Rows of medications fill the shelves. There are antihistamines, decongestants, even a spray that promises to clear your nasal passages. How do you choose?

Very carefully, pharmacists, allergists and general practitioners agree. Some medications can make you drowsy, some keep you awake. Some don't seem to do much at all.

"There's a lot of stuff to chose from," says Dr. Wallace Carroll, a Modesto allergist.

Here's a rundown of allergy remedies:

* Control your environment -- Before you run to the drug store, allergy experts recommend trying to avoid plants and activities that are known to trigger allergic reactions.

Don't mow the lawn. Don't venture outside much during dry, windy days, when conditions make it easy for pollen to travel from the orchard across town to your residential neighborhood.

Avoid walnut, olive, mulberry and oak trees, common allergens in the San Joaquin Valley. Bermuda and rye grass -- commonly found in lawns or growing between rows of trees in orchards -- also irritate seasonal allergy sufferers.

* Antihistamines -- If you're holing up inside instead of working in the yard and you're still experiencing itchy eyes and a runny nose, consider an over-the-counter antihistamine, says Dr. Richard Davis, a Modesto allergist. "It's time to go to the drugstore."

Antihistamines take their name from the word histamine, a chemical released during an allergic reaction. Antihistamines compete with the chemical, relieving allergy symptoms. Common over-the-counter antihistamines include Benadryl and Tavist.

Beware: drugstore antihistamines almost always cause drowsiness. Many packages advise users not to drive or operate heavy machinery while taking the drug.

Some doctors recommend taking antihistamines before an allergic reaction. If you know you're going on a family picnic under the oak tree, try popping an antihistamine in the morning.

* Decongestants -- These drugstore remedies open up nasal passages and relieve stuffy noses without drowsiness. A common brand is Sudafed.

Davis emphasizes that decongestants don't block allergic reactions, but relieve symptoms for a short time. Packages warn patients to use decongestants for only short-term relief.

Since decongestants work by shrinking blood vessels, they're not recommended for those with high blood pressure. Doctors also note decongestants are associated with strokes in elderly patients.

* Over-the-counter nasal sprays -- Carroll hopes allergy suffers won't be swayed by the claims of these sprays. While these products open up nasal passages, they must be used four to six times a day to have any effect. Also, package instructions tell allergy sufferers to use the sprays for only short-term relief.

Instead, he recommends drugstore brands of salt water solution intended to be sprayed in the nose. They also open up closed nasal passages.

* See the doctor -- If you've tried drugstore remedies and you're still suffering, experts say it's time for an appointment.

Doctors can prescribe antihistamines that don't cause drowsiness like the over-the-counter versions. Zyrtec and Allegra are common brands.

They also can prescribe nasal sprays. These sprays contain cortisone and are considered by some to be the most effective treatment for allergies, more effective than over-the-counter sprays. These are sold under several names including Beconase, Flonase and Nasarel.

Some general practitioners also will draw blood to determine what's causing the allergy, says Dr. Gene LaMonica, director of the Stanislaus County Health Services Agency urgent care center. The blood tests can be expensive, but offer an alternative to more extensive skin testing typically performed by allergists.

* See an allergist -- If you've tried drugstore and prescription remedies and still can't sleep or if you miss work because of allergies, it's time to see an allergist, Carroll says.

Allergists use skin tests to pinpoint exactly what tree or grass is irritating the eyes and nose. That way, allergy sufferers can avoid triggering flare-ups.

Allergists also give allergy shots. Doctors sensitize patients to the elements they're allergic to by injecting them with traces of allergens repeatedly over time.

While doctors used to give these shots just before spring, when most people experience allergies, they now give them year-around. Studies show this lessens symptoms over a period of years.

For more allergy sufferers, shots are a last resort.

"You don't want to make the treatment worse than the problem," Davis says.

Staff writer Kerry McCray can be reached at 578-2358 or e-mail kmccray@modbee.com.

Reprinted by permission of Modesto Bee.