Treatment of Hay Fever

Nasal Sprays

• Antihistamines provide relief from congestion, itchy/runny nose, sneezing and postnasal drip by blocking the effects of histamine. Examples include:

  • Axzelastine hydrochloride (Astelin) is a steroid-free antihistamine nasal spray (available by prescription only)

• Steroids - These are often recommended as first-line therapy for moderate to severe allergic rhinitis. Side effects are few - the most common is nosebleed (epistaxis) which occurs in 10% of users. These preparations may take a week to be maximally effective. Examples include:

  • Beclomethasone dipropionate (Beconase, Vancenase)
  • Fluticasone propionate (Flonase)
  • Flunisolide (Nasalide)
  • Triamcinolone acetonide (Nasacort)

• Anticholinergic Agents - Examples include:

  • Ipratropium (Atrovent) - relieves rhinorrhea (runny nose)

• Topical Decongestants - These act directly on the blood vessels in the nasal tissues to cause constriction leading to drainage of these areas and a decrease in congestion. These preparations should not be used for extended periods (> 3 days) because of the risk of rebound congestion. Examples include:

  • Oxymetazoline (Afrin) is available over the counter

• Mast-Cell Stabilizers - Available without a prescription, these medications are usually most effective when given prior to exposure to known allergens. They have been proven to be safe for use in children. Examples include:

  • Cromolyn sodium (NasalCrom)