizers when using the product.
The 0.15% strength is approved for over-the-counter use, but the 0.1% strength will remain by prescription for perennial and seasonal allergic rhinitis. The manufacturer expects Astepro Allergy to be available in nationwide retail stores in the first quarter of 2022.9
Role of the pharmacist
Pharmacists can help patients with allergic symptoms in the selection and proper use of over-the-counter products. They can also provide patients with key information on the most effective non-pharmacological and pharmacological measures to prevent or reduce allergy symptoms. Masks have been used to reduce the transmission of COVID-19, but some study results have shown that masks can also be helpful in reducing allergy symptoms.
During counseling, patients should be advised to use over-the-counter products as recommended and to be aware of potential side effects.
Patients with severe allergy symptoms should be encouraged to seek additional care from their primary health care provider. They can also make recommendations on patient education resources that teach patients about back-to-school allergy plans such as the Allergy & Asthma Network website (https://allergyasthmanetwork.org/health-az / covid-19 / covid-19-school -resources-for-managing-asthma-and-allergies /) and the ACAAI website (https://www.aaaai.org/tools-for-the-public / conditions-library / asthma / back-to-school-with -allergies-et-asthma).
- Asthma and Allergy Foundation of America. Allergy capitals. Fall 2018. Accessed July 25, 2021. https://www.aafa.org/media/2183/AAFA-2018-Fall-Allergy-Capitals-Report.pdf
- Ragweed allergy. American College of Allergy, Asthma and Immunology. Updated April 23, 2018. Accessed July 25, 2021. https://acaai.org/allergies/types/ragweed-allergy
- Nall R. Ragweed allergy: what it is and foods to avoid. Medical news today. April 13, 2018. Accessed July 25, 2021. https://www.medicalnewstoday.com/articles/321490.php
- More D. What to expect during the fall allergy season. Very good Health. September 30, 2020. Accessed July 25, 2021. https://www.verywellhealth.com/fall-allergies-83184
- Mold allergy. American Academy of Allergy, Asthma and Immunology. Accessed July 25, 2021. https://www.aaaai.org/conditions-and-treatments/allergies/mold-allergy
- Four things you might not know about fall allergies. American College of Allergy, Asthma, and Immunology. Accessed July 25, 2021. https://acaai.org/news/four-things-you-might-not-know-about-fall-allergies
- Busse PJ, Cohn RD, Salo PM, Zeldin DC. Characteristics of allergic sensitization in adults with asthma over 55 years of age: results from the National Health and Nutrition Survey, 2005-2006. Ann Allergy Asthma Immunol. 2013; 110 (4): 247-252. doi: 10.1016 / j.anai.2013.01.016
- Scolaro K. Common cold and allergy disorders. In: Krinsky D, Berardi R, Ferreri S, et al. Manual of Over-the-Counter Drugs. 19th ed. American Association of Pharmacists; 2018.
- The FDA approves Astepro Allergy nasal spray for over-the-counter use in the United States. Press release. Bayer. June 17, 2021. Accessed June 17, 2021. https://www.businesswire.com/news/home/20210617005872/en/FDA-Approves-Astepro%C2%AE-Allergy-Nasal-Spray-for-Over-the – Counter-use-in the United States