There are three basic steps to treating allergic rhinitis. The first step is to identify the allergens that the patient is sensitive to (by skin or blood testing) and institute measures for avoiding these allergens. There are specific, proven methods to reduce the levels of indoor allergens such as house dust mites, animal danders, indoor molds, and cockroaches. Exposure to outdoor allergens, such as plant pollens and outdoor molds, can only be reduced by staying indoors during peak hours (usually between 11 AM and 3 PM).
If allergen avoidance does not adequately control nasal allergy symptoms, the next step is to add medications. There are several types of medications used to treat allergic rhinitis , and in patients with moderate to severe symptoms, a combination of these drugs is often required. If allergen avoidance and medications are not successful in treating the rhinitis, allergen immunotherapy (allergy shots) is then typically recommended.
Commonly Used Oral Antihistamines
Drug (Generic/Brand Name) | Generation/OTC | Child Dose | Adult Dose |
---|---|---|---|
Chlorpheniramine/ Chlortrimeton |
Older/Yes | 2 mg 2 × /d | 4 mg 2 × /d |
Diphenhydramine/ Benadryl |
Older/Yes | 12.5 mg 3 × /d | 25 mg 3 × /d |
Desloratadine/ Clarinex |
Newer/No | 2.5 mg/d | 5 mg/d |
Loratadine/Claritin | Newer/Yes | 5 mg/d | 10 mg/d |
Cetirizine/Zyrtec | Newer/Yes | 2.5 mg 2 × /d | 10 mg/d |
Levocetirizine/Xyzal | Newer/No | 2.5 mg/d | 5 mg/d |
Fexofenadine/Allegra | Newer/No | 30 mg 2 × /d | 60 mg 2 × /d or 180 mg/d |