Allergic rhinitis (“allergies” or nasal congestion) is a common condition. In essence, it is inflammation of the nasal membranes caused by different allergens in the air. Symptoms could include: sneezing, runny nose, itchy eyes, and a slight sore throat at night due to post nasal drip. Eczema and nasal congestion run together as part of a triad: eczema, nasal congestion, and sometimes asthma. This congestion is often mistaken for a cold. It can impair one’s quality of life if left untreated.
Aggravating Factors
- A variety of factors can trigger or aggravate allergic rhinitis:
- Change in the seasons (increase pollen in the air)
- Pet Dander
- Dust
- Air Pollution
- Smoke
Treatment
There is no specific cure for nasal congestion. Fortunately, treatment is straightforward with a daily non-sedating antihistamine pill. This is often paired with nasal spray cortisone for maximum relief.
- Oral Antihistamines are safe OTC (no prescription needed), generic medicines
- Allegra (fexofenadine) Claritin (loratadine) and Zyrtec (cetirizine) daily. These three are very similar and can be used interchangeably.
- A daily pills is essential for preventing symptoms from flaring and for maintenance
- These can be taken in the am, pm, or both. 24 hour formulations can be effective as well
- Nasal Sprays
- Prescriptions: Flonase (fluticasone), Nasonex (mometasone), & Rhinocort (budesonide)
- Nasacort Allergy 24 was recently approved for sale OTC
- These are a safe way to use a cortisone (a great anti inflammatory) as it is localized to the nasal passage and effective at relieving allergic nasal congestion.
- Patients find great relief from their symptoms with these medications
- Spray once in each nostril morning and night (alternating nostrils)
Helpful Hints
- Labeled adult dose: Claritin 10mg, Zyrtec 10 mg, Allegra 180mg
- Try taking double the typical daily dose, especially for the first week or two or more if symptoms are severe. (antihistamines are safe, patients with hives take 4x daily dose).
- Claritin 24 hr comes in dissoluble 10 mg tablet Alavert that can be convenient to take.
- An “allergy shot” is an injection of a cortisone slowly absorbed in the arm or flank muscles. These are given to decrease an overactive immune system if allergies are severe. The injection usually lasts 4-5 weeks which “buys” time until the peak allergy season passes.
- Zyrtec is slightly sedating in 15% of patients; if so, use in the pm.
- Some also take Benedryl, as it is sedating, at night if symptoms are severe.
- In Allegra-D or Claritin-D ect, the “D” is for the decongestant Sudafed which helps dry up nasal congestion (lasts 406 weeks). Sudafed is a stimulant and could keep you up at night.
If you have any questions or concerns feel free to call our office at (801) 768-8800
