What is the best treatment for allergic rhinitis?

Corticosteroid (anti-inflammatory) nasal sprays

Most people with allergic rhinitis will benefit from using nasal sprays containing medications that reduce inflammation in the lining of the nose (corticosteroids). These medications are available over the counter and on prescription. Your doctor can advise which is best for you.

For best results, these medications are taken regularly and long term, just like preventers for asthma. Corticosteroid nasal sprays for allergic rhinitis have a good safety record, including in children and people of all ages with asthma.

It can take up to 2 weeks to experience the full effect of treatment, so your doctor or pharmacist may suggest that you also use another medication for a short time to relieve your symptoms immediately.

For people who experience allergic rhinitis symptoms only part of the year, and can predict when symptoms will occur, it is sometimes possible to take a corticosteroid nasal spray for 6 weeks or more, then stop.

Other medications

• Antihistamine tablets (available over the counter) are effective against itching and sneezing. They can be used alone (for people who only need intermittent relief) or in combination with other medications including nasal sprays. Newer antihistamines are less sedating. Your doctor or pharmacist may advise you to take antihistamines before going anywhere that usually triggers your allergy symptoms.

• Antihistamine nasal sprays (available over the counter) can provide quick relief of itching and sneezing. They can be used as well as a corticosteroid nasal spray.

• Decongestant nasal sprays and tablets are used to unblock the nose. These should never be taken for more than a few days at a time.

• Saline irrigations: Your doctor may recommend that you use a salt water (saline) solution daily to help clear your nose and soothe the lining of the nose. Various types are available from pharmacies.

 Other medications may be prescribed by your doctor or suggested by your pharmacist.

 Before taking any medication for allergic rhinitis, you should tell your doctor or pharmacist if:

• you have any other medical conditions or are pregnant

• you are taking other medications (including over-the-counter, complementary medicines or food supplements)

• you have been experiencing nose bleeds.

I’m pregnant – can I take allergic rhinitis medications?

If you have troublesome symptoms of allergic rhinitis, or if effective medication for your allergic rhinitis helps control your asthma symptoms, your doctor might recommend that you take medication while you are pregnant.

Some corticosteroid nasal sprays have a good safety rating for pregnancy. There is also good evidence for the safety of these medications from very large numbers of pregnant women who have taken these same medications in an inhaled form (puffer) for asthma.

If you discover that you are pregnant while using medications for allergic rhinitis, tell your doctor. Most allergic rhinitis medications have no particular safety concerns for pregnant or lactating women, so the risk of harm to the foetus is very low. While medications are generally avoided in pregnancy, particularly during the first trimester, some allergic rhinitis medications have been taken by pregnant women with no evidence of harm.

How is allergic rhinitis treated in children?

Treatments for allergic rhinitis in children are generally similar to those used in adults.

• Corticosteroid nasal sprays are appropriate in children who need long-term treatment, and some can be used in children as young as 3 years.

• Newer, less sedating oral antihistamines are effective for children whose symptoms are only mild or only need intermittent treatment. Some can be taken by children as young as 12 months. The older, more sedating antihistamines should be avoided.