Curing the World One Patient at a Time
TOLL FREE: 855.251.9116

Dx Allergic Rhinitis Treatment:


The cause and treatment of allergic rhinitis is complex and described below. For chronic rhinosinusitis (nose and sinus), over-the-counter(OTC) nasal irrigations with the "use of a high-volume, low-pressure system like a squeeze bottle remains the optimal delivery device".

Additionally, "the use of OTC xylitol in chronic rhinosinusitis and topical [prescription] fluconazole in allergic fungal sinusitis appear promising."
subcutaneous immunotherapy(SCIT) shows "moderate to strong evidence of effectiveness for treatment of allergic rhinitis and asthma, particularly with single-allergan immunotherapy regimens".

Many products are inexpensive: over-the-counter Afrin®, Zyrtec®; liquid promethazine, generic nasal sprays of Flonase®, Nasocort® AQ, and oral Singular®.

 Allergic Rhinitis

The Merck Manual Home Edition
states "The nose is the most commonly infected part of the upper airways. Rhinitis may be acute (short-lived) or chronic (long-standing). Acute rhinitis commonly results from viral infections but may also be a result of allergies or other causes. Chronic rhinitis usually occurs with chronic sinusitis.

Acute viral rhinitis:
Acute viral rhinitis (the common cold) can be caused by a variety of viruses. Symptoms consist of runny nose, sneezing, congestion, postnasal drip, cough, and a low-grade fever. Stuffiness can be relieved by taking decongestants such as oxymetazoline or phenylephrine as a nasal spray or pseudoephedrine by mouth. These drugs, available over the counter, cause the blood vessels of the nasal mucous membrane to narrow (constrict). Nasal sprays should be used for only 3 or 4 days because after that period of time, when the effects of the drugs wear off, the mucous membrane often swells even more than before. This phenomenon is called rebound congestion. Antihistamines help control runny nose but cause drowsiness and other problems, especially in older people. Antibiotics are not effective for acute viral rhinitis."

Treatment of acute sinusitis is aimed at improving sinus drainage and curing the infection. Steam inhalation; hot, wet towels over the affected sinuses; and hot beverages may help relieve the swollen membranes and promote drainage. Flushing a saltwater solution through the nose (nasal irrigation) or using a salt-water spray also can help symptoms. Nasal sprays, such as phenylephrine or oxymetazoline, which cause swollen membranes to shrink, can be used for a limited time. Similar drugs, such as pseudoephedrine, taken by mouth are not as effective. Corticosteroid nasal sprays also can help relieve symptoms but take at least 10 days to work. For acute sinusitis that is severe or persistent, antibiotics such as amoxicillin/clavulanate, doxycycline, or levofloxacin are given.

People who have chronic sinusitis take the same antibiotics but for a longer period of time, typically 4 to 6 weeks. When antibiotics are not effective, surgery may be performed either to wash out the sinus and obtain material for culture or to improve sinus drainage, which allows the inflammation to resolve."

Medication Used in :
1. Corticosteroid nasal sprays and oral medications
2. Antihistamine Nasal Sprays
3. Antihistamines: Promethegan®, Phenadoz®, Claritin®, etc.
4. Leukotriene Receptor Antagonists: Singulair®
5. Combinations with Antihistamines: Promethazine® DM, Promethazine® VC, Bromfed® DM, Dec-Chlorphen®DM, Tussionex®, promethazine vc/codeine, Tussicaps®, Zutripro®
6. NSAID cough and Cold Combinations: Advil Allergy Sinus
7. Actaminophen Combinations: Nyquil® over-the-counter
8. Subcutaneous immunotherapy (SCIT)
9. Anticholinergics: Atrovent®

Suggested Links:
*N.H.S. Choices (with Video)

*[Editor] The consensus is that (1) little support that nasal irrigation or these antihistamines show "effectiveness" above and beyond IntraNasal Steroids (INS). INS are not highly toxic. However, (2) it is a good idea Restricting cough and cold medicine in children because "particular medications, including diphenhydramine and codeine appear to be associated with a high frequency of severe adverse effects and toxicity."

Copyrighted© 2014