Different people will find different products and combinations work for them. Additionally, your response to products can change from time-to-time. There are oral tablets, nasal sprays and eye drops available for relieving hayfever symptoms. I will discuss each seperately, but remember you can use them concurrently.
There are sedating and non-sedating oral antihistamines. You've tried two non-sedating antihistamines: loratadine (Claratyne) and fexofenadine (Telfast). Different oral antihistamines will work for different people, and there's no way to tell what will be best for you. Because response to oral antihistamines can change from time-to-time, it might be worth retrying loratadine or fexofenadine if you have any at home. Another non-sedating antihistamine that is available in Australia is cetirizine (Zyrtec).
In general sedating antihistamines are more effective than non-sedating ones and not everyone will be sedated by them. Given you have a range of symptoms a small dose (e.g. quarter to half a tablet) of a sedating antihistamine at night may be helpful. Taking it at night means that the sedation is less likely to be a problem (if at all), and you will be covered for the morning when your symptoms are worse.
If you find the oral antihistamines are not sufficient, you can add a nasal spray and/or eye drop to your regimen, depending on which symptom(s) continue to persist. The World Health Organisation recommends nasal corticosteroids as first-line therapy because of their confirmed efficacy, but it does take up to a week of regular use to achieve the optimum response.
Nasal decongestants can be used to treat symptoms quickly and are often used for immediate relief while waiting for nasal corticosteroids to take effect. NB: If nasal decongestants are used for a prolonged period they can cause 'rebound congestion'. Nasal antihistamines are well tolerated & have a rapid onset of action. Studies show they are comparable to oral antihistamines, but less effective than nasal corticosteroids.
Options for your eyes include antihistamines & mast cell stabilisers. Please note occular mast cell stabilisers can take 2 to 6 weeks to reach maximal response; thus they are often only used when you can predict well in advance that you are going to experience hayfever symptoms in the coming months. Occular antihistamines are effective, but be wary of those that include decongestants in the same preparation, as there is the possibility of rebound congestion if used for too long; and they can increase the blood pressure in your eyes.
As always, if you have multiple co-morbidities please speak to a pharmacist before commencing any new medications.
- Australian Medicines Handbook 2010
- Community Pharmacy: Symptoms, Diagnosis and Treatment, 2009