Allergist and Immunologist Questions Allergic Rhinitis

What could be the best medicine for allergic rhinitis?

I am 23 years old and I am suffering from allergic rhinitis for the last 1 year. Is there permanent cure for this condition? What is the best medicine for this allergy? Please advice.

8 Answers

The drug of choice for allergic rhinitis is a nasal steroid. There is no cuhre for allergic rhinitis,however the treatment is first avoidance then pharmacotherapy and then allergy immunotherapy.
Antihistamines and nasal sprays help temporarily, but the only "permanent" cure would be skin testing and if positive, allergy shots will help for a number of years, sometimes leading to permanent improvement of symptoms.
One of the best treatments is allergy injections. Initially, you can start on an over-the-counter antihistamine and nasal spray. Check with your local Allergist.

Talal M. Nsouli, M.D., FACIP, FACAAI, FAAAAI
Hello, allergy sufferer, 

There are several options for you, each of them has risks/benefits, pluses and minuses, so I cannot say that one is the "best" one. I hope that by going through the options and dissecting them for you, you can make the choice that is a best fit for you. 

1. Allergy medications - the one class of medications that offers most relief is nasal steroid sprays. Most of them are OTC now - Rhinocort, Nasacort, Flonase, Flonase sensimist. The work of variety of pathways and thus offer relief of most symptoms - sneezing, nasal congestion, post nasal drip, eye itching and swelling as well. However they will offer such relief only if taken consistently (daily) during the season which bothers you the most. Another advantage is that they can offer what we call pre-seasonal prophylaxis - if you start them 2-3 weeks before the peak of the season you will minimize or eliminate the breakthrough symptoms once the pollen gets very high. The most common side effects are nasal irritation and potentially nose bleeds, some people also get a sore throat. 
Antihistamines  - Claritin, Zyrtec, Allegra, Xyzal, the good old Benadryl can also help but they work on fewer symptoms compared to the nasal steroid sprays. They primarily help with itching, sneezing and runny nose. 
Oral decongestants such as Sudafed, phenylephrine can help with congestion but we do not advise using them frequently because of their stimulant effects and stress on the cardiovascular system. 

2. Immunotherapy - known commonly as "allergy shots" is a very effective way to desensitize patients and make them mostly symptom free over time. They require allergy testing to decide which allergens need to be included in the solution and should be administered by a licensed allergist or another doctor's office that is comfortable with giving allergy shots. That is necessary to minimize the risk of an allergic reaction which is the biggest risk one takes on when pursuing allergen immunotherapy. 
There are some oral tablets for oral immunotherapy which can be done at home by the patient that are less risky and while helpful in reducing symptoms, may be not as potent as the shots. However, you still need an evaluation by an allergist to see if you are a candidate. 

Hope that helps inform you of your options so you can decide what is best for you. 

Sincerely, 

Monika Korff, MD
Many over the counter medicines are now available to treat allergic rhinits, or hay fever. These include antihistamines which can be taken as needed or daily and which last 24 hours. Steroid nasal sprays which are over the counter are also effective but need to be used for prolonged periods and can be used with antihistamines. Allergy immunotherapy administered by an allergist will reduce overall symptoms by 80-90% and is the closet thing to a cure for allergies.
You can use an over-the-counter antihistamine such as claritin, zyrtec, or allegra. You could also use an intranasal steroid spray such as Flonase or others. The more permanent cure usually requires immunotherapy by injections or sometimes with an FDA approved oral therapy.
There is no "permanent cure" though allergy immunotherapy (allergy shots or allergy drops) can be very effective in essentially desensitizing you. There is no such thing as "best medicine". The choice of medicine depends on your symptoms - essentially you can take a nasal spray (there are at least five choices) and/or a pill (an antihistamine or leukotriene modifier) and/or decongestant or any combination of the above plus more. The choice of medicines is something you should discuss with your healthcare provider. I am sorry if this information seems too vague; it is the best answer I could come up with given the information your provided.
There really is no cure for an allergy outside of complete avoidance. The best long term treatment option would be allergen immunotherapy, also known as allergy shots, if it is an appropriate option for you. That would be determined by appropriate testing with a board-certified allergist/immunologist. From a symptomatic treatment approach, the intranasal steroids such as Flonase, Rhinocort or Nasacort OTC would work best. My recommendation would be to see a board-certified allergies and have the correct diagnosis made and then go from there. There are a variety of non-allergic conditions that cause “allergy” symptoms.