Top 5 Topical Medications for Allergy

Jun 15, 2015
3 min read

With up to 30% of the US population being affected by seasonal allergy symptoms, Dr. Corte highlights the top 5 topical allergy drops he prescribes.


Up to 30% of the US population is affected by seasonal allergy symptoms, with as many as 70%-80% of these demonstrating symptoms such as ocular itching(1). Consider these allergy drops.

In North Carolina, it feels like allergy season runs almost all year long! With this in mind, I’m constantly addressing allergic conjunctivitis with my patients, whether they are symptomatic at their visit or not. Allergy drops are something I frequently prescribe.

These are my top 5 topical drops I routinely prescribe for these patients:

1) Lastacaft Allergy Drops


Lastacaft (alcaftadine, 0.25%) is proven effective for up to 16 hours (2) and is labeled pregnancy Category B. From my experience, it tends to have better insurance coverage than the newer Pazeo (olopatadine, 0.7%), making it my top option for managing allergic conjunctivitis, especially in expecting or nursing mothers. These are allergy drops I often prescribe.

2) Lotemax gel Allergy Drops


Lotemax gel (loteprednol etabonate ophthalmic gel, 0.5%) can be very effective for patients with advanced symptoms that aren’t responding well to the combination topical mast cell stabilizer/antihistamine medications most doctors use.  Keep in mind that it’s off-label(3) for allergic conjunctivitis and should only be used as a short-term treatment.

3) Pazeo Allergy Drops


As the newest topical mast cell stabilizer/antihistamine medication on the market, Pazeo is creating quite the buzz. This once a day drop has shown statistically significantly improved relief at 24 hours post-treatment compared to Alcon’s own Pataday (olopatadine, 0.2%)(4). Still, with limited insurance coverage, I’m still not convinced the extra relief is worth the price tag.

4) Pataday Allergy Drops


In North Carolina, Pataday is covered by Medicaid, which is why I find it to be an excellent, low cost option for these patients. Simply Google “(your state) Medicaid medication formulary 2015” to see what’s covered by Medicaid in your state.

5) OTC agent Allergy Drops

Zaditor Alcon and Alaway Bausch + Lomb

If your patient has a fixed income or doesn’t have prescription drug coverage, OTC agents are most likely their best option. Priced between $10-$20/bottle, Alaway (ketotifen, 0.025%) and Zaditor (ketotifen, 0.035%) are two effective OTC agents you should always consider.

When it comes to managing ocular allergy, selecting the right topical agent is only part of the solution! Be sure to consider environmental factors, oral medications, contact lens hypersensitivities and more when managing these patients.

Don’t see your favorite topical allergy medication listed above? Comment below to add to the list! Be sure to check out Patricia Fulmer’s Topical Allergy Medication Reference Guide as well!


  1. “FDA Approves Novartis Eye Drops Pazeo.” Pharma Times Digital. Pharma Times, 02 Feb. 2015. Web. 8 June 2015.
  2. Torkildsen G, Shedden A. The safety and efficacy of alcaftadine 0.25% ophthalmic solution for the prevention of itching associated with allergic conjunctivitis. Curr Med Res Opin.    2011;27(3):623-631.
  3. Lotemax® prescribing information.
  4. Pazeo™  prescribing information.
About Ryan Corte, OD

Ryan Corte attended The Ohio State University College of Optometry and graduated in 2012. He completed an Optometric Residency in Primary Care and Ocular Disease at the Illinois College of Optometry in 2013. He currently splits time between Modern Eye …

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