Allergic rhinitis guide
Snapshot
- Common symptoms: Sneezing, nasal congestion, rhinorrhea, postnasal drip, itchy eyes/nose.
- Goal: Symptom control with minimal sedation and improved daytime functioning.
First-line strategy
- Trigger reduction (dust, pollen, pet dander as feasible).
- Intranasal corticosteroid daily during active symptom periods.
- Add non-sedating oral antihistamine as needed.
Step-up options
- Intranasal antihistamine for breakthrough symptoms.
- Combination intranasal steroid + antihistamine for persistent moderate-severe symptoms.
- Saline irrigation for mucus burden and comfort.
Safety notes
- Review sedating antihistamine burden, especially in older adults.
- Reassess proper spray technique before escalating medication.
Follow-up
- Recheck in 2–6 weeks after regimen changes.
- Consider allergy/immunology referral for refractory disease or unclear triggers.