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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, fexofenadine, and loratadine. The antihistamines chlorpheniramine and diphenhydramine are known to cause drowsiness. If your primary complaint is sneezing and itching, your doctor may recommend one of these.

Decongestants. Though antihistamines can control many allergy symptoms, they don’t relieve congestion. That’s where oral decongestants come in, such as phenylephrine 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. Doctors recommend this as your first choice for treatment because of effectiveness and simplicity of use. 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. 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 (Naphcon-A, AK-Con-A) and tetrahydrozoline (OptiClear) can relieve red eyes. Other eye drops with ketotifen (Zaditor, Alaway), 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 are the recommended 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 beclomethasone diproprionate (Qnasal, Beconase AQ), budesonide (Rhinocort), fluticasone propionate, and mometasone ( Nasonex). Nasacort and Flonase are available without a prescription.


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