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Top 5 Medications for Managing Seasonal Allergic Rhinitis

Seasonal Allergic Rhinitis
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Written by Andrew Le, MD.
Medically reviewed by
Last updated April 19, 2024

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Allergic rhinitis is a common condition that affects over 400 million people worldwide, but it is often not diagnosed or treated correctly. In the US, it affects up to 30% of adults and up to 40% of children, making it the fifth most prevalent chronic disease.

Seasonal allergic rhinitis can cause discomfort, with symptoms like sneezing and itchy or runny nose. It can disrupt daily activities, impact sleep quality, and decrease productivity. Many seek effective ways to alleviate these bothersome symptoms with the changing seasons.

In this article, you will learn about the top 5 medications that can help you manage seasonal allergic rhinitis. These medications can relieve troublesome symptoms, allowing you to enjoy the changing seasons more comfortably and efficiently.

What Is Seasonal Allergic Rhinitis?

Seasonal allergic rhinitis, or hay fever, is an allergy that occurs during specific times of the year. It is caused by the immune system's response to airborne substances, which are usually harmless but trigger an allergic reaction in some people. These substances, also known as allergens, include:

  • Pollen from trees
  • Grasses
  • Weeds

When people with seasonal allergies are exposed to an allergen, their immune system produces antibodies to fight the perceived threat. This results in the release of histamine and other chemicals that cause a range of symptoms, such as:

  • Sneezing: Frequent and repetitive sneezing is a common symptom.
  • Runny or Stuffy Nose: Nasal congestion, along with a runny or stuffy nose, is a hallmark of allergic rhinitis.
  • Itchy or Watery Eyes: Irritation, itching, and redness of the eyes are common symptoms.
  • Itchy Throat or Ears: Some individuals may experience itchiness in the throat or ears.
  • Coughing: A persistent cough may be present, mainly if postnasal drip occurs.
  • Fatigue: Allergic rhinitis can lead to fatigue and a general feeling of being unwell.
  • Headache: Some people may experience headaches due to sinus congestion and pressure.
  • Difficulty Sleeping: The symptoms, especially nasal congestion and difficulty breathing, can interfere with sleep.
  • Decreased Sense of Taste or Smell: Some individuals may notice a temporary decrease in their sense of taste or smell.
  • Dark Circles Under the Eyes: Often called "allergic shiners," dark circles under the eyes can be a sign of allergic rhinitis.

How Is Seasonal Allergic Rhinitis Diagnosed?

Diagnosing seasonal allergic rhinitis typically involves various methods to identify specific allergens triggering the allergic reactions. Two common diagnostic tests are:

1. Prick or Scratch Test

Allergy testing is often done using the prick or scratch test. An allergen extract is put on the skin during this test, usually on the forearm or back. Then, a tiny needle is used to prick or scratch the skin, allowing the allergen to enter the skin.

If a person is allergic to a substance, the test site will become red or have a small raised bump. Studies show that this simple method is accurate and can quickly identify allergens. The test's accuracy varies from 68% to 100% for sensitivity and 70% to 91% for specificity.

2. Intradermal Test

The intradermal test is another type of allergy test that involves injecting a small amount of allergen solution into the deeper layers of skin on the forearm using a small needle. If the person is allergic to the substance, a raised bump or redness will appear at the injection site, indicating an allergic reaction.

This test is typically used when prick tests fail to provide conclusive results or when a healthcare provider suspects a specific allergen. The accuracy of this test for diagnosing allergic rhinitis ranges from 60 to 79% in sensitivity and from 68 to 69% in specificity.

Top 5 Medications for Managing Seasonal Allergic Rhinitis

Managing seasonal allergic rhinitis often involves a combination of lifestyle modifications, environmental controls, and medications. Here are six commonly prescribed medications for managing seasonal allergic rhinitis:

1. Corticosteroids

Corticosteroids are medications that come in nasal sprays or oral forms, effectively reducing inflammation in the nasal passages. A study shows that oral corticosteroids are highly effective but may have unwanted effects on the whole body.

However, intranasal corticosteroids have been the most effective pharmacologic treatment for allergic rhinitis in the past decade. They work by relieving symptoms such as congestion and runny nose, providing much-needed relief to individuals affected by nasal allergies or related conditions.

Flonase Allergy Relief Nasal Spray, 24 Hour Non-Drowsy Allergy Medicine, Metered Nasal Spray - 72 Sprays

Flonase 24-Hour Non-Drowsy Decongestant Allergy Relief Medicine Nasal Spray is a potent solution that helps relieve various allergy symptoms, such as runny nose, sneezing, itchy nose and eyes, and nasal congestion. It costs $16.78.

Its formula contains Fluticasone Propionate, which effectively targets seasonal and year-round allergies caused by common allergens like pollen, mold, dust, and pet dander. The nasal spray is easy to use and is recommended for adults and children 12 years and older as a convenient and effective way to manage allergy symptoms.

Pros

  • Flonase provides 24-hour, all-in-one relief for various allergy symptoms, making it a versatile solution for individuals dealing with different triggers.
  • Unlike some allergy medications, Flonase's non-drowsy formula ensures that users can experience relief without the side effects of drowsiness, allowing for normal daily activities.
  • As the number one doctor-recommended brand in allergy relief, Flonase instills confidence in its efficacy and safety, backed by widespread medical endorsement.

Cons

  • While highly effective, Flonase may take a few days to kick in, requiring consistent use for optimal results.
  • Some users may experience nasal congestion in the evening after using Flonase, necessitating individualized adjustments to the application frequency.
  • The product is unsuitable for children under 4, limiting its use to families with younger children who may also suffer from allergies.

2. Antihistamines

Antihistamines are medicines that can block the effects of histamine, a chemical substance that the body releases in response to an allergic reaction. Histamine causes various allergy symptoms, such as sneezing, itching, and a runny nose.

A study has shown that first- and second-generation antihistamines effectively relieve histamine-mediated symptoms associated with allergic rhinitis, such as sneezing, itching, runny nose, and eye symptoms. These medicines work quickly, usually within 15 to 30 minutes, making them a suitable option for patients with mild symptoms that need "as needed" treatment. It's important to note that antihistamines are generally safe for use in children over six months old.

Claritin Liqui-Gels 24-Hour Allergy Relief, Non-Drowsy Allergy Medicine, Loratadine Antihistamine Capsules

Claritin Liqui-Gels 24-Hour Allergy Relief is a non-drowsy medication that helps relieve allergy symptoms caused by common allergens such as pollen, mold, dust, and pet dander. It is a powerful solution for both indoor and outdoor allergies, providing relief for a full day. The capsules are easy to swallow and offer convenient use. The price of the medication is $30.40.

Pros

  • Claritin Liqui-Gels claim to offer 24-hour non-drowsy relief, ensuring continuous protection against allergy symptoms throughout the day.
  • Claritin Liqui-Gels is designed to address symptoms triggered by over 200 different allergens, including those from pets, pollen, dust, and mold.
  • Claritin provides flexibility with its allergy relief products, offering orally disintegrating tablets and liquid-filled capsules to cater to different preferences and needs.

Cons

  • The price is relatively high.
  • Some customers express dissatisfaction with the packaging and shipping, citing a demolished package upon receipt.

3. Decongestants

Decongestants help reduce swelling and congestion in the nasal passages by constricting blood vessels. This relieves symptoms like a stuffy or runny nose and makes breathing easier. In a study involving 435 patients with seasonal allergic rhinitis, a combination medication (SCH 434) containing 5mg of loratadine and 120mg of pseudoephedrine (decongestant) was administered twice daily.

The results showed that SCH 434 provided a 50% reduction in total symptom scores by day 4 and was significantly more effective than its components or a placebo. Loratadine and pseudoephedrine alone also showed effectiveness, with 43% and 33% decreases in symptom scores, respectively, compared to a placebo.

Advil Allergy and Congestion Relief Tablets

Advil Allergy and Congestion Relief is a reliable solution to combat severe allergy and sinus symptoms for $15.33. Each tablet is packed with potent ingredients, including 200mg of ibuprofen for pain relief, 10mg of Phenylephrine HCl as a nasal decongestant, and 4mg of chlorpheniramine maleate as an antihistamine.

This combination effectively addresses symptoms such as headaches, fever, nasal congestion, sneezing, and itchy and watery eyes. The coated tablets are easily portable, preparing you for allergy and sinus pressure symptoms.

Pros

  • The formulation provides comprehensive relief, targeting multiple symptoms simultaneously.
  • Coated tablets are convenient for on-the-go use, allowing users to carry relief wherever needed.
  • Advil is a well-known and reputable brand, instilling confidence in the product's effectiveness.

Cons

  • It is unsuitable for children under 12, limiting its usability for younger individuals.
  • Requires taking one tablet every 4 hours, which may be inconvenient for those with busy schedules.
  • As with any medication, side effects are possible, such as drowsiness, and individuals with certain medical conditions should consult a doctor before use.

4. Intranasal mast cell stabilizers

Intranasal mast cell stabilizers are a type of medication that helps prevent the release of histamine and other chemicals from mast cells responsible for causing allergic symptoms like congestion, itching, and sneezing.

According to a study, these stabilizers, such as cromolyn sodium (CS), work by stopping the release of inflammatory mediators, including histamine, from mast cells. This reduces the symptoms of seasonal allergic rhinitis (SAR), such as sneezing, runny nose, and nasal itching. By inhibiting the release of these chemicals, intranasal mast cell stabilizers relieve these symptoms and improve the overall quality of life for people with allergies.

Cromolyn Sodium Nasal Solution

Cromolyn Sodium Nasal Solution 26mL is an excellent remedy for preventing and treating allergy symptoms. It relieves stuffy nose, sneezing, runny nose, and other symptoms caused by allergies. Made by Bausch & Lomb, it functions by blocking the release of substances that cause inflammation in the nasal passages.

The product is priced at $16.80 and is only intended for external use. It is recommended that users consult a doctor before use if they have certain conditions such as fever, discolored nasal discharge, sinus pain, or wheezing. The solution may take several days to be effective, with optimal results achieved after 1 to 2 weeks of use.

Pros

  • The Cromolyn Sodium Nasal Solution is cost-effective for individuals seeking relief from allergy symptoms.
  • Customer reviews highlight the product's effectiveness in managing conditions such as Mast Cell Activation Syndrome (MCAS) and hayfever symptoms.
  • Users appreciate the availability of this over-the-counter option, which provides relief for allergy sufferers without needing a doctor's prescription.

Cons

  • Some users express dissatisfaction with the bottle design, finding it challenging to extract a spray efficiently. Issues include difficulty getting a spray out and instances where the bottle fails to spray.
  • While effective, the product requires frequent use, with some users noting the need for 2-4 daily applications. This may pose a challenge for individuals seeking a more low-maintenance solution.
  • The solution specifically targets allergy symptoms. It may not be suitable for addressing conditions such as sinus infections, asthma, or cold symptoms, limiting its versatility for broader health issues.

5. Cysteinyl leukotriene modifiers

Cysteinyl leukotriene modifiers, more commonly known as leukotriene inhibitors, are recommended for prophylaxis and chronic treatment of asthma. However, they are generally not effective in treating seasonal allergic rhinitis symptoms. Clinical trials suggest that leukotriene inhibitors (e.g. montelukast) used as a monotherapy is not the preferred treatment for seasonal allergic rhinitis.

Intranasal glucocorticoids are strongly recommended for initial therapy in seasonal allergic rhinitis patients aged 12 years or older without prior treatment. Intranasal glucocorticoids are more effective than montelukast in symptom relief and improving quality of life. Although montelukast may have a role in managing seasonal allergic rhinitis in some cases, its effectiveness is generally lower than intranasal glucocorticoids.

Montelukast, 10 MG Tablets

Montelukast, a generic version of Singulair, is now available on Amazon Pharmacy. This medication is used to manage asthma and allergy symptoms. The medication is administered orally, and the 10 MG tablet helps reduce airway inflammation, enhancing respiratory ease.

The medication costs $10.70 monthly (with insurance) or $1070 without insurance. However, Prime members can avail of an 81% discount, making it more affordable.

Pros

  • Provides effective relief for symptoms of Seasonal Allergic Rhinitis.
  • Available at a significantly discounted price for Prime members.
  • Conveniently accessible through Amazon Pharmacy with fast, free delivery.

Cons

  • May cause mood and behavior changes, including anxiety and thoughts of suicide, in some individuals.
  • Potential for allergic reactions, such as skin rash or swelling of the face, lips, or throat.
  • Interacts with certain medications, necessitating careful consideration and monitoring by healthcare professionals.

Wrap-Up

Managing seasonal allergic rhinitis is possible with the right medication. Individuals can find relief and enjoy the changing seasons more comfortably by exploring options. Among the medications, a few stand out based on their effectiveness and versatility in addressing the diverse range of symptoms associated with seasonal allergic rhinitis.

One such medication is Flonase Allergy Relief Nasal Spray, which contains Fluticasone Propionate. It is known for providing 24-hour non-drowsy relief and targets symptoms like runny nose, sneezing, itchy nose, and nasal congestion. This nasal spray is a comprehensive solution for individuals with different allergy triggers. Moreover, Flonase has earned the trust of healthcare professionals as the number one doctor-recommended brand in allergy relief.

These medications play a crucial role in alleviating the discomfort associated with seasonal allergic rhinitis. Individuals experiencing symptoms like nasal congestion, itchy or watery eyes, and sneezing can explore these medications under healthcare professionals' guidance to find the most suitable relief for their needs.

FAQs On Seasonal Allergic Rhinitis

What distinguishes allergic rhinitis from seasonal allergies?

Allergic rhinitis refers to the inflammation of nasal passages due to an allergic reaction. Allergic rhinitis can occur throughout the year following exposure to a variety of allergens. Seasonal allergies on the other hand, involves a component of allergic rhinitis, but occurs due to exposure to specific allergens during particular times of the year.

What foods should you avoid if you have rhinitis?

Some individuals may find benefit from modifying their diet, however dietary triggers for allergic rhinitis are variable. Milk and dairy products, nuts, seafood, and hot and spicy foods can potentially trigger symptoms. If you notice worsening of allergic rhinitis when eating these food types, it could be beneficial to avoid them.

Is there a specific drink that is beneficial for allergic rhinitis?

There is limited data on this subject, but green tea is a potential option as it has been found to strengthen the immune system. Chamomile is another good choice as it is believed to have anti-inflammatory properties, which can potentially help fight allergic rhinitis symptoms.

Can I take cetirizine for allergic rhinitis?

Cetirizine is a safe and effective medication for treating allergic rhinitis, urticaria, and conjunctivitis. Patients can purchase cetirizine over the counter, but should be aware of possible side effects like drowsiness, fatigue, and dry mouth.

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Jeff brings to Buoy over 20 years of clinical experience as a physician assistant in urgent care and internal medicine. He also has extensive experience in healthcare administration, most recently as developer and director of an urgent care center. While completing his doctorate in Health Sciences at A.T. Still University, Jeff studied population health, healthcare systems, and evidence-based medi...
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