Which medications in the drug class Nasal corticosteroids are used in the treatment of Allergic Rhinitis?

Answer

Nasal corticosteroids

The intranasal steroids are divided into three generations based on their bioavailability. First generation corticosteroids, such as, beclomethasone, are more bioavailable and tend to produce more systemic adverse effects than newer intranasal corticosteroids. The second- and third-generation categories are less bioavailable and have limited systemic adverse effects.

Nasal steroid sprays are highly efficacious in treating allergic rhinitis.^{[97, 98, 99, 100, 101]}They control the 4 major symptoms of rhinitis (ie, sneezing, itching, rhinorrhea, congestion). They are effective as monotherapy, although they do not significantly affect ocular symptoms. Studies have shown nasal steroids to be more effective than monotherapy with nasal cromolyn or antihistamines.^{[98, 99]}Greater benefit may occur when nasal steroids are used with other classes of medication. They are safe to use and not associated with significant systemic adverse effects in adults (this may also be true for children, but the data are less clear).

In October 2013, the FDA approved once-daily triamcinolone acetonide (Nasacort Allergy 24HR) nasal spray as an over-the-counter treatment for nasal allergy symptoms in children aged 2 years or older, adolescents, and adults. It is the first over-the-counter glucocorticoid approved for the treatment of nasal allergy symptoms.Flonase was approved by FDA to be available over the counter on July 24, 2014, and Rhinocort was recently approved last year March 23, 2015.^[102]

Local adverse effects of nasal steroid sprays are limited to minor irritation or nasal bleeding, which resolve with temporary discontinuation of the medication. Nasal septal perforations are rarely reported and are less common with the newer corticosteroids and delivery systems. Safety during pregnancy has not been established; however, clinical experience suggests nasal corticosteroids (particularly beclomethasone, which has most experience in use) are not associated with adverse fetal effects.

The nasal steroids can be used prn, but seem to be maximally effective when used on a daily basis as maintenance therapy. They may also be helpful for vasomotor rhinitis or mixed rhinitis (a combination of vasomotor and allergic rhinitis) and can help to control nasal polyps.

Beclomethasone, intranasal (Beconase AQ, QNASL)

Corticosteroid with potent anti-inflammatory properties. Elicits effects on various cells, including mast cells and eosinophils. It also elicits effects on inflammatory mediators (eg, histamine, eicosanoids, leukotrienes, cytokines). Available in solution or suspension forms and delivered as a metered-dose nasal sprays.

Budesonide, intranasal (Rhinocort Aqua, Rhinocort Allergy)

Corticosteroid considered efficacious and safe for allergic rhinitis. May decrease number and activity of inflammatory cells, resulting in decreased nasal inflammation.

Fluticasone (Flonase Allergy Relief, GoodSense Nasoflow, Ticaspray, Veramyst)

Intranasal corticosteroid. Indicated for seasonal and perennial allergic rhinitis. Relieves nasal symptoms associated with allergic rhinitis. Has also demonstrated improvement in allergic eye symptoms. May decrease number and activity of inflammatory cells, resulting in decreased nasal inflammation.

Ciclesonide (Omnaris, Zetonna)

Newer corticosteroid nasal spray indicated for allergic rhinitis. Prodrug that is enzymatically hydrolyzed to pharmacologic active metabolite C21-desisobutyryl-ciclesonide following intranasal application. Corticosteroids have a wide range of effects on multiple cell types (eg, mast cells, eosinophils, neutrophils, macrophages, lymphocytes) and mediators (eg, histamines, eicosanoids, leukotrienes, cytokines) involved in allergic inflammation. Each spray delivers 50 mcg.

Triamcinolone (Nasacort Allergy 24 HR, Nasal Allergy 24 HR)

Intranasal corticosteroid efficacious and safe for allergic rhinitis. May decrease number and activity of inflammatory cells, resulting in decreased nasal inflammation.

Mometasone, intranasal (Nasonex, Propel Mini)

Nasal spray; may decrease number and activity of inflammatory cells, resulting in decreased nasal inflammation. Demonstrated no mineralocorticoid, androgenic, antiandrogenic, or estrogenic activity in preclinical trials. Decreases rhinovirus-induced up-regulation in respiratory epithelial cells and modulate pretranscriptional mechanisms. Reduces intraepithelial eosinophilia and inflammatory cell infiltration (eg, eosinophils, lymphocytes, monocytes, neutrophils, plasma cells).

Did this answer your question?

Yes No

Additional feedback? (Optional)

Thank you for your feedback!

Druce HM. Allergic and nonallergic rhinitis. Middleton EM Jr, Reed CE, Ellis EF, Adkinson NF Jr, Yunginger JW, Busse WW, eds. Allergy: Principles and Practice. 5th ed. St. Louis, Mo: Mosby Year-Book; 1998. 1005-16.
Togias AG. Systemic immunologic and inflammatory aspects of allergic rhinitis. J Allergy Clin Immunol. 2000 Nov. 106(5 Suppl):S247-50. [Medline].
Blaiss MS. Quality of life in allergic rhinitis. Ann Allergy Asthma Immunol. 1999 Nov. 83(5):449-54. [Medline].
Thompson AK, Juniper E, Meltzer EO. Quality of life in patients with allergic rhinitis. Ann Allergy Asthma Immunol. 2000 Nov. 85(5):338-47; quiz 347-8. [Medline].
Ray NF, Baraniuk JN, Thamer M, Rinehart CS, Gergen PJ, Kaliner M. Direct expenditures for the treatment of allergic rhinoconjunctivitis in 1996, including the contributions of related airway illnesses. J Allergy Clin Immunol. 1999 Mar. 103(3 Pt 1):401-7. [Medline].
Bhattacharyya N. Incremental healthcare utilization and expenditures for allergic rhinitis in the United States. Laryngoscope. 2011 Sep. 121(9):1830-3.
Skoner DP. Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis. J Allergy Clin Immunol. 2001 Jul. 108(1 Suppl):S2-8. [Medline].
Walls AF, He S, Buckley MG, McEuen AR. Roles of the mast cell and basophil in asthma. Clin Exp Allergy. 2001. 1:68.
Haberal I, Corey JP. The role of leukotrienes in nasal allergy. Otolaryngol Head Neck Surg. 2003 Sep. 129(3):274-9. [Medline].
Iwasaki M, Saito K, Takemura M, Sekikawa K, Fujii H, Yamada Y. TNF-alpha contributes to the development of allergic rhinitis in mice. J Allergy Clin Immunol. 2003 Jul. 112(1):134-40. [Medline].
Cates EC, Gajewska BU, Goncharova S, Alvarez D, Fattouh R, Coyle AJ. Effect of GM-CSF on immune, inflammatory, and clinical responses to ragweed in a novel mouse model of mucosal sensitization. J Allergy Clin Immunol. 2003 May. 111(5):1076-86. [Medline].
Salib RJ, Kumar S, Wilson SJ, Howarth PH. Nasal mucosal immunoexpression of the mast cell chemoattractants TGF-beta, eotaxin, and stem cell factor and their receptors in allergic rhinitis. J Allergy Clin Immunol. 2004 Oct. 114(4):799-806. [Medline].
Hansen I, Klimek L, Mosges R, Hormann K. Mediators of inflammation in the early and the late phase of allergic rhinitis. Curr Opin Allergy Clin Immunol. 2004 Jun. 4(3):159-63. [Medline].
World Allergy Organization (WAO). Pawanker R, Canonica GW, Holgate ST, Lockey RF, Blaiss MS. White Book on Allergy: Update 2013. Milwaukee, WI: World Allergy Organization; 2013. [Full Text].
Bloom B, Jones LI, Freeman G. Summary health statistics for U.S. children: National Health Interview Survey, 2012. Vital Health Stat 10. 2013 Dec. 1-81. [Medline].
Björkstén B, Clayton T, Ellwood P, Stewart A, Strachan D, ISAAC Phase III Study Group. Worldwide time trends for symptoms of rhinitis and conjunctivitis: Phase III of the International Study of Asthma and Allergies in Childhood. Pediatr Allergy Immunol. 2008 Mar. 19 (2):110-24. [Medline].
Heinrich J, Richter K, Frye C, Meyer I, Wölke G, Wjst M, et al. [European Community Respiratory Health Survey in Adults (ECRHS)]. Pneumologie. 2002 May. 56 (5):297-303. [Medline].
Nihlen U, Greiff L, Montnemery P, Lofdahl CG, Johannisson A, Persson C. Incidence and remission of self-reported allergic rhinitis symptoms in adults. Allergy. 2006 Nov. 61(11):1299-304. [Medline].
Sly RM. Changing prevalence of allergic rhinitis and asthma. Ann Allergy Asthma Immunol. 1999 Mar. 82(3):233-48; quiz 248-52. [Medline].
Von Mutius E, Weiland SK, Fritzsch C, et al. Increasing prevalence of hay fever and atopy among children in Leipzig, East Germany. Lancet. 1998. 351:862.
Romano-Zelekha O, Graif Y, Garty BZ, Livne I, Green MS, Shohat T. Trends in the prevalence of asthma symptoms and allergic diseases in Israeli adolescents: results from a national survey 2003 and comparison with 1997. J Asthma. 2007 Jun. 44(5):365-9. [Medline].
Lima RG, Pastorino AC, Casagrande RR, et al. Prevalence of asthma, rhinitis and eczema in 6 - 7 years old students from the western districts of Sao Paulo City, using the standardized questionnaire of the "International Study of Asthma and Allergies in Childhood" (ISAAC)-phase IIIB. Clinics. 2007. 62:225.
Aït-Khaled N, Pearce N, Anderson HR, Ellwood P, Montefort S, Shah J, et al. Global map of the prevalence of symptoms of rhinoconjunctivitis in children: The International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three. Allergy. 2009 Jan. 64 (1):123-48. [Medline].
Watson WT, Becker AB, Simons FE. Treatment of allergic rhinitis with intranasal corticosteroids in patients with mild asthma: effect on lower airway responsiveness. J Allergy Clin Immunol. 1993 Jan. 91(1 Pt 1):97-101. [Medline].
Meltzer EO, Grant JA. Impact of cetirizine on the burden of allergic rhinitis. Ann Allergy Asthma Immunol. 1999 Nov. 83(5):455-63. [Medline].
Nayak AS. The asthma and allergic rhinitis link. Allergy Asthma Proc. 2003 Nov-Dec. 24(6):395-402. [Medline].
Kiyohara C, Tanaka K, Miyake Y. Genetic susceptibility to atopic dermatitis. Allergol Int. 2008 Mar. 57(1):39-56. [Medline].
Fireman P. Otitis media and eustachian tube dysfunction: connection to allergic rhinitis. J Allergy Clin Immunol. 1997 Feb. 99(2):S787-97. [Medline].
McColley SA, Carroll JL, Curtis S, Loughlin GM, Sampson HA. High prevalence of allergic sensitization in children with habitual snoring and obstructive sleep apnea. Chest. 1997 Jan. 111(1):170-3. [Medline].
Craig TJ, Teets S, Lehman EB, Chinchilli VM, Zwillich C. Nasal congestion secondary to allergic rhinitis as a cause of sleep disturbance and daytime fatigue and the response to topical nasal corticosteroids. J Allergy Clin Immunol. 1998 May. 101(5):633-7. [Medline].
Dykewicz MS, Fineman S, Skoner DP, Nicklas R, Lee R, Blessing-Moore J. Diagnosis and management of rhinitis: complete guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology. American Academy of Allergy, Asthma, and Immunology. Ann Allergy Asthma Immunol. 1998 Nov. 81(5 Pt 2):478-518. [Medline].
U.S. Department of Health and Human Services. Agency for Healthcare Research and Quality. Management of Alllergic and Nonallergic rhinitis. May 2002. AHQR publication 02:E023, Boston, MA. Summary, Evidence Report/Technology Assessment: No 54. http://www.ahrq.gov/clinic/epcsums/rhinsum.htm. Last accessed August 3, 2007.
Settipane RA. Demographics and epidemiology of allergic and nonallergic rhinitis. Allergy Asthma Proc. 2001 Jul-Aug. 22(4):185-9. [Medline].
Bousquet J, Van Cauwenberge P, Khaltaev N, Aria Workshop Group., World Health Organization. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol. 2001 Nov. 108 (5 Suppl):S147-334. [Medline].
Banov CH, Lieberman P,. Efficacy of azelastine nasal spray in the treatment of vasomotor (perennial nonallergic) rhinitis. Ann Allergy Asthma Immunol. 2001 Jan. 86(1):28-35. [Medline].
Colás C, Galera H, Añibarro B, Soler R, Navarro A, Jáuregui I, et al. Disease severity impairs sleep quality in allergic rhinitis (The SOMNIAAR study). Clin Exp Allergy. 2012 Jan 18. [Medline].
Li Z, Celestin J, Lockey RF. Pediatric Sleep Apnea Syndrome: An Update. J Allergy Clin Immunol Pract. 2016 Sep-Oct. 4 (5):852-61. [Medline].
Kalpaklioğlu AF, Kavut AB, Ekici M. Allergic and nonallergic rhinitis: the threat for obstructive sleep apnea. Ann Allergy Asthma Immunol. 2009 Jul. 103 (1):20-5. [Medline].
Craig TJ, McCann JL, Gurevich F, Davies MJ. The correlation between allergic rhinitis and sleep disturbance. J Allergy Clin Immunol. 2004 Nov. 114 (5 Suppl):S139-45. [Medline].
Tsai JD, Chang SN, Mou CH, Sung FC, Lue KH. Association between atopic diseases and attention-deficit/hyperactivity disorder in childhood: a population-based case-control study. Ann Epidemiol. 2013 Apr. 23(4):185-8. [Medline].
Torres-Borrego J, Molina-Teran AB, Montes-Mendoza C. Prevalence and associated factors of allergic rhinitis and atopic dermatitis in children. Allergol Immunopathol (Madr). 2008 Mar-Apr. 36(2):90-100. [Medline].
Frew AJ. Advances in environmental and occupational diseases 2003. J Allergy Clin Immunol. 2004 Jun. 113(6):1161-6. [Medline].
Boulet LP, Turcotte H, Laprise C, Lavertu C, Bedard PM, Lavoie A. Comparative degree and type of sensitization to common indoor and outdoor allergens in subjects with allergic rhinitis and/or asthma. Clin Exp Allergy. 1997 Jan. 27(1):52-9. [Medline].
Fornadley JA, Corey JP, Osguthorpe JD, Powell JP, Emanuel IA, Boyles JH. Allergic rhinitis: clinical practice guideline. Committee on Practice Standards, American Academy of Otolaryngic Allergy. Otolaryngol Head Neck Surg. 1996 Jul. 115(1):115-22. [Medline].
Hadley JA. Evaluation and management of allergic rhinitis. Med Clin North Am. 1999 Jan. 83(1):13-25. [Medline].
Vazquez-Nava F, Quezada-Castillo JA, Oviedo-Trevino S, Saldivar-Gonzalez AH, Sanchez-Nuncio HR, Beltran-Guzman FJ. Association between allergic rhinitis, bottle feeding, non-nutritive sucking habits, and malocclusion in the primary dentition. Arch Dis Child. 2006 Oct. 91(10):836-40. [Medline].
Siracusa A, Desrosiers M, Marabini A. Epidemiology of occupational rhinitis: prevalence, aetiology and determinants. Clin Exp Allergy. 2000 Nov. 30(11):1519-34. [Medline].
Gelber LE, Seltzer LH, Bouzoukis JK, Pollart SM, Chapman MD, Platts-Mills TA. Sensitization and exposure to indoor allergens as risk factors for asthma among patients presenting to hospital. Am Rev Respir Dis. 1993 Mar. 147(3):573-8. [Medline].
Kang B, Vellody D, Homburger H, Yunginger JW. Cockroach cause of allergic asthma. Its specificity and immunologic profile. J Allergy Clin Immunol. 1979 Feb. 63(2):80-6. [Medline].
Eggleston PA, Ansari AA, Ziemann B, Adkinson NF Jr, Corn M. Occupational challenge studies with laboratory workers allergic to rats. J Allergy Clin Immunol. 1990 Jul. 86(1):63-72. [Medline].
Phipatanakul W, Eggleston PA, Wright EC, Wood RA,. Mouse allergen. II. The relationship of mouse allergen exposure to mouse sensitization and asthma morbidity in inner-city children with asthma. J Allergy Clin Immunol. 2000 Dec. 106(6):1075-80. [Medline].
Matsui EC, Simons E, Rand C, Butz A, Buckley TJ, Breysse P. Airborne mouse allergen in the homes of inner-city children with asthma. J Allergy Clin Immunol. 2005 Feb. 115(2):358-63. [Medline].
Gendo K, Larson EB. Evidence-based diagnostic strategies for evaluating suspected allergic rhinitis. Ann Intern Med. 2004 Feb 17. 140(4):278-89. [Medline].
Platts-Mills TA. Allergen avoidance. J Allergy Clin Immunol. 2004 Mar. 113(3):388-91. [Medline].
Morgan WJ, Crain EF, Gruchalla RS, O'Connor GT, Kattan M, Evans R 3rd. Results of a home-based environmental intervention among urban children with asthma. N Engl J Med. 2004 Sep 9. 351(11):1068-80. [Medline].
McDonald LG, Tovey E. The role of water temperature and laundry procedures in reducing house dust mite populations and allergen content of bedding. J Allergy Clin Immunol. 1992 Oct. 90(4 Pt 1):599-608. [Medline].
Miller JD, Miller A. Ten minutes in a clothes dryer kills all mites in blankets. J Allergy Clin Immunol. 1996. 97:423.
Korsgaard J. House-dust mites and absolute indoor humidity. Allergy. 1983 Feb. 38(2):85-92. [Medline].
de Blay F, Chapman MD, Platts-Mills TA. Airborne cat allergen (Fel d I). Environmental control with the cat in situ [see comments]. Am Rev Respir Dis. 1991. 143:1334.
Weber RW. Immunotherapy with allergens. JAMA. 1997 Dec 10. 278(22):1881-7. [Medline].
Li JT. Immunotherapy for allergic rhinitis. Immunol Allergy Clin North Am. 2000. 20:383.
Leynadier F, Banoun L, Dollois B, Terrier P, Epstein M, Guinnepain MT. Immunotherapy with a calcium phosphate-adsorbed five-grass-pollen extract in seasonal rhinoconjunctivitis: a double-blind, placebo-controlled study. Clin Exp Allergy. 2001 Jul. 31(7):988-96. [Medline].
Walker SM, Pajno GB, Lima MT, Wilson DR, Durham SR. Grass pollen immunotherapy for seasonal rhinitis and asthma: a randomized, controlled trial. J Allergy Clin Immunol. 2001 Jan. 107(1):87-93. [Medline].
Ewbank PA, Murray J, Sanders K, Curran-Everett D, Dreskin S, Nelson HS. A double-blind, placebo-controlled immunotherapy dose-response study with standardized cat extract. J Allergy Clin Immunol. 2003 Jan. 111(1):155-61. [Medline].
Nanda A, O'connor M, Anand M, Dreskin SC, Zhang L, Hines B. Dose dependence and time course of the immunologic response to administration of standardized cat allergen extract. J Allergy Clin Immunol. 2004 Dec. 114(6):1339-44. [Medline].
Bozek A, Ignasiak B, Filipowska B, Jarzab J. House dust mite sublingual immunotherapy: a double-blind, placebo-controlled study in elderly patients with allergic rhinitis. Clin Exp Allergy. 2013 Feb. 43(2):242-8. [Medline].
Virchow JC, Backer V, Kuna P, Prieto L, Nolte H, Villesen HH, et al. Efficacy of a House Dust Mite Sublingual Allergen Immunotherapy Tablet in Adults With Allergic Asthma: A Randomized Clinical Trial. JAMA. 2016 Apr 26. 315 (16):1715-25. [Medline].
FDA OKs Oralair, First US Sublingual Allergy Immunotherapy. Medscape. Available at http://www.medscape.com/viewarticle/822975. Accessed: April 4, 2014.
Grastek [package insert]. Whitehouse Station, NJ: Merck & Co, Inc. April 2014. Available at [Full Text].
Maloney J, Bernstein DI, Nelson H, Creticos P, Hébert J, Noonan M, et al. Efficacy and safety of grass sublingual immunotherapy tablet, MK-7243: a large randomized controlled trial. Ann Allergy Asthma Immunol. 2014 Feb. 112(2):146-153.e2. [Medline].
Creticos PS, Esch RE, Couroux P, Gentile D, D'Angelo P, Whitlow B, et al. Randomized, double-blind, placebo-controlled trial of standardized ragweed sublingual-liquid immunotherapy for allergic rhinoconjunctivitis. J Allergy Clin Immunol. 2014 Mar. 133(3):751-8. [Medline].
Creticos PS, Maloney J, Bernstein DI, Casale T, Kaur A, Fisher R, et al. Randomized controlled trial of a ragweed allergy immunotherapy tablet in North American and European adults. J Allergy Clin Immunol. 2013 May. 131(5):1342-9.e6. [Medline].
Nolte H, Bernstein DI, Nelson HS, Kleine-Tebbe J, Sussman GL, Seitzberg D, et al. Efficacy of house dust mite sublingual immunotherapy tablet in North American adolescents and adults in a randomized, placebo-controlled trial. J Allergy Clin Immunol. 2016 Dec. 138 (6):1631-1638. [Medline].
Di Bona D, Plaia A, Leto-Barone MS, La Piana S, Di Lorenzo G. Efficacy of subcutaneous and sublingual immunotherapy with grass allergens for seasonal allergic rhinitis: A meta-analysis-based comparison. J Allergy Clin Immunol. 2012 Sep 26. [Medline].
Chhabra N, Houser SM. The surgical management of allergic rhinitis. Otolaryngol Clin North Am. 2011 Jun. 44 (3):779-95, xi. [Medline].
Gunhan K, Unlu H, Yuceturk AV, Songu M. Intranasal steroids or radiofrequency turbinoplasty in persistent allergic rhinitis: effects on quality of life and objective parameters. Eur Arch Otorhinolaryngol. 2011 Jun. 268 (6):845-50. [Medline].
Di Rienzo Businco L, Di Rienzo Businco A, Ventura L, Laurino S, Lauriello M. Turbinoplasty with quantic molecular resonance in the treatment of persistent moderate-severe allergic rhinitis: Comparative analysis of efficacy. Am J Rhinol Allergy. 2014 Mar-Apr. 28 (2):164-8. [Medline].
De Corso E, Bastanza G, Di Donfrancesco V, Guidi ML, Morelli Sbarra G, Passali GC, et al. Radiofrequency volumetric inferior turbinate reduction: long-term clinical results. Acta Otorhinolaryngol Ital. 2016 Jun. 36 (3):199-205. [Medline].
Lin HC, Lin PW, Friedman M, Chang HW, Su YY, Chen YJ, et al. Long-term results of radiofrequency turbinoplasty for allergic rhinitis refractory to medical therapy. Arch Otolaryngol Head Neck Surg. 2010 Sep. 136 (9):892-5. [Medline].
Seidman MD, Gurgel RK, Lin SY, Schwartz SR, Baroody FM, et al. Clinical practice guideline: Allergic rhinitis. Otolaryngol Head Neck Surg. 2015 Feb. 152 (1 Suppl):S1-43. [Medline].
Henderson, D. New Guidelines for Allergic Rhinitis Released. Medscape Medical News. Available at http://www.medscape.com/viewarticle/839130. Accessed: February 9, 2015.
Meltzer EO. Performance effects of antihistamines. J Allergy Clin Immunol. 1990 Oct. 86(4 Pt 2):613-9. [Medline].
Vacchiano C, Moore J, Rice GM, Crawley G. Fexofenadine effects on cognitive performance in aviators at ground level and simulated altitude. Aviat Space Environ Med. 2008 Aug. 79(8):754-60. [Medline].
Newer antihistamines. Med Lett Drugs Ther. 2001 Apr 30. 43(1103):35. [Medline].
De Weck AL, Derer T, Bahre M. Investigation of the anti-allergic activity of azelastine on the immediate and late-phase reactions to allergens and histamine using telethermography. Clin Exp Allergy. 2000 Feb. 30(2):283-7. [Medline].
Lee TA, Pickard AS. Meta-analysis of azelastine nasal spray for the treatment of allergic rhinitis. Pharmacotherapy. 2007 Jun. 27(6):852-9. [Medline].
Berger W, Hampel F Jr, Bernstein J, Shah S, Sacks H, Meltzer EO. Impact of azelastine nasal spray on symptoms and quality of life compared with cetirizine oral tablets in patients with seasonal allergic rhinitis. Ann Allergy Asthma Immunol. 2006 Sep. 97(3):375-81. [Medline].
Chervinsky P, Philip G, Malice MP, Bardelas J, Nayak A, Marchal JL. Montelukast for treating fall allergic rhinitis: effect of pollen exposure in 3 studies. Ann Allergy Asthma Immunol. 2004 Mar. 92(3):367-73. [Medline].
Perry TT, Corren J, Philip G, Kim EH, Conover-Walker MK, Malice MP. Protective effect of montelukast on lower and upper respiratory tract responses to short-term cat allergen exposure. Ann Allergy Asthma Immunol. 2004 Nov. 93(5):431-8. [Medline].
Patel P, Philip G, Yang W, et al. Randomized, double-blind, placebo-controlled study of montelukast for treating perennial allergic rhinitis. Ann Allergy Asthma Immunol. 2005 Dec. 95(6):551-7. [Medline].
Nayak A, Langdon RB. Montelukast in the treatment of allergic rhinitis: an evidence-based review. Drugs. 2007. 67(6):887-901. [Medline].
Gengo FM, Manning C. A review of the effects of antihistamines on mental processes related to automobile driving. J Allergy Clin Immunol. 1990 Dec. 86(6 Pt 2):1034-9. [Medline].
Verster JC, Volkerts ER. Antihistamines and driving ability: evidence from on-the-road driving studies during normal traffic. Ann Allergy Asthma Immunol. 2004 Mar. 92(3):294-303; quiz 303-5, 355. [Medline].
O'Hanlon JF, Ramaekers JG. Antihistamine effects on actual driving performance in a standard test: a summary of Dutch experience, 1989-94. Allergy. 1995 Mar. 50(3):234-42. [Medline].
Ray WA, Thapa PB, Shorr RI. Medications and the older driver. Clin Geriatr Med. 1993 May. 9(2):413-38. [Medline].
Cimbura G, Lucas DM, Bennett RC, Warren RA, Simpson HM. Incidence and toxicological aspects of drugs detected in 484 fatally injured drivers and pedestrians in Ontario. J Forensic Sci. 1982 Oct. 27(4):855-67. [Medline].
van Bavel J, Findlay SR, Hampel FC Jr, Martin BG, Ratner P, Field E. Intranasal fluticasone propionate is more effective than terfenadine tablets for seasonal allergic rhinitis. Arch Intern Med. 1994 Dec 12-26. 154(23):2699-704. [Medline].
Welsh PW, Stricker WE, Chu CP, Naessens JM, Reese ME, Reed CE. Efficacy of beclomethasone nasal solution, flunisolide, and cromolyn in relieving symptoms of ragweed allergy. Mayo Clin Proc. 1987 Feb. 62(2):125-34. [Medline].
Kaszuba SM, Baroody FM, deTineo M, Haney L, Blair C, Naclerio RM. Superiority of an intranasal corticosteroid compared with an oral antihistamine in the as-needed treatment of seasonal allergic rhinitis. Arch Intern Med. 2001 Nov 26. 161(21):2581-7. [Medline].
Rak S, Heinrich C, Jacobsen L, Scheynius A, Venge P. A double-blinded, comparative study of the effects of short preseason specific immunotherapy and topical steroids in patients with allergic rhinoconjunctivitis and asthma. J Allergy Clin Immunol. 2001 Dec. 108(6):921-8. [Medline].
Pullerits T, Praks L, Ristioja V, Lotvall J. Comparison of a nasal glucocorticoid, antileukotriene, and a combination of antileukotriene and antihistamine in the treatment of seasonal allergic rhinitis. J Allergy Clin Immunol. 2002 Jun. 109(6):949-55. [Medline].
Brooks M. FDA OKs OTC Triamcinolone (Nasacort) Nasal Spray. Medscape [serial online]. Available at http://www.medscape.com/viewarticle/812522. Accessed: October 21, 2013.
Norris AA, Alton EW. Chloride transport and the action of sodium cromoglycate and nedocromil sodium in asthma. Clin Exp Allergy. 1996 Mar. 26(3):250-3. [Medline].
Dykewicz MS, Wallace DV, Baroody F, Bernstein J, Craig T, et al. Treatment of seasonal allergic rhinitis: An evidence-based focused 2017 guideline update. Ann Allergy Asthma Immunol. 2017 Nov 2. [Medline].
Meltzer EO. The prevalence and medical and economic impact of allergic rhinitis in the United States. J Allergy Clin Immunol. 1997 Jun. 99(6 Pt 2):S805-28. [Medline].
Brown T. FDA OKs Oralair, first US sublingual allergy immunotherapy. Medscape Medical News. April 2, 2014. [Full Text].
Brown T. FDA OKs Sublingual Grastek for Timothy Grass Pollen Allergy. Medscape Medical News. Available at http://www.medscape.com/viewarticle/823627. Accessed: April 22, 2014.
Onrust SV, Lamb HM. Mometasone furoate. A review of its intranasal use in allergic rhinitis. Drugs. 1998 Oct. 56(4):725-45. [Medline].
US Food and Drug Administration. FDA approves first sublingual allergen extract for the treatment of certain grass pollen allergies [press release]. April 2, 2014. Available at http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm391458.htm. Accessed: April 7, 2014.
Lin SY, Nnacheta LC. American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) will publish its latest “Clinical practice guideline: allergic rhinitis (AR) in February, 2015”. Am J Rhinol Allergy. 2015 Jan-Feb. 29 (1):82. [Medline].

Media Gallery

of 0

Author

Javed Sheikh, MD Assistant Professor of Medicine, Harvard Medical School; Clinical Director, Division of Allergy and Inflammation, Clinical Director, Center for Eosinophilic Disorders, Beth Israel Deaconess Medical Center

Javed Sheikh, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Allergy, Asthma and Immunology

Disclosure: Received grant/research funds from Genentech for other.

Coauthor(s)

Tiffany Jean, MD Fellow, Department of Allergy and Immunology, Kaiser Permanente Los Angeles Medical Center

Tiffany Jean, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Stephen C Dreskin, MD, PhD Professor of Medicine, Departments of Internal Medicine, Director of Allergy, Asthma, and Immunology Practice, University of Colorado Health Sciences Center

Stephen C Dreskin, MD, PhD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Association for the Advancement of Science, American College of Allergy, Asthma and Immunology, Clinical Immunology Society, Joint Council of Allergy, Asthma and Immunology, American Association of Immunologists

Disclosure: Received consulting fee from Genentech for consulting; Received grant support from NIH for research; Received consulting fee from Clinical Immunization and Safety Assessment (CISA) Network (administered by Vanderbilt University) for consulting; Received consulting fee from o Member, Medical Expert Panel, Division of Vaccine Injury Compensation (DVIC), Department of Health and Human Services. for med legal reviews; Received consulting fee from o Member, Medical Expert Panel, Vaccine Review, Pfize.

Chief Editor

Michael A Kaliner, MD Clinical Professor of Medicine, George Washington University School of Medicine; Medical Director, Institute for Asthma and Allergy

Michael A Kaliner, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Association of Immunologists, American College of Allergy, Asthma and Immunology, American Society for Clinical Investigation, American Thoracic Society, Association of American Physicians

Disclosure: Nothing to disclose.

Additional Contributors

William F Schoenwetter, MD Consultant in Allergic Diseases, Brainerd Medical Center, Brainerd, Minnesota

William F Schoenwetter, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Allergy, Asthma and Immunology, American College of Physicians, American Medical Association, Joint Council of Allergy, Asthma and Immunology, Minnesota Medical Association

Disclosure: Nothing to disclose.

Umer Najib, MD Clinical Research Fellow, Department of Medicine, Division of Allergy and Inflammation, Beth Israel Deaconess Medical Center

Disclosure: Nothing to disclose.

Which medications in the drug class Nasal corticosteroids are used in the treatment of Allergic Rhinitis?

Nasal corticosteroids

Beclomethasone, intranasal (Beconase AQ, QNASL)

Budesonide, intranasal (Rhinocort Aqua, Rhinocort Allergy)

Fluticasone (Flonase Allergy Relief, GoodSense Nasoflow, Ticaspray, Veramyst)

Ciclesonide (Omnaris, Zetonna)

Triamcinolone (Nasacort Allergy 24 HR, Nasal Allergy 24 HR)

Mometasone, intranasal (Nasonex, Propel Mini)

Related Questions:

References

Tables

Contributor Information and Disclosures