Allergic rhinitis is inflammation of the inside of the nose caused by an allergen triggering an IgE mediated type 1 hypersensitivity reaction to tree pollen, such as pollen, dust, mould, or flakes of skin from certain animals.
Symptoms:
Severity
Mild to moderate
- Intranasal antihistamine first-line, or a second-generation, non-sedating oral antihistamine, depending on the person’s age and personal preference.
- Oral antihistamine options include loratadine or cetirizine, which may be available over-the-counter
- Consider the use of an intranasal treatments such as sodium cromoglicate to be used ‘as needed’, if antihistamines are contraindicated or not tolerated.
Moderate to severe
- Options include intranasal mometasone furoate, fluticasone furoate, or fluticasone propionate.
- Advise the patient that the onset of action is 6–8 hours post initial dose, but the maximal effect may not be seen until after two weeks.
- Nasal drops may be preferred if there is severe nasal obstruction-may need to be referred.
- Advise the person not to increase beyond the prescribed dose as there is no evidence of additional benefit, and suggest not to switch to an alternative preparation, as they all have comparable efficacy.