From the Guidelines
The best prescription allergy eye drops are typically dual-action agents that combine antihistamine and mast cell stabilizer properties, such as olopatadine (Pataday, Patanol) or ketotifen (Alaway, Zaditor), which provide quick relief and ongoing protection from allergy symptoms. These medications work by blocking histamine receptors and preventing the release of inflammatory chemicals from mast cells, making them suitable for acute and longer-term treatment of allergic conjunctivitis symptoms 1.
Key Characteristics of Recommended Medications
- Olopatadine 0.2% once daily is particularly effective for moderate to severe allergic conjunctivitis
- Ketotifen (Alaway, Zaditor) is another option that provides both antihistamine and mast cell stabilizer activities
- These dual-action agents generally have an onset of action within 30 minutes, making them suitable for acute symptom relief
Important Considerations
- If these medications don't provide sufficient relief, your doctor might prescribe steroid eye drops like loteprednol (Alrex) for short-term use to reduce inflammation, though these require medical supervision due to potential side effects like increased eye pressure and cataract formation 1
- Some patients may benefit from prescription-strength medications for chronic allergic eye conditions
- Always follow your doctor's instructions regarding dosage and duration, and remember to wait at least 5-10 minutes between applying different eye medications
- If you wear contact lenses, remove them before using eye drops and wait 10-15 minutes before reinserting them unless otherwise directed by your doctor
From the FDA Drug Label
CLINICAL PHARMACOLOGY Corticosteroids inhibit the inflammatory response to a variety of inciting agents and probably delay or slow healing. Clinical Studies:In two double-masked, placebo-controlled six-week environmental studies of 268 patients with seasonal allergic conjunctivitis, Loteprednol Etabonate Ophthalmic Suspension, 0. 2%, when dosed four times per day was superior to placebo in the treatment of the signs and symptoms of seasonal allergic conjunctivitis.
The best prescription allergy eye drop is Loteprednol Etabonate Ophthalmic Suspension, 0.2% as it has been shown to be effective in treating the signs and symptoms of seasonal allergic conjunctivitis in clinical studies 2.
- It provides reduction in bulbar conjunctival injection and itching, beginning approximately 2 hours after instillation of the first dose and throughout the first 14 days of treatment.
- It is dosed four times per day. Note that Ketotifen is now available over-the-counter (OTC) and not a prescription option 3.
From the Research
Prescription Allergy Eye Drops
- The most effective prescription allergy eye drops can vary depending on individual patient needs and responses to treatment 4, 5, 6, 7.
- Studies have compared the efficacy of olopatadine and ketotifen, two commonly used prescription allergy eye drops, with varying results:
- A 2003 study found that ketotifen had a higher responder rate and global efficacy ratings compared to olopatadine 4.
- A 2018 study found that olopatadine provided quicker relief of symptoms and improved quality of life compared to ketotifen, with fewer side effects 5.
- A 2004 study found that patients preferred olopatadine over ketotifen due to its efficacy and comfort 6.
- A 2009 study found that olopatadine was more effective than ketotifen in improving itching, tearing, and burning in patients with allergic conjunctivitis 7.
Key Findings
- Olopatadine and ketotifen are both effective in treating allergic conjunctivitis, but may have different advantages and disadvantages 4, 5, 6, 7.
- Patient preference and comfort can play a significant role in determining the most effective treatment 6.
- A once-daily medication with sustained 24-hour effectiveness may be a desirable treatment option for patients with allergic conjunctivitis 8.
Treatment Options
- Dual-acting antihistamine-mast cell stabilizing agents, such as olopatadine and ketotifen, are considered first-line therapeutics for allergic conjunctivitis due to their ability to provide acute relief and block persistent inflammation 8.
- Higher-concentration formulations of dual-acting antihistamine-mast cell stabilizers may provide a 24-hour duration of action with once-daily dosing 8.