This text is based on the latest medical evidence and my personal experience in selecting and recommending over-the-counter medications, without favoring any particular pharmaceutical company or product. If new medical evidence is published, the recommended medications will be promptly updated accordingly.
In Japan, most allergy medications for allergic rhinitis that are prescribed in hospitals can also be purchased at drugstores.
This makes drugstores convenient for people who don’t have time to visit a hospital or already know which medication suits them and don’t need to consult a doctor.
Allergic rhinitis medications can be broadly divided into two types: oral medications and nasal sprays. The timing of starting these medications is crucial.
For optimal effectiveness, it’s recommended to begin taking them or using the nasal spray on the predicted day of pollen dispersal, when symptoms of hay fever start to appear, or even a few days earlier.
On the other hand, if you begin taking the medication after the symptoms have become severe, it may take longer for the medicine to take effect.
Oral Medication for Allergic Rhinitis
Oral medications for allergic rhinitis are broadly classified into first-generation and second-generation drugs.
Among these, second-generation drugs are currently the mainstream treatment for hay fever because they cause fewer side effects, such as drowsiness and dry mouth.
However, even among second-generation drugs, there are differences in how likely they are to cause drowsiness.
It is recommended to start taking the medication on the predicted day of pollen dispersal, when hay fever symptoms begin to appear, or even a few days earlier.
If you start taking the medication only after the symptoms become severe, it may take considerable time for the medication to take effect.
Oral medications for allergic rhinitis are effective for symptoms like a runny nose and sneezing but are less effective for nasal congestion.
If you have nasal congestion in addition to symptoms like a runny nose and sneezing, steroid nasal sprays are an effective option.
①Allegra FX(Hisamitsu)
This medication is one of the second-generation treatment for allergic rhinitis, with fexofenadine as its main active ingredient, which is known for causing minimal drowsiness compared to other second-generation drugs.
Therefore, it is recommended as a first option for hay fever patients.
It is also safe for use by pregnant and breastfeeding women.
It is effective for symptoms such as a runny nose and sneezing caused by allergens like pollen or house dust but is less effective for nasal congestion.
For individuals with severe nasal congestion, steroid nasal sprays are recommended.
Precautions
Taking this medication with fruit juices (such as apple, orange, or grapefruit juice) can significantly reduce its effectiveness. If you have consumed fruit juice, wait at least four hours before taking the medication.
②Allerbi（Kokando）
This medication is one of the second-generation treatment for allergic rhinitis, with fexofenadine as its main active ingredient, which is particularly known for causing minimal drowsiness compared to other second-generation drugs.
Therefore, it is recommended as the first choice for hay fever patients.
It is also safe for pregnant and breastfeeding women to use.
It is effective for symptoms such as a runny nose and sneezing caused by pollen or house dust but is less effective for nasal congestion.
For individuals with severe nasal congestion, steroid nasal sprays are recommended.
Additionally, its price is set lower than Allegra FX ( Hisamitsu Pharmaceutical).
Precautions
Taking this medication with fruit juices (such as apple, orange, or grapefruit juice) can significantly reduce its effectiveness. If you have consumed fruit juice, wait at least four hours before taking the medication.
③Alesion 20（SS Pharmaceutical）
This medication is one of the second-generation treatments for allergic rhinitis, with epinastine as its main active ingredient.
Among second-generation drugs, it is the second least likely to cause drowsiness.
A key feature of this medication is its 24-hour efficacy with just a single dose per day.
It is effective for symptoms such as a runny nose and sneezing caused by pollen or house dust but is less effective for nasal congestion.
For individuals with severe nasal congestion, steroid nasal sprays are recommended.
Precautions
The safety of Alesion 20 for pregnant and breastfeeding women has not yet been established. Pregnant and breastfeeding women should avoid choosing this medication and instead opt for Allegra FX, Allerbi, or Claritin EX.
④Claritin EX（Taisho）
This medication is one of the second-generation treatments for allergic rhinitis and contains loratadine as its main active ingredient, which is the third least likely to cause drowsiness among second-generation drugs.
One of its key features is that a single dose provides 24-hour effectiveness.
It is safe for use by pregnant and breastfeeding women.
It is effective for symptoms such as a runny nose and sneezing caused by pollen or house dust but is less effective for nasal congestion.
For individuals with severe nasal congestion, steroid nasal sprays are recommended.
Precautions
Taking this medication on an empty stomach can significantly reduce its effectiveness, so please take it after a meal.
Nasal Spray for Allergic Rhinitis
Nasal sprays for allergic rhinitis can be broadly classified into steroid nasal sprays and vasoconstrictor nasal sprays.
Among these, steroid nasal sprays are highly effective for treating runny nose, sneezing, and nasal congestion, while posing minimal concerns for side effects.
As a pharmacist, I would strongly recommend these medications.
On the other hand, vasoconstrictor nasal sprays work extremely quickly (as fast as 5 minutes), making them a suitable choice for those experiencing severe nasal congestion and seeking immediate relief.
However, prolonged use can worsen nasal congestion, so it’s best to limit their use to a maximum of two weeks.
Although vasoconstrictor nasal sprays are less expensive than steroid nasal sprays and are widely available in stores, their effects are only temporary and limited to relieving nasal congestion.
Therefore, it’s important to choose a nasal spray that aligns with your specific goals for treating hay fever.
⑤Flunaze Nasal Spray (Haleon Japan)
This medication is a steroid nasal spray with fluticasone as its main active ingredient.
It remains in the nasal cavity and works locally.
One major advantage it has over second-generation oral medications is its efficacy not only for runny nose and sneezing but also for nasal congestion.
As a pharmacist, I highly recommend this medication.
Additionally, since it does not contain menthol, it is suitable for those who are sensitive to the smell of cooling agents.
It may take 1–2 days for the effects to become noticeable.
Therefore, in cases of severe nasal congestion that require immediate relief, it is advisable to use it in combination with the vasoconstrictor nasal spray introduced below.
⑥Pabron Rhinitis Attack JL（Taisho）
This medication is a steroid nasal spray with beclomethasone as its main active ingredient.
It remains in the nasal cavity and works locally.
One major advantage it has over second-generation oral medications is its efficacy not only for runny nose and sneezing but also for nasal congestion.
It contains menthol as a cooling agent.
It may take 1–2 days for the effects to appear. Therefore, in cases of severe nasal congestion that require immediate relief, it is recommended to use it in combination with the vasoconstrictor nasal spray introduced below.
Precautions
As this nasal spray has a higher rate of systemic absorption compared to prescription nasal sprays, it is advisable for pregnant women to avoid using it.
⑦NazalαAR0.1%（Sato）
This medication is a steroid nasal spray with beclomethasone as its main active ingredient.
It remains in the nasal cavity and works locally.
One major advantage it has over second-generation oral medications is its efficacy not only for runny nose and sneezing but also for nasal congestion.
It contains menthol as a cooling agent.
It may take 1–2 days for the effects to appear.
Therefore, in cases of severe nasal congestion that require immediate relief, it is recommended to use it in combination with the vasoconstrictor nasal spray introduced below.
Precautions
As this nasal spray has a higher rate of systemic absorption compared to prescription nasal sprays, it is advisable for pregnant women to avoid using it.
⑧Pabron Nasal Spray(Taisho)
There are various types of vasoconstrictive nasal sprays, but here I’ll introduce Taisho Pharmaceutical’s Pabron Nasal Spray, commonly found at drugstore counters.
Its main ingredient is naphazoline, a vasoconstrictor, which quickly relieves severe nasal congestion.
It is suitable for use from the age of 7.
Precautions
Continuous use may worsen nasal congestion, so it is recommended to limit usage to a maximum of two weeks.
