Common Conditions

Hayfever is a condition that occurs seasonally, typically in spring. Symptoms can be similar to a cold. You may also have an itchy nose, roof of the mouth or eyes, sneezing, a blocked or runny nose, a sore or tickly throat and/or red or watery eyes. The medical term for hayfever is seasonal or intermittent allergic rhinitis. People who suffer from similar symptoms all year round are said to have persistent allergic rhinitis, which is not hayfever, although it may be treated in a similar way.

Hayfever is mostly associated with triggers or allergens, such as pollens, grasses, moulds, or fungal spores. Symptoms usually appear when there are levels of these allergens around, which may be in spring, in the morning or evening, or in hot, humid, or windy weather. Symptoms may get worse as the season goes on.

People who have suffered from allergies, asthma or eczema in the past, or who have a family member with one of these conditions, are more prone to hayfever. It commonly occurs in children and teenagers, but tends to improve with age.

Hayfever can be troublesome enough to interfere with sleep, work or learning, and for this reason, it is important to try and prevent and treat this condition.

If you have other medical conditions, take regular medication for any reason, are elderly or frail, or if the person with hayfever is a young child, you should always talk to a pharmacist. Also talk to a pharmacist if:

• you have shortness of breath, coughing or wheezing – this could be asthma
• you have swollen glands, a fever and/or a persistent headache – you may have an infection
• you have yellow discharge coming from your eyes or nose, or a bloody nose
• only one side of your nose or one eye is affected
• your ears or sinuses – around your cheekbones – are painful
• your symptoms seem to occur all year round
• you are pregnant or breastfeeding – some hayfever medicines may not be suitable
• you have allergies to any medicines
• hayfever medicines do not seem to work after five days.

• try to identify activities or allergens that seem to bring on your hayfever or make it worse
• avoid or limit exposure to these activities or allergens if possible
• avoid grassy areas (especially if the grass has just been cut) and try to stay indoors when pollen counts are high. Keep windows and doors closed 
• wear sunglasses (the wrap-around variety are best) when going outside can help keep pollen out of your eyes
• consider wearing a mask or scarf around the nose or face if pollen-abundant areas can't be avoided
• wash your hands and face, and also wipe pets down with a damp cloth after being outside (this can remove pollen or grasses attached to your skin or your pet's fur)
• start treatment early – especially if you know you will be exposed to triggers
• if you are using a corticosteroid nasal spray, remember to use it regularly since the maximum relief may not be obtained for several days
• if you have eye and nasal symptoms, controlling nasal symptoms often improves the eye symptoms.

There are two main types of medicines to treat hayfever:

• medicines that treat or prevent an allergic reaction, such as corticosteroid nasal sprays and antihistamines
• medicines, such as decongestants, that relieve the symptoms rather than treat the allergic reaction.

It is better to treat or prevent the allergic reaction, so the treatment choice depends on what your main symptoms are, when they happen and how severe they are.

Some medicines need to be taken before you have symptoms and be used regularly to be effective.

There are also many tablet and syrup products available that combine an antihistamine with a decongestant, and sometimes a pain reliever as well.

Some combination options are included in this information but there are many more available. Your pharmacist can tell you if one may be suitable.

Always discuss treatment options with your pharmacist to ensure the best outcome.

Nasal corticosteroid sprays

[PHARMACY ONLY]
eg, Alanase, Beconase Allergy and Hayfever, Flixonase Hayfever and Allergy, Telnase

• nasal corticosteroid sprays work by suppressing the body’s response to allergens or triggers
• these sprays are particularly effective for more severe or persistent hayfever
• use the spray every day throughout the hayfever season to prevent hayfever
• you can begin the spray a few weeks before the hayfever season starts
• these sprays may take a few days to start working and a nasal decongestant or an antihistamine may be required initially, just for a few days. The full effect of nasal corticosteroid sprays may not be seen until after several weeks of regular use
• nasal corticosteroids are considered safe but some minor side effects include irritation, unpleasant taste, headache, coughing and nasal dryness.

Nasal decongestant sprays

[PHARMACY ONLY]
eg, Dimetapp 12 Hour Nasal Spray, Drixine, Otrivin

• these decongestants unblock your nose and make breathing easier
• decongestants may be used for symptom relief while waiting for nasal corticosteroids to take effect
• decongestants may not be suitable for young children. Ask your pharmacist 
• do not use for longer than three days, otherwise their effect is lost and a blocked nose from rebound congestion is likely.

Oral antihistamines (tablets and syrups)

When you have an allergic reaction your body releases histamine, which leads to hayfever. Antihistamines block this reaction. There are two types:

• newer non-sedating antihistamines, which do not typically cause drowsiness
• older sedating antihistamines that cause drowsiness.

Antihistamines are good for treating hayfever symptoms as they occur, especially if you have a lot of different symptoms. You can also take them in advance if you know you are going to be exposed to allergens or triggers.

Newer non-sedating antihistamines

[GENERAL SALE]
eg, Telfast range (60mg and 120mg)

[PHARMACY ONLY]
eg, Aerius Tablets,  Allerid-C, Arrowcare Fexofast, Arrowcare Zetopp, Claratyne, Lorfast, Razene, Telfast range (180mg), Xergic, Zyrtec

• some of these products are available as syrups for children – check correct doses for different age groups
• newer antihistamines may rarely cause drowsiness – do not drive or operate machinery if you are affected.

Older sedating antihistamines

[PHARMACIST ONLY]
eg, Phenergan, Polaramine, Tixylix

• not available without a prescription for children under two years old
• these medicines can cause drowsiness, sometimes the next day – it is important you do not drive or operate machinery
• do not drink alcohol with any medicine that makes you drowsy
• sedating antihistamines are not suitable for everyone and must be sold by a pharmacist
• if you have other medical conditions, such as glaucoma, epilepsy or prostate problems, or you take antidepressants, check with your pharmacist before taking these medicines.

Anti-allergy nasal sprays and eye drops

[PHARMACY ONLY]
eg, Azep Nasal Spray, Livostin Eye Drops or Nasal Spray, Visine Allergy Eye Drops, Zaditen eye drops

• anti-allergy drops and sprays can relieve symptoms such as itching, sneezing and watery eyes
• some eye drops combine an antihistamine with a decongestant (eg, naphazoline) which reduces redness – these are for short term use only
• you may need to remove contact lenses before using – check instructions
• throw drops away one month after opening – mark the opening date on the bottle
• some eye drops cause temporary stinging.

Combination products

• these treat a range of symptoms, and may include:
  –analgesics  – these relieve pain
  –decongestants and antihistamines – these can help to relieve a blocked or runny nose

Decongestant + analgesic
[GENERAL SALE]
eg, Panadol Sinus Relief PE

[PHARMACY ONLY]
eg, Sudafed PE Sinus + Pain Relief, Sudafed Sinus + Pain Relief

Decongestant + antihistamine
[PHARMACY ONLY]
eg, Maxiclear Hayfever & Sinus Relief

Decongestant + antihistamine + analgesic
[PHARMACY ONLY]
eg, Coldrex Day & Night, Sudafed PE Sinus + Allergy & Pain Relief, Sudafed PE Sinus Day + Night Relief, Sudafed Sinus Day + Night Relief

• use these products occasionally, when symptoms are particularly bad, but don't use them continuously (ie, for longer than 3-5 days at a time)
• many of these medicines are not suitable for children
• always check the ingredient list on the packet and make sure you are not doubling up with other products you may be taking. (The maximum daily dose of paracetamol for an adult is 4g (4000mg) – and no more than 1g (1000mg) every four hours. See manufacturer’s directions for children’s doses.)

Availability of medicines

• GENERAL SALE available through pharmacies and possibly other retail outlets.
• PHARMACY ONLY available for sale through pharmacies only.
• PHARMACIST ONLY may only be sold by a pharmacist.

Consumer Medicine Information on some medicines is available at the government website www.medsafe.govt.nz