Why Your Allergy Medicines Stop Working—and What Doctors Say Might Help Your doctor may consider something called “dosing flexibility,” where you ramp up the dosage of your medication to meet the conditions you’re dealing with. Navigating allergy season can be a humbling experience, even if you’ve been here many times before. You can take your medications as prescribed and still wind up with a stuffy nose, itchy eyes, and cough, making it fair to wonder where you’re going wrong. “If your symptoms don’t improve or are worsened through the initial few weeks of spring season, that’s a sign that your medications are not effective enough,” Aleena Banerji, MD, a Mass General Brigham allergist, clinical director of Allergy and Clinical Immunology at Massachusetts General Hospital, and professor at Harvard Medical School, tells SELF. But that doesn’t necessarily mean you need to switch medications. Instead, you may want to consider something called “dosing flexibility,” where you ramp up the dosage of your medication to meet the conditions you’re dealing with, David Corry, MD, professor of immunology, allergy and rheumatology at Baylor College of Medicine, tells SELF. As you can imagine, there’s a lot to unpack here. And, of course, you should only do this with the help of a healthcare provider. Here’s how allergists recommend navigating this process. Signs your current allergy medication regimen isn’t working for you There are some people who feel like a million bucks after they start allergy medication, but that’s not the case for everyone. “The best indication of efficacy of allergy medications is simply, are you feeling better?” Dr. Corry says. Punam Thakkar, MD, associate professor of Otolaryngology/Head and Neck Surgery at George Washington University School of Medicine and Health Sciences, tells SELF that “if your treatment is working, you should notice meaningful relief.” But symptoms that interfere with your ability to sleep, work, go to school, or your daily activities are red flags that your current treatment plan isn’t enough, Dr. Thakkar says. Another red flag that your medication isn’t doing its job, per Dr. Banerji: Your symptoms return a few hours after taking the medication. “If this happens, it may mean the medication type, dosage, or timing isn’t right for your specific allergies, and it’s worth reassessing your treatment plan with your allergist,” she says. Doctors may recommend increasing your dosage under certain circumstances. There are a lot of reasons why your current allergy regimen isn’t working for you, including that you may need a different treatment or that an additional medication may be helpful. But it’s also possible that your dosing just isn’t right, Dr. Corry says. If you like your current medication or have already stocked up and don’t want to toss what you’ve got, he says it’s worth talking with your doctor about whether increasing the dose is an option. “Failure of current meds to reduce symptoms substantially should trigger dose escalation,” Dr. Corry says. But what’s happening in the environment still matters, Dr. Thakkar says. Meaning, if pollen counts are suddenly through the roof—and you’re feeling pretty crummy—you may need to ramp up your dose to get relief. Only certain allergy medications are appropriate for dosing flexibility Your doctor may advise you to increase the dose of your allergy medication, but only certain types, such as these oral antihistamines medications: Cetirizine Fexofenadine Loratadine Levocetirizine “In some cases, doses up to two to four times the standard FDA-approved dose are used for persistent symptoms,” Dr. Thakkar says. “Studies suggest this can be tolerated, though drowsiness may increase, especially at higher doses.” You can also usually increase the dose of these nasal allergy sprays, according to Dr. Corry: Fluticasone Azelastine “The nasal sprays can be taken as one or two sprays in each nostril once or twice daily,” Dr. Corry says. He also points out that fluticasone and azelastine are available in multiple strengths—you may need to ramp up to a higher strength if you’re still not getting relief. Rely on eye drops? You can usually increase the dosing of these, too, according to Dr. Corry: Ketotifen Olopatadine “For some people with seasonal allergies, allergists may advise adjusting the dose of these medications to better control symptoms during peak allergy seasons, but using a lower dose during other seasons,” Dr. Banerji says. Doctors don’t recommend adjusting the dose of these allergy medications. These medications aren’t used as much anymore, but Dr. Corry still recommends being aware that you shouldn’t mess with the dosing of them: Montelukast . “This is a fixed dose. Do not attempt to take more,” Dr. Corry says. “It either will help a lot or not at all—usually the latter.” Cromolyn sodium . “This is a mast cell stabilizer that helps with allergic rhinitis, but has been largely replaced by the more effective inhaled glucocorticoids,” Dr. Corry says. Oxymetazoline . These should only be used at most two to three days at a time and only once daily. “It can make things worse if used excessively,” Dr. Corry says. Other options to consider If you’ve increased the dosage of your allergy medication and still aren’t getting relief, you still have options. Adding on medication from another drug class to take alongside your existing medication can be helpful, according to Dr. Thakkar. If that doesn’t work, you may be a good fit for immunotherapy shots or drops to try to train your immune system to better tolerate allergens, Dr. Thakkar says. Ultimately, it’s important to know that you have options if your existing allergy treatment isn’t working for you. “There is never a ‘right’ answer, but an allergist can get you started on the ‘right’ approach based on your symptoms and certainly adjust if your symptoms aren’t controlled,” Dr. Banerji says. Related: If You Take Allergy Meds, You Should Know About This Withdrawal Symptom Can You Develop Allergies Later in Life? Sadly, Yes—Here’s How to Deal 6 Signs Your Angry Skin Rash Might Be an Allergic Reaction Get more of SELF's great relationship reporting delivered right to your inbox—for free.