The information provided here is meant to give you a general idea about each of the medications listed below. Only the most common side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
There are many types of medications—both over the counter and prescription—that can be used to treat symptoms of allergic rhinitis. Each class of medications works differently in the body.
However, once a definite diagnosis of allergic rhinitis is made, the first-line treatment of choice is nasal corticosteroid spray, as it is has been shown to be the most effective with the fewest side effects. Ask your doctor which medications may offer the best prevention against allergic rhinitis symptoms.
Antihistamines DiphenhydramineFexofenadineLoratadine, prescription strengthCetirizine hydrochlorideChlorpheniramineBrompheniramineDexbrompheniramine and pseudoephedrineClemastineChlorpheniramine and pseudoephedrine
Oral Decongestants Loratadine and pseudoephedrinePseudoephedrineTriprolidine and pseudoephedrineNaphazoline
Nasal Decongestants OxymetazolinePhenylephrine
Saline Nasal Spray Salinex
Common names include: DesloratadineLevocetirizine dihydrochloride
Antihistamines block or reduce the action of histamine, a chemical that is released when the immune system reacts to an allergen. The release of histamine leads to the symptoms of allergic rhinitis.
Possible side effects include: DrowsinessLightheadednessBlurry visionChange in ability to think clearlyDry mouth, nose, or throatGastrointestinal upset, stomach pain, or nauseaIncreased appetite and weight gainThickening of mucus
Increased effects in people with
due to slower removal from the body
Nasal antihistamine sprays are also available, such as
Common names include: Fexofenadine and pseudoephedrineAcrivastine and pseudoephedrineAzatadine and pseudoephedrine
Decongestants help to narrow the blood vessels, which results in a clearing of nasal congestion. Antihistamines help stop or reduce the production of histamine, a chemical that is released when the immune system reacts to an allergen.
Possible side effects of the oral decongestant/antihistamine combinations include: DrowsinessCoughIncrease in blood pressureHeadacheNervousness, difficulty sleepingNauseaRapid heart rate
Common names include: BeclomethasoneBudesonide nasalFluticasoneTriamcinoloneMometasoneFlunisolide
Nasal corticosteroids are sprayed or inhaled into the nose to help relieve the stuffy nose and discomfort of allergies.
Possible side effects include: Burning, dryness, or other irritation inside the nose (mild, lasting only a short time)Increase in sneezingIrritation of the throat
Common name: Cromolyn sodium (Intal)
Cromolyn is unique in that it is preventative. It changes the body's immunological response to allergens. It is most effective when used before coming into contact with substances that cause allergies or before allergy season. Cromolyn may be used alone or with other medications.
Possible side effects include: Burning, stinging, or irritation inside of noseFlushingIncrease in sneezing
This medication is also used to prevent allergy symptoms. It works by decreasing how many leukotrienes (chemicals) the body creates in response to an allergen.
Possible side effects include: Flu-like symptomsNervousnessHeadache and stomach acheNausea and vomitingNasal congestion
The US Food and Drug Administration (FDA) recommends that this medication have a label that warns that there may be a link between taking this medication and having suicidal thoughts. Talk to your doctor if you have any suicidal thoughts. If you are taking montelukast, do not stop right way. Talk to your doctor first.
The following medications are available without a prescription. Many of these are older or first-generation antihistamines. First-generation antihistamines can cause drowsiness. However, both loratadine and cetirizine are nonsedating second-generation antihistamines. DiphenhydramineFexofenadineLoratadine, prescription strengthCetirizine hydrochlorideChlorpheniramineBrompheniramineDexbrompheniramine and pseudoephedrineClemastineChlorpheniramine and pseudoephedrine
Several second-generation antihistamines are also available over the counter. Second-generation antihistamines are non-sedating. LoratadineCetirizine hydrochlorideFexofenadine
Antihistamines help reduce or block the action of histamine, a chemical that is released when the immune system reacts to an allergen. The release of histamine leads to the symptoms of allergic rhinitis.
Possible side effects include: Drowsiness
(some brands are non-sedating.)Slowed reaction timeDry mouth
Common names include: Pseudoephedrine-containing products
Decongestants help to narrow the blood vessels, which results in a clearing of nasal congestion. One possible side effect is an increase in blood pressure.
Common names include: AfrinNeosynephrine
Nasal sprays help relieve the stuffy nose and discomfort of allergies.
Possible side effects include: Burning, stinging, or irritation inside of noseFlushingIncrease in sneezingRebound (increased nasal congestion) if nasal decongestant sprays are used for more than 3 days
is a nasal spray that contains a saltwater solution to rinse your nose and help relieve mild congestion, loosen mucus, and prevent crusting. Though it can be useful for relieving symptoms of a stuffy nose and has no side effects, saline cannot prevent allergy symptoms from occurring, as some other allergy treatments can.
If you are taking medications, follow these general guidelines: Take the medication as directed. Do not change the amount or the schedule. Ask what side effects could occur. Report them to your doctor.Talk to your doctor before you stop taking any prescription medication.Plan ahead for refills if you need them.Do not share your prescription medication with anyone.Drugs can be dangerous when mixed. Talk to your doctor if you are taking more than one drug, including over-the-counter products and supplements.
Allergic rhinitis. American College of Allergy, Asthma, & Immunology
website. Available at: http://acaai.org/allergies/types/hay-fever-rhinitis. Accessed September 15, 2016.
Allergic rhinitis. EBSCO DynaMed Plus website. Available at:
http://www.dynamed.com/topics/dmp~AN~T116217/Allergic-rhinitis. Updated July 22, 2016. Accessed September 15, 2016.
Leukotriene inhibitors: montelukast (marketed as Singulair), zafirlukast (marketed as Accolate), and zileuton (marketed as Zyflo and Zyflo CR).
US Food and Drug Administration website. Available at:
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm166246.htm. Updated August 29, 2013. Accessed Septemgber 15, 2016.
5/6/2010 DynaMed's Systematic Literature Surveillance.
http://www.ebscohost.com/dynamed. Segall N, Gawchik S, Georges G, Haeusler JM. Efficacy and safety of levocetirizine in improving symptoms and health-related quality of life in US adults with seasonal allergic rhinitis: a randomized, placebo-controlled study.
Ann Allergy Asthma Immunol.
Last reviewed September 2016 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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