As Fall Allergy Season Approaches, Encourage Patients to Begin Medicating Today
Ragweed season begins in late August and can run through early November.
August may be the height of summer, but for those living with allergies, it’s also time to start thinking about managing fall allergy symptoms. Although many associate the spring season with red itchy eyes, runny noses, and sneezing, pollen from ragweed—the most common culprit for fall allergies—“wreaks havoc” in the late summer and fall, according to the American College of Allergy, Asthma, and Immunology (ACAAI).1
“If you suffer from fall allergies, you should be thinking now, in mid-August, about starting the medications you normally take to treat symptoms,” said Gailen Marshall, MD, PhD, ACAAI president, in a news release. “Although spring, summer, and fall have distinct sets of allergens that crop up, the symptoms are often the same. People who have multiple triggers may not be able to distinguish between what’s causing their symptoms. They just know they’re congested, with red eyes and an itchy nose.”
Ragweed season begins in late August. | Taisiia - stock.adobe.com
Ragweed begins releasing pollen in August, as warm days begin to transition into cooler nights. Ragweed season can last into September and October, and many individuals who are allergy to spring plants also experience ragweed allergies; the wild plant is especially prevalent on the East Coast and in the Midwest.2
READ MORE: OTC Product Roundup: Allergies
According to the ACAAI, other plants that can trigger fall allergies include burning bush, cocklebur, Lamb’s-quarters, pigweed, sagebrush, mugwort, tumbleweed, and Russian thistle. Mold allergies also peak in the fall: These spores are light, small, and easily inhaled, and can be found in soil, compost piles, and piles of dead leaves; they are especially common after ragweed season.3
Patients with fall allergies are encouraged to begin using their allergy medications approximately 2 weeks before their symptoms typically begin and continuing for 2 weeks after the first frost.
Put It Into Practice
For pharmacists, this guidance means that allergy counseling and OTC allergy products should remain top of mind even during the summer months. Even patients who are prescribed allergy medications from an allergist or other health care provider may need additional OTC products to help control symptoms or manage medication costs. For these patients especially, it’s crucial to provide counseling to ensure that there are no adverse drug-drug interactions.
Patient counseling may also include suggestions to help patients mitigate and manage allergy triggers. Remind patients who work or spend leisure time outdoors to take off clothes, shoes, and hats at the door to avoid tracking ragweed pollen into their homes. NIOSH N95-rated masks can also help patients minimize pollen exposure, as well as avoiding open windows and opting to use air conditioning when possible.1
For patients who rely solely on OTC medications to control their allergy symptoms, pharmacists should know when to refer a patient to an allergist or other health care provider for additional testing and treatment. These patients may experience allergy symptoms several months out of the year, have frequent sinus infections that won’t go away, commonly experience stuffy nose or trouble breathing, feel that their day-to-day lives and activities are negatively impacted, and/or experience unpleasant adverse effects from OTC medications.
Additionally, patients who take antihistamines for long periods of time—months to years—may develop a tolerance to these medications.4 These patients may benefit from the guidance of an allergist to adjust dosing, discontinue treatment, or review alternative or prescription medication options.
In a 2022 study published in Patient Preference and Adherence, researchers conducted a cross-sectional study surveying patients who used OTC drugs to treat allergic rhinitis in order to evaluate the relationship between inappropriate OTC medication use and the occurrence of adverse events.5 Over 1800 responses, the most common adverse effect was somnolence, present in 59.1% of participants who reported experiencing it often or sometimes. A total of 31.2% of participants admitted to continuing to use their medication for 1 month or more without symptoms subsiding, while 30.3% said that they “may use [OTC medication] according to my own symptoms rather than the usage described” in the instructions.
More than 100 million Americans are living with allergies, according to CDC National Center for Health Statistics Data from 2021. One in 4 adults and 1 in 5 children, or 80 million individuals, report living with seasonal allergies.6 A combination of rising temperatures due to climate change and other environmental factors have worsened seasonal allergy triggers including tree pollen, mold, and other spores and extended pollen season by as long as 3 weeks in certain parts of the country.
Although 2021 was the first year these data were collected by the CDC, allergists have anecdotally reported increases in the number of patients—in particular, adults7—seeking treatment for seasonal allergies in recent years.
READ MORE: Allergy Resource Center
References
Get ahead of fall allergy symptoms by starting your medication in mid-August. News release. American College of Allergy, Asthma, and Immunology. August 8, 2024. Accessed August 15, 2024. https://acaai.org/news/your-two-week-timeline-to-start-fall-allergy-medication-begins-now/
Ragweed allergy. American College of Allergy, Asthma, and Immunology. Reviewed June 28, 2023. Accessed August 15, 2024. https://acaai.org/allergies/allergic-conditions/ragweed-allergy/
Seasonal allergies. American College of Allergy, Asthma, and Immunology. Reviewed December 28, 2017. Accessed August 15, 2024. https://acaai.org/allergies/allergic-conditions/seasonal-allergies/
Can I develop tolerance to antihistamines? Asthma and Allergy Foundation of America. January 29, 2024. Accessed August 15, 2024. https://community.aafa.org/db/ask-the-allergist/record/can-i-develop-tolerance-to-antihistamines
Nakajima R, Morita N, Watanabe F, Kosuge Y. Association between inappropriate use of over-the-counter drugs for allergic rhinitis and side effects on the central nervous system—a cross sectional survey. Patient Prefer Adherence. 2022;16:3111-3118. doi:10.2147/PPA.S288226
Balch B. Do seasonal allergies seem to be getting worse? Blame climate change. Association of American Medical Colleges. April 9, 2024. Accessed August 15, 2024. https://www.aamc.org/news/do-seasonal-allergies-seem-be-getting-worse-blame-climate-change
Edwards E. Adults are getting allergies for the first time. Thanks, climate change. NBC News. April 25, 2023. Accessed August 15, 2024. https://www.nbcnews.com/health/health-news/climate-change-allergy-season-pollen-adults-rcna81227
