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Allergic Rhinitis Treatments: Over-the-Counter Medicine

For mild allergic rhinitis -- or symptoms that only strike for a few weeks a year -- over-the-counter medicines may be enough. OTC treatments for allergic rhinitis include:

Antihistamines. These drugs work by blocking histamine, a chemical that causes many allergy symptoms. They help relieve itching and sneezing. Examples include certirizine (Zyrtec), chlorpheniramine (Ahist, Chlor-Trimeton), diphenhydramine (Benadryl, Genahist), fexofenadine (Allegra), and loratadine (Agistam, Alavert, Claritin).

Decongestants. Though antihistamines can control many allergy symptoms, they don’t relieve congestion. That’s where oral decongestants come in, such as phenylephrine hydrochloride (Lusonal, Sudafed PE, Sudogest PE) and pseudoephedrine hydrochloride  (Sudafed, Sudogest). They reduce swelling in the nasal passages, opening them up.  Don't use nasal spray decongestants like naphazoline (Privine), oxymetazoline hydrochloride (Afrin, Dristan, Duramist), or phenylephrine hydrochloride (Neo-Synephrine, Rhinall, Sinex) for more than three days at a time. Used for too long, they can cause a rebound effect, making symptoms worse.

Steroid nasal sprays. These drugs work by reducing the swelling in the nasal passages. Many are available by prescription but only two, Nasacort and Flonase, are available over the counter.

Other drugs. A few other over-the-counter drugs may help too. Nasacort is the only steroid nasal spray available over the counter. Many others are available by prescription, as mentioned below. Cromolyn sodium (NasalCrom) is a nasal spray that can ease a runny or itchy nose, sneezing, and a stuffy nose due to allergies. Allergy eye drops with the ingredients naphazoline and tetrahydrozoline can relieve red eyes. Other eye drops with ketotifen, an antihistamine, help relieve itchy eyes.

Prescription Treatments for Allergic Rhinitis

If over-the-counter medicines aren’t giving you relief, you might need prescription drugs. Prescription treatments for allergic rhinitis include:

Steroid nasal sprays. These have become the standard prescription treatment for allergic rhinitis. “The great thing about steroid sprays is that with just one medication, you can treat the congestion, the itchiness, and the sneezing,” says Corinna Bowser, MD, an allergist in Narbeth, Pa. Examples include budesonide (Rhinocort), fluticasone propionate (Flonase), funisolide (Nasarel), and mometasone (Nasonex). One nasal steroid -- Nasacort -- is available without a prescription.     

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