In July of 2010, I wrote a piece on my experience with Medco getting my prescription for Patanol filled. The medication is a prescription antihistamine that is administered by drops to the eye. It is prescribed for hay fever and similar allergies that cause itchy eyes.
During my struggles with Medco, my local pharmacist recommended an over-the-counter medication that he said was just as effective called ketotifen fumarate, which is sold under the brand name of Alaway but also under other brand names.
After some experience using both medications, I thought I should report back on my experience. First, I need to insert all the necessary caveats. I am not a medical doctor or a pharmacist. If you need medical advice, see your family doctor, or ophthalmologist.
My experience as a patient is that both medications helped to stop my eyes from itching, however, Alaway stings when the drops are added, whereas I do not have this experience with Patanol. If you do not mind the sting, Alaway may be fine, but I prefer the Patanol.
Update (5/31/2013): See my subsequent post on the topic: Eye Allergies: Patanol Still the Best for Me
19 comments:
I agree with you; Alaway doesn't cause me discomfort, works well, and is about $70 cheaper than Patanol . Even with good insurance, an RX of Patanol costs $80. Alaway is sold over the counter for about $10.
It appears that you do not agree with me. Both medications are effective for me, but Alaway *does* cause me discomfort. With my insurance coverage, the cost to me is about equal actually.
It sounded like it was brief discomfort. Maybe you could write a teaching moment about why one product retails for $26/month and the other costs $130/month (not including insurance)? You gave a case report of one working better than the other, but what about the real science of comparing the two in a double-blind study?
Thanks for your comment. I am lucky to have good enough insurance that Patanol only costs me $10 out of pocket. I did not give a case report of one working better than the other. In fact, I explicitly stated that they both worked for me. The discomfort of the Alaway is enough that I will continue to use Patanol. I have no doubt that the trade-off for others may vary. I am not in the profession of evaluating the efficacy of medication and make no claim to anything other than anecdotal evidence. I would recommend that any readers with allergies consult their family physician.
I like to make my eyewash at home using a boric acid eye wash solution. Way cheaper.
I'm glad that Patanol worked for you, but it's not for everyone. A good description of the drug can be found hereat rxwiki.com/patanol.
Thanks for the reference.
Thanks for sharing your experience. I started off using Pataday and then tried Alaway (to compare effectiveness plus I really like that $11 OTC price). Alaway drops burn, not sting, burn every single time I put them on and are not as effective for me as Pataday (residual redness, etc.). It's been 2 weeks and I can't stand it anymore. I'm starting back on Pataday tomorrow (refill arrived today). It's a very effective solution for me (and I'm beyond grateful ... only found my way to it a couple of months ago after allergy testing and on recommendation from that dr.) I thought the two medications might be more interchangeable -- sounds like that's the case for many? Unfortunately -- they're not interchangeable for me.
Due to the cost of Patanol, I have been searching OTC eye drops, too. There was a slight sting, but something I can handle, since I found it at Big Lots for $4.00.
Rich- thank you for starting the topic and sharing your experience. I was wondering how bad your eye redness was and how much it was reduced, and, over what period of time?
I've been taking Alaway for three weeks now, and although it works temporarily, the redness and slight itch returns after less than five hours.
I would return to the allergist, but the cost is too steep. I've also been prescribed Pataday but have not tried it yet. Third consecutive year with this allergy and the redness seems to last all summer. Thanks again.
@Ted: mine varies from very bad to less bad depending on the season, what's blooming etc. Try the Pataday or Patanol; it's expensive, but for me it is money well spent.
I used patanol for a few years but my insurance refused to cover it anymore when Zatador become available. Zatador works pretty well for me. I purchased Alaway because it was cheaper but will cost more in the long run because it causes stinging for me but not Zatador. Live and learn as they say.
I also tried Zaditor. It is the same active ingredient as Alaway, but it does not sting my eyes either. I suspect it is a difference in inactive ingredients. At any rate, I am now a convert to Zaditor.
I've been using Patanol for a while and worked well for me. I just switched to Ketotifen as of today due to my current insurance not carrying my former formulary. I had used Ketotifen at the start of my allergies 3years ago, which didn't help at the time. My allergy was so bad that I had to be treated with strong steroids for about two months. After that, I was given Patanol and it worked well with no issues. I had just applied my first dose of Ketotifen a little while ago and I can't say I felt the sting noticeably more than what I feel when I use other ophthalmic solutions such as Retinol or Refresh classic. I'd need to use Ketotifen for a while to see its effectiveness and also if any discomfort.
For anyone interested in a little more information on research based comparison for the afore mentioned using patients reported experiences, please look at http://www.medscape.com/viewarticle/489382. Thank you for sharing your experiences.
While my mystified by the different reactions to Zaditor vs Alaway (since they have the same active ingredient, ketotifen, which is known to sting), your preference for Patanol (Olopatadine) is typical. Repeated studies have shown that both are effective but comfort level and patient preference is by far higher for Olopatadine. In side-by-side blinded comparisons (where subjects used Ketitifen in one eye and Olopatadine in the other, without knowing which is which), preference for Olopatadine was a whopping 81%.
Go to the last page if you only want to see the results:
http://www.medscape.com/viewarticle/489382
Borazan M, Karalezli A, Akova YA, Akman A, Kiyici H, Erbek SS. Efficacy of olopatadine HCI 0.1%, ketotifen fumarate 0.025%, epinastine HCI 0.05%, emedastine 0.05% and fluorometholone acetate 0.1% ophthalmic solutions for seasonal allergic conjunctivitis: a placebo-controlled environmental trial. Acta Ophthalmol. 2009 Aug;87(5):549-54. Epub 2008 Jul 9.
Hida WT, Nogueira DC, Schaefer A, Dantas PE, Dantas MC. Comparative study between 0.025% ketotifen fumarate and 0.1% olopatadine hydrochloride in the treatment of vernal keratoconjunctivitis. Arq Bras Oftalmol. 2006 Nov-Dec;69(6):851-6.
Leonardi A, Zafirakis P. Efficacy and comfort of olopatadine versus ketotifen ophthalmic solutions: a double-masked, environmental study of patient preference.Curr Med Res Opin. 2004 Aug;20(8):1167-73.
Buring with keototifen is common and can be relieved or eliminated for large number of people by just storing it in the fridge, cool drops tend to sting much less and can actually feel soothing, I suggest this for ALL eye drops (allergy or otherwise). This may save some of you a lot of money. I am an allergist BTW.
Best
Olopatadine the active ingredient in Pataday, has recently been approved for over the counter sale.
Do the above eye drops contain steroids? Want steroid free. My eyes water and itch. Feels like sand in them. Never experienced anything like this before. First timer.
Alaway (ketotifen)
Zadidor
Patan
Pataday
In my 50's and have suffered from allergic conjuctivitis and hay fever generally my whole life. I've probably tried every known antihistamine tablet, nasal spray, and eye drop. I've tried Patanol/Pataday (even in conjunction with Alamast) with very little, if any, relief. They also were very expensive if on a high deductible plan - so not worth the cost. Alaway/Zaditor have similar efficacy for me, slight relief with just a minimal short sting. But far less expensive. I also tried a new drop - Bepreve. This works best for me - by far. Again, they are stupid expensive - as in about $200 for a tiny bottle. I use these on the worst days and Alaway for normal itchiness. I also find that use of Flonase starting a month before allergy season has helped control the severity of my eye symptoms. No antihistamines tablets work for me, whether OTC or prescription with the exception of benadryl. Benadryl is amazing for me, a half dose works but also drops me into a coma. Great for when I'm going to mow the lawn and be physically active or for before bed. Hope this helps. Everyone's body chemistry is different, so not everything will work for everyone.
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