Medications for Allergic Rhinitis

The medicines below are used to treat allergic rhinitis. Only the most basic problems are listed. Ask your doctor if there are any other steps you need to take. Use each of them as your doctor tells you. If you have any questions or can’t follow the package instructions, call your doctor.

There are many types of medicines that will ease symptoms of allergic rhinitis. Your doctor may have you take more than one type. This is because they work in different ways.

Prescription Medicines

Antihistamines

  • Desloratadine
  • Levocetirizine dihydrochloride

Oral Decongestants and Antihistamine Combinations

  • Fexofenadine and pseudoephedrine
  • Acrivastine and pseudoephedrine
  • Azatadine and pseudoephedrine

Corticosteroid Nose Spray

  • Beclomethasone
  • Budesonide nasal
  • Fluticasone
  • Triamcinolone
  • Mometasone
  • Flunisolide

Mast Cell Stabilizer for the Nose

  • Cromolyn sodium

Leukotriene Inhibitor

  • Montelukast

Over-the-Counter Medicines

Antihistamines

  • Diphenhydramine
  • Fexofenadine
  • Loratadine, prescription strength
  • Cetirizine hydrochloride
  • Chlorpheniramine
  • Brompheniramine
  • Dexbrompheniramine and pseudoephedrine
  • Clemastine
  • Chlorpheniramine and pseudoephedrine

Oral Decongestants

  • Loratadine and pseudoephedrine
  • Pseudoephedrine
  • Triprolidine and pseudoephedrine
  • Naphazoline

Decongestants for the Nose

  • Oxymetazoline
  • Phenylephrine

Saline Nose Spray

  • Salinex

Prescription Medicines    TOP

Antihistamines

  • Desloratadine
  • Levocetirizine dihydrochloride

Antihistamines block or lower the action of a certain chemical released by the immune system. Blocking it helps lessen allergy symptoms. These can be in a pill or nose spray.

Some problems are:

  • Drowsiness
  • Lightheadedness
  • Vision problems
  • Problems thinking clearly
  • Dry mouth, nose, or throat
  • Belly pain
  • Nausea
  • More hunger and weight gain
  • Phlegm that feels thicker
  • People with kidney disease may feel these more because the medicines are filtered from the body at a slower rate

Oral Decongestants and Antihistamine Combinations

  • Fexofenadine and pseudoephedrine
  • Acrivastine and pseudoephedrine
  • Azatadine and pseudoephedrine

Decongestants clear a stuffy nose by making blood vessels smaller. Antihistamines block or lower the action of a certain chemical released by the immune system.

Some problems are:

  • Drowsiness
  • Cough
  • Rise in blood pressure
  • Headache
  • Nervousness
  • Sleeping problems
  • Nausea
  • Rapid heart rate

Corticosteroid Nose Spray

  • Beclomethasone
  • Budesonide nasal
  • Fluticasone
  • Triamcinolone
  • Mometasone
  • Flunisolide

These are sprayed or breathed into the nose. They will ease a stuffy nose and other problems with allergies.

Some problems are:

  • Burning, dryness, or other irritation inside the nose (mild, lasting only a short time)
  • Increase in sneezing
  • Irritation of the throat

Mast Cell Stabilizer for the Nose

  • Cromolyn sodium

Cromolyn is preventative. It changes the how the body responds to allergens. It's best to use this before you're exposed to an allergen or the start of allergy season.

Some problems are:

  • Burning, stinging, or irritation inside of nose
  • Flushing
  • More sneezing

Leukotriene Inhibitor

  • Montelukast

This can also prevent allergy symptoms. It works by lowering the numbers of a certain chemical that leads to inflammation.

Some problems are:

  • Flu-like symptoms
  • Nervousness
  • Headache
  • Bellyache
  • Nausea or vomiting
  • Stuffy nose

The US Food and Drug Administration advises this medicine should have a label warning. This is because of a link between taking it and having thoughts of taking your own life. If you have any of these thoughts, call your doctor right away. Don't stop taking this on your own. Talk to your doctor first.

Over-the-Counter Medicines    TOP

Antihistamines

Many of these are older and can cause drowsiness. But, both loratadine and cetirizine are newer and don't cause this problem.

  • Diphenhydramine
  • Fexofenadine
  • Loratadine, prescription strength
  • Cetirizine hydrochloride
  • Chlorpheniramine
  • Brompheniramine
  • Dexbrompheniramine and pseudoephedrine
  • Clemastine
  • Chlorpheniramine and pseudoephedrine

These don't cause drowsiness:

  • Loratadine
  • Cetirizine hydrochloride
  • Fexofenadine

Antihistamines block or lower the action of a certain chemical released by the immune system. Blocking it helps lessen allergy symptoms.

Some problems are:

  • Drowsiness in some types of these medicines
  • Slowed reaction time
  • Dry mouth

Oral Decongestants

  • Products that have pseudoephedrine

Decongestants clear a stuffy nose by making blood vessels smaller.

Decongestants for the Nose

  • Afrin
  • Neosynephrine

Decongestants clear a stuffy nose by making blood vessels smaller.

Some problems are:

  • Burning, stinging, or irritation inside of nose
  • Flushing
  • More sneezing
  • More stuffiness if this is used form more than 3 days

Saline Nose Spray

Salinex is a spray with saltwater. This will rinse your nose and help ease mild stuffiness, loosen phlegm, and stop crusting. It only eases problems. It doesn't stop allergies from happening.

Special Considerations    TOP

If you are taking medicines:

  • Take the medicine as directed. Don’t change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medicine.
  • Don’t share your prescription medicine.
  • Medicines can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medicine. This includes over-the-counter products and supplements.
  • Plan for refills as needed.

References:

Allergic rhinitis. American College of Allergy, Asthma & Immunology website. Available at: https://acaai.org/allergies/types/hay-fever-rhinitis. Accessed October 17, 2018.
Allergic rhinitis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116217/Allergic-rhinitis. Updated July 9, 2018. Accessed October 17, 2018.
Allergic rhinitis. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/immunology-allergic-disorders/allergic,-autoimmune,-and-other-hypersensitivity-disorders/allergic-rhinitis. Updated January 2018. Accessed October 17, 2018.
5/6/2010 DynaMed Plus Systematic Literature Surveillance. http://www.dynamed.com/topics/dmp~AN~T116217/Allergic-rhinitis. Segall N, Gawchik S, Georges G, Haeusler JM. Efficacy and safety of levocetirizine in improving symptoms and health-related quality of life in US adults with seasonal allergic rhinitis: a randomized, placebo-controlled study. Ann Allergy Asthma Immunol. 2010;104(3):259-267.
Last reviewed September 2018 by EBSCO Medical Review Board Marcin Chwistek, MD

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