"What can I take for my allergies?"
That's one of the most common questions posed to Kristen Wilmot, CVS pharmacist in Atlanta, GA.
Wilmot, a graduate of the University of Florida and the Mercer University School of Pharmacy, moved to Atlanta for pharmacy school. She recalls the moment when she realized that allergies would be a big problem in Atlanta: "I grew up in Florida and moved up here, and the first time I ever came out of class one day and saw my car covered in pollen, I said, 'What is this?'"
"I've had several people tell me, 'As a kid, I was fine and never had allergies, but I moved to Atlanta, and now I have allergies.' Sure enough, you can develop allergies later in life," says Wilmot. "Probably half of the people who come in to the pharmacy are coming in not to pick up a prescription, but to simply ask me what they can do for their allergies, especially when pollen season hits. I would have to say probably 75 percent of the people at that point are coming in to ask what they can do for their allergies."
When a customer asks what to take for allergies, Wilmot first asks what they've taken in the past and if that's helped. "If they haven't taken anything, I ask them if they've tried Claritin. That's a pretty good antihistamine," says Wilmot. "Some people say Claritin hasn't worked, and I tell them they might need to talk to their doctor about prescription-strength medication, such as Allegra and Zyrtec, and see if those will help them."
"When your body is faced with an allergen, it's going to produce histamine, which causes the allergy symptoms," explains Wilmot. "Antihistamines like Claritin block the histamine so that your body's not going to get the reaction that it would've gotten without the medication."
"Several of the antihistamine medications can make people a little drowsy," cautions Wilmot. "If you're going to take Benadryl, I recommend you take it at night."
Many allergy medications combine an antihistamine with another type of drug. Wilmot explains, "A lot of drug manufacturers combine a decongestant with the antihistamine, like in Claritin-D or Benadryl-D. And there's Singulair, which is targeted more for asthmatic patients, but I have seen a lot of doctors write Singulair prescriptions for allergies. Also, there's the nasal sprays with steroids, which open the airways to help you breathe better."
OTC Allergy Medication vs. Prescription Allergy Medication
"The main difference between OTC drugs and prescription drugs is that some of the prescription drugs will have steroids, which cannot be dispensed over-the-counter, because of the reactions that people can have to them. Over-the-counter antihistamines aren't as strong. Also, with Albuterol and rescue inhalers, people can over-use them and become somewhat addicted, but over-the-counter medications are safe for people to take without seeing a doctor," says Wilmot.
Pseudoephedrine & Allergy Medication
Since the Combat Methamphetamine Act of 2005 passed, many allergy sufferers have complained about having to stand in line and sign a log sheet in order to purchase OTC medications containing pseudoephedrine, which is the main decongestant used in allergy medications.
"With a mixture of available OTC items, pseudofed being the main one, people are able to make methamphetamines," explains Wilmot. "The government decided that due to how easy it was for people to come in and get tens of thousands of boxes of pseudofed, they had to do something about that. A lot of manufacturers actually decided to reformulate pseudofed, and it became phenylephrine, which works differently, and it's a lot harder to make methamphetamines from phenylephrine."
"In addition, because people still want to take pseudofed - I have several people come in and tell me that the phenylephrine just doesn't work for them - and the good news is that they haven't discontinued pseudofed," says Wilmot. "We have to keep it behind the counter, and we can't sell more than a certain amount to one person at a time. We also have to keep a log of who the person is and how much pseudofed they've purchased."
Allergy Medication & Insurance Coverage
Another common complaint from allergy sufferers is that their insurance often does not cover allergy medication. Wilmot says, "A lot of people just want an over-the-counter solution, but others who have tried all the OTC medicines will come in with a prescription for Allegra, let's say, and chances are, their insurance company doesn't want to cover it. What I've found is that insurance companies generally want them to use over-the-counter Claritin. If they have used over-the-counter Claritin, and if their doctor makes the call, they may be able to get a prior authorization if their doctor explains that the OTC medicine is not working. But sometimes the insurance companies won't pay for it. A lot of the prescription medications are very expensive, and the insurance companies don't want to pay because they don't see allergies as a severe problem. I don't think they see allergies as the horrible thing that many people experience."
If neither OTC drugs nor prescription drugs work, then immunotherapy (allergy shots) may be necessary. "If they're having really bad allergies and they've taken all the different types medications, they may need to have allergy shots," says Wilmot. "Over a period of years, they become desensitized to the allergen."
Non-Drug Allergy Relief
Visit the Allergy Relief Learning Center to learn more about allergen avoidance and other non-drug methods of allergy relief.
Communication is Key
Kristen Wilmot feels lucky to work as a pharmacist at CVS in Atlanta, even during the busy allergy season: "I just want to help people, and pharmacy allows me to do that, but it also allows me to have hours in which I can have a family and do other things."
"I feel best when I'm communicating with patients," concludes Wilmot. "A lot of times, people will go to the doctor's office, and the doctor will hand them their prescription, and they're kind of rushed. Sometimes people come to the pharmacy not knowing anything about their medication, and there are several important things they need to know. Should they take it with food? Should they take it on an empty stomach? Will it cause nausea or dizziness or any other side effects? Those are important things everybody should know when they're getting a new medication."
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