Allergic Rhinitis (Nasal Congestion)

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


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