SOMETHING TO SNEEZE AT ALLERGY SUFFERERS TRY ALTERNATIVE REMEDIES AS MANY INSURERS STOP COVERING THE NEWER DRUGS.

Byline: Mariko Thompson Staff Writer

Pass the antihistamine.

Whether it's the tree in the back yard or pet dander in your best friend's car, allergens await. With potential triggers lurking inside and outside, sometimes there's no escape from the sneezing, itching and stuffiness.

For some people, seasonal allergic rhinitis or hay fever is an inconvenience. For others, a flare-up can lead to more serious problems. Cory Hacker's 7-year-old daughter, Allison, suffers from both allergies and asthma.

``It triggers an asthma attack if her allergies are in full bloom,'' said Hacker, a West Hills resident.

The runny nose, watery eyes, and congestion occur when the body's immune system treats benign particles as foreign invaders, said Dr. Michael Hirt of the Center for Integrative Medicine at Encino-Tarzana Regional Medical Center.

``Your body is over-responding, as if the dust or the pollen from the oak tree in the back yard is a bacteria or fungus,'' Hirt said. ``The body releases histamine. You have to block that response.''

Claritin controversy

Hay fever affects an estimated 35 million Americans. Allergic reactions can be triggered year-round in Southern California by any number of irritants, including pollen, dust, mold and pet dander. Until last year, many allergy sufferers would have reached for a medication called Claritin, a newer generation of antihistamine that doesn't make users drowsy. But in December, Claritin switched from being a prescription drug to an over-the-counter medication when maker Schering-Plough's patent expired.

Initially the move was hailed as a boon for consumers, especially those who lack health insurance. But retail prices for Claritin, which many doctors and pharmacists say runs $1 per pill, have sent consumers scurrying for cheaper alternatives. For patients who had Claritin prescriptions covered by insurance, what they received for a $10 co-pay now can cost $100, said Peggy Han, clinical coordinator at the USC community pharmacy.

``Someone with chronic allergies is paying an arm and a leg,'' Han said. ``There are generics out there, but they're not much cheaper.''

Schering-Plough saw pharmaceutical sales plummet in the U.S., down to $648 million in the first quarter of 2003 from $1.3 billion in the first quarter of 2002. The company attributed the decline to Claritin no longer selling as a prescription drug.

Other prescription medications for allergies are available in pill and nasal spray forms. But Claritin's change in status had a domino effect. Once Claritin went over-the-counter, many insurance plans declined to cover other prescription allergy medications, said Michael Lenoir, an associate clinical professor in pediatrics at UC San Francisco and a representative from the American Academy of Allergy, Asthma & Immunology. While that trend is unlikely to change, Lenoir predicts over-the-counter remedies will come down in price in the long term as competition kicks in.

``Ultimately, it will be cheaper,'' he said.

Different remedies

Until then, what to do when the sneezing and wheezing begins? For the occasional bout of allergies, Han suggests trying less costly over-the- counter remedies such as Benadryl - but only if you don't have to drive or do tasks that require you to be sharp mentally. Benadryl is an older generation of antihistamine that can cause drowsiness.

Natural remedies are another solution. Hirt provides his patients with what he calls a block-and-rinse. To block the histamine released by the body, he uses either a root called butterbur or the antioxidant quercitin. Then he suggests a rinse to soothe inflamed nasal membranes. The rinse - four cups of spring water, one-quarter teaspoon baking soda, and two to three teaspoons kosher salt - is blown into the nasal passages with a bulb syringe. An over-the-counter saline spray also can serve the same purpose, he said.

Myra Abrams was skeptical at first. Tired of feeling lethargic from allergy pills, the 63-year-old Tarzana resident decided to give butterbur a try.

``I came in with some hesitation, but this worked for me,'' Abrams said. ``It's simple, and I use it morning and night.''

Rather than constantly purchase medications, people with chronic allergies often turn to immunotherapy. With immunotherapy, patients undergo skin tests to determine the triggers. Then they're injected with small doses of the allergen with the goal of creating resistance in the body, said Dr. Vera Cecilio, an ear, nose and throat specialist at Sherman Oaks Hospital.

``It's not a quick fix,'' Cecilio said. ``There are certain allergens that cause response that are part of our air pollution, and it's not possible to re-create them in a bottle.''

Allergy specialists also are waiting for a new medication called Anti-IgE to hit the market later this year. The antibody IgE tells immune cells to release the chemical histamine, which results in allergic reactions. Anti-IgE, an injectable medication, would stop the antibodies from sending that message.

Besides medications, the other strategic move to keep allergies at bay is avoidance when possible, doctors say. Dust the house. Make the bedrooms pet-free zones. Do yard work on still and cloudy days.

``The individual has to be susceptible - and then the environment makes it happen,'' Cecilio said. ``Sometimes I jokingly tell my patients, 'If I could put you in a glass bubble, you wouldn't have this.' ''

Mariko Thompson, [phone]

mariko.thompson(at)dailynews.com

Breathe easier in your garden

For the gardening enthusiast with allergies, pollen can be a real problem. Seasonal allergic rhinitis or hay fever afflicts more than 35 million Americans. But there are ways to keep weeds and allergies in check at the same time. The American Academy of Allergy, Asthma & Immunology (www.aaaai.org) offers gardening tips for the pollen sensitive:

--Use antihistamines or nasal sprays before going outside.

--When you finish gardening, wash your clothes and hair to remove dust and pollen.

--Garden on days with low pollen counts, cool weather and no wind.

--Get rid of the grass. Lawns may be pleasant to the eye - but not to the nose. Mowing the lawn can wreak havoc for those whose triggers include grass and mold.

--Choose colorful flowers to reduce airborne pollen. Plants with bright, showy flowers are pollinated by insects rather than wind.

--Trees, shrubs and plants that are best for people with allergies include alyssum, apple, azalea, begonia, cactus, cherry, clematis, columbine, crocus, daffodil, dahlia, daisy, dogwood, dusty miller, geranium, hibiscus, hosta, hyacinth, hydrangea, impatiens, iris, lilac, lily, magnolia, narcissus, pansy, pear, petunia, phlox, plum, rose, salvia, snapdragon, sunflower, tulip, verbena, viburnum and zinnia.

--Trees to avoid include alder, ash, aspen, beech, birch, box elder, cedar, cottonwood, cypress, elm, hickory, juniper, mulberry, oak, olive, palm, pecan, poplar, sycamore, walnut and willow.

- M.T.

CAPTION(S):

7 photos, box

Photo:

(1 -- cover -- color) Aah chooo

Allergy sufferes can find help to alleviate their misery

Tina Burch/Staff Photographer

(2) no caption (flower)

(3) no caption (cats)

(4) no caption (bug)

(5) no caption (trees)

(6) no caption (dog)

(7) Daisies are pollinated by insects, not through the air, making the flowers the allergy sufferer's friend.

John McCoy/Staff Photographer

Box:

Breathe easier in your garden (see text)