Expert: Understanding OTC Allergy Medications and Symptom Management

In an interview with Pharmacy Times^®, Jennifer Guthrie, RPh, district leader at CVS Pharmacy, discusses the 3 main OTC products for seasonal allergies: antihistamines, corticosteroids, and decongestants. Additionally, she differentiates allergies from colds and respiratory infections based on symptoms and duration. Guthrie highlights CVS by describing how pharmacists can provide counseling, OTC medications, and access to other health care professionals, emphasizing proactive care and personalized service to improve patient outcomes.

Pharmacy Times: Can you introduce yourself?

Jennifer Guthrie, RPh: Sure, my name is Jennifer Guthrie; I am a pharmacist and district leader with CVS Health.

Pharmacy Times: What are the different classes of OTC seasonal allergy medications, and what are their mechanisms of action?

Guthrie: Really, there's 3 main classes of OTC products for seasonal allergies: antihistamines, corticosteroids, and decongestants. So, starting with antihistamines, essentially, those guys really do what their name indicates. They block the actions of histamine, which is a chemical created by our immune systems that really overreacts to an allergen—such as pet dander or, this time of year, the spring pollen—so, they typically cause symptoms such as sneezing, coughing, itchy [and] watery eyes, runny nose.

Decongestants, they're really used to support the relief of nasal and sinus congestion by vasoconstriction, which is really just the narrowing of the sinus passages. So, that really leads to a decrease in mucosal production, swelling, fluid accumulation, thereby really alleviating those symptoms that come with that as well.

And then, corticosteroids, I'd say specifically, nasal corticosteroids really help to relieve allergy symptoms, specifically inflammation, right? So, the nasal sprays within that corticosteroid line really help to prevent stuffiness, sneezing, and runny nose as well.

Pharmacy Times: Are there nonpharmacological strategies patients can practice to minimize their allergy symptoms?

Guthrie: Definitely. So, I would probably mention to start out with rinsing your nasal passages with a saline spray, that also helps to remove the allergen from your airways, within your nose. There's also a salt within that saline solution, so that can really work as a drying agent to reduce some of that moisture within your nasal passages as well. And there's also saline eye drops, essentially doing the same thing for your eyes, really rinsing them from those allergens, too.

Pharmacy Times: How do you differentiate between seasonal allergies and other respiratory infections? Are there key distinguishing factors?

Guthrie: I would say, really, seasonal allergies can be differentiated between from cold or respiratory infections, really, from the way the symptoms present and the symptom patterns. So, with allergies, you typically have watery, itchy eyes, essentially...we typically don't have a fever with allergies, we have more of a clear nasal discharge. They persist as long as…the allergen is present. So, again, springtime, you know, we have a lot of pollen, so those allergies are going to persist as long as those pollen levels are high.

Colds really...more develop gradually, I would say, they usually resolve themselves within a week or so. Some of the nasal discharge with colds can be a little bit thicker, and sometimes there are some mild fatigue. With respiratory infections, they really often include that fever, they present with a fever, those body aches, and more of that thicker, elevated nasal discharge So, [those are] just a few [ways] to differentiate between the 3 of those.

Pharmacy Times: What is the pharmacist’s role in seasonal allergy management?

Guthrie: At CVS pharmacy, our pharmacists really can help our patients [with] all the varieties of seasonal allergy needs, from providing counseling and advice to our patients and our customers experiencing allergy symptoms, offering the variety of OTC medications that we have available, and really just increasing access to medical providers as well, you know, being that bridge to that gap of access for that personalized treatment.

Pharmacy Times: Does CVS have anything unique to offer in this space?

Guthrie: Definitely, I would say I would really hit on proactivity, right? So, our pharmacists play an incredibly proactive role in seasonal allergy management [by] being super accessible for the patients within our communities, to walk right into our stores and be able to speak to somebody directly, easily. So, you know, it's being able to be that offer in that space within our communities is huge. We're dispensing medications, as our pharmacists do within our stores at CVS, but we're also counseling patients on OTC medications. [We're] also identifying, maybe [patients] may need further evaluation from a provide, and then we can use tools like our Minute Clinic Pathways and our health care platforms digitally to assist in in allowing those patients to be seen by further medical evaluator treatment.

Really, to sum it up, I would say we really take pride in our ability to offer that personalized service. You know, that 1-on-1 friendly patient interaction, [being] easily accessible, really seeing it as an opportunity to build relationships, improve outcomes, really through education and convenience.

Pharmacy Times: Any final or closing thoughts?

Guthrie: I would just again reiterate that we at CVS emphasize that patient-centered approach, right? Giving our pharmacists a unique opportunity to build trust, guide patient outcomes, and really be able to do that in an all in 1 convenient setting.