The FDA has released a useful consumer guide on prescription and over-the-counter drugs that have been approved to treat seasonal allergy in children.
Seasonal allergic rhinitis, or hay fever, is a condition that can affect up to 20% of people in the spring, summer, and fall. Hay fever occurs when the immune system becomes sensitized to grass, tree or weed pollen, and in response the body releases chemicals to combat what it perceives to be an infection. This immune reaction in turn causes symptoms of sneezing, runny and stuffy nose, itchy eyes, and fatigue. According to the National Institute of Allergy and Infectious Disease, up to 40% of children also develop hay fever. Children with seasonal allergies are often moody and irritable, and their symptoms may be associated with missed days of school, problems remembering things, impaired hand-eye coordination, and injuries. In addition, untreated allergies may complicate health conditions like asthma.
Taking your child to an allergist is a good idea if you suspect they have hay fever. The allergist will likely conduct a skin test where diluted allergens are applied to the skin with a small prick of a needle, followed by a reading of their immune response. If your child does have hay fever, monitoring outdoor pollen levels and choosing to keep your child inside when counts are high is one of the most effective ways to manage allergy symptoms. Keeping the windows closed may also help. When it is not possible to avoid the outdoors, parents can control their child’s symptoms with over-the-counter (OTC) or, if necessary, prescription medicines.
To help parents navigate OTC and prescription treatments for their child, the US FDA has released a consumer report on approved options for the treatment of seasonal allergies in children. The FDA defines children as those up to 17 years of age but recommends that parents carefully check labels to ensure their medications are appropriate for the age of their children. They also state that Common OTC and prescription drugs include nasal corticosteroids (like Nasacort Allergy 24hr for children that are at least 2 years old), oral and topical antihistamines (Benadryl for 12 years or older, Allegra for 6-11 year olds, Clarinex for 12 year or older), Decongestants (Sudafed PE, Claritin D), non-steroidal nasal sprays (NasalCrom, Atrovent) and prescription leukotriene receptor antagonists. Recent legislation has facilitated updated testing of OTC and prescription allergy medications for children with respect to dosing, safety, and child-friendly formulation (liquid, flavouring, sub-lingual), but it is still critical that parents read OTC medicine labels carefully to determine if it is appropriate for their child.
When a child has poor response to OTC and prescription medications, an alternative treatment is subcutaneous immunotherapy, commonly known as allergy shots. Using information from skin test results, small amounts of the problem allergen(s) are injected into the body, followed by shots of increasing dosage over time to build up immunity. This form of treatment has been demonstrated to reduce symptoms of hay fever in patients by 80% over the course of a year. The recently-approved prescription immunotherapy treatments, Oralair and Grastek, now allow children to take immunotherapy doses sublingually and at home, rather than receiving traditional shots from their health care provider.
For the full guide to FDA-approved treatments for children with hay fever, please see the guide below:
Written By: Fiona Wong, PhD