DaytonDailyNews.com

For allergy symptoms, the safe and effective drug requires a prescription while the riskiest and least effective is available for the asking.

"People should use the steroid nasal sprays before they use decongestants," said Dr. Dawn Zacharias, of the Allergy & Asthma Centre of Dayton. "It's the only thing that can relieve all the symptoms, from itchy and runny nose to congestion and post-nasal drip."

Prescription-free decongestant pills can help "a lot of patients," she said, but are dangerous for others. Increased blood pressure, pulse and sleeplessness are the most common side effects, but others range from urinary dysfunction to delirium.

"There are folks taking decongestants who are better-advised not to, so they should always be discussed with your physician," said Dr. William Parker of Allergy and Asthma Associates.

The first medicine to try is an antihistamine, both allergists said. It's relatively cheap, safe and effective for relieving runny and itchy noses and eyes.

But even before that, Zacharias said, "the avoidance measures are at the top of the list of what people should be doing."

Those tips aren't always practical in the real world, where people must maintain lawns and leave home for work, Zacharias said, but two are less onerous.

• Use air conditioning, she said. "Although it's real tempting to open up the window and enjoy the fresh, spring air, you're letting in the pollen, too."

• Kids, especially, should change clothes after being outside for a while and even shower. "Otherwise they're carrying that pollen around all day."

As another alternative to medicine, Parker said, "We probably don't use enough nasal saline solutions. It can have a mild decongestant effect and it rinses the nose and removes some pollen or mold spores."

Parker expects a lot of pollen floating into noses this spring. The warm March weather jump-started production, and alternating rainy days have kept it circulating.

"Rain keeps the levels down, but plants require rain to produce the pollen," he said. "Then dispersion requires drier, windier conditions. So when we get dry, windy days following a spell of rain, that's a bad combination for pollen and mold allergies."

Contact this reporter at (937) 225-2129 or klamb@DaytonDailyNews.com.

Allergy medications Antihistamines:

Inhibit the release of histamine, an immune-system response to an allergen, which causes symptoms by enlarging blood vessels and causing redness, swelling, itching and increased fluid in the nose, eyes, sinuses and skin.

Nasal steroids:

(Flonase) Decrease inflammation caused by histamine and other immune-system chemicals, relieving congestion along with itches and excess fluids. Steroid sprays require daily use.

Decongestant pills:

(Often signified by "D" at end of brand name, as in prescription Zyrtec-D) Constrict blood vessels, shrinking tissues and opening up airways. Mostly nonprescription, but doctor should advise about drug interactions and multiple side effects.

Decongestant nasal sprays:

(Afrin) Safer than pills because they affect only nose and sinuses, but using them more than three to five days can cause chronic congestion.

Saline nasal sprays:

(Ocean) Clean and lubricate nose and sinuses without drugs.