Oxnard - Port Hueneme Optometry Dr. Don Steensma 465 W. Channel Islands Blvd, Port Hueneme, CA 93041 805/486-3585
OTC eye medications
Prescription allergy medications work better than non-prescription (OTC) medications, but in many cases an OTC medication may be adequate. Over-the-counter allergy medications include topical decongestants, oral antihistamines, topical antihistamine/mast-cell stabilizer combinations and topical decongestant/antihistamine combinations.
• Topical decongestants reduce ocular injection and edema. Topical decongestants are prescribed up to four times daily, typically work within minutes and last about two hours. Chronic use of vasoconstrictors can lead to toxic, follicular reactions and or contact dermatitis. These medications are usually reserved for acute reactions and should only be used occasionally. If used frequently they lead to a rebound effect in which less and less relief is achieved and the eyes become more irritated. In rare cases they can cause glaucoma, a potential cause of blindness.
Refresh Redness Relief ® (phenylephrine HCl 0.12%, Allergan)
Visine ® (tetrahydrozoline HCl 0.05%, McNeil)
Visine L.R. ® (oxymetazoline HCL 0.25%, McNeil)
Clear Eyes ® (naphazoline HCl 0.12%, Prestige Brands).
• Oral antihistamines are helpful with eye allergic sumptoms and a concurrent allergic rhinitis, but these drugs have a superficial drying effect on the ocular surface.
Benadryl ® (diphenhydramine, McNeil)
Chlor-Trimeton ® (chlorpheniramine, Schering-Plough)
Claritin ® (loratadine, Schering-Plough). < This is the one that I prefer in this catagory
These third-generation antihistamines are generally well tolerated and non-sedating.
• Topical antihistamine/mast-cell stabilizer combinations are all different brands with the same active ingredient, ketotifen 0.025%.
These medications work faster than oral antihistamines at relieving ocular symptoms. The antihistamine quickly relieves itching and the mast-cell stabilizer prevents itching for an extended period of time, usually 12 hours. Dosing is twice a day.
Alaway ® (Bausch + Lomb) < This is the one that I prefer in this catagory (The bottle is twice as big for about the same cost.)
Claritin Eye ® (Schering-Plough)
Refresh Eye Itch Relief ® (Allergan)
Visine All Day Itch Relief ®(McNeil)
Zaditor ® (Novartis).
• Topical decongestant/antihistamine combinations include both decongestants and antihistamines. The dosing is up to four times a day during acute symptoms. Chronic use of decongestants can lead to toxic, follicular reactions and or contact dermatitis. These medications are usually reserved for acute reactions and should only be used occasionally. If used frequently they lead to a rebound effect in which less and less relief is achieved and the eyes become more irritated. In rare cases they can cause glaucoma, a potential cause of blindness.
Opcon-A ® (naphazoline HCl 0.03%/pheniramine maleate 0.32%, Bausch + Lomb)
Naphcon-A ® (naphazoline HCl 0.025%/pheniramine maleate 0.3%, Alcon)
Visine-A ® (naphazoline HCl 0.025%/pheniramine maleate 0.3%, McNeil).
When OTC medications do not provide adequate relief, prescription medications are used. Prescription allergy medications include topical mast cell stabilizers, antihistamines, combination antihistamine/mast-cell stabilizers and mild steroids.
• Topical mast-cell stabilizers block the first step in the allergic cascade. They are used for chronic mild itching such as in perennial allergic conjunctivitis. The dosing is up to four times daily during acute symptoms. I think that an antihistamine/mast cell stabilizer is much more effective than a pure mast cell stabilizer, so I do not use this type of medication.
Alamast ® (pemiroloast 0.1%, Vistakon Pharmaceuticals)
Alocril ® (nedocromil 2.0%, Allergan)
Alomide ® (lodoxamide 0.1%, Alcon)
Crolom ® (cromolyn 4.0%, Bausch + Lomb)
• Topical antihistamines block histamine receptors in the conjunctiva and eyelids. This type of medication is used for short-term, acute symptoms of itching.
Emadine ® (emedastine 0.05%, Alcon),
• Topical combination antihistamine/mast-cell stabilitizers are the preferred medications for chronic recurrent episodes of allergic conjunctivitis. This is generally defined as more than two episodes per month. The advantage of these combination medications is the quick onset of relief and the long-lasting effect of reducing redness, tearing and burning. These medications are usually prescribed two times daily (Pataday is once a day) for relief of symptoms. These medicines may be used up to four times a day for severely symptomatic patients.
Bepreve ® (bepotastine 1.5%, ISTA)
Elestat (epinastine ® HCl 0.05%, Allergan)
Patanol ® (olopatadine 0.1%, Alcon)
Pataday ®(olopatadine 0.2%, Alcon)
Optivar ® (azelastine 0.05%, Meda)
Lastacaft ® (alcaftadine ophthalmic solution 0.25%, Allergan) < This is the one that I prefer in this catagory
• Mild steroids are used with severely symptomatic patients.In severe cases a mild steroid is also used short term with the long term combination antihistamine/mast-cell stabilitizers to decrease inflammation. Long term use of steroids can cause serious complications,
Lotemax ® (lotepredol 0.5%, Bausch + Lomb)
Alrex ® (lotepredol 0.2%, Bausch + Lomb)