Rhinitis Medicines Selection Guide

1. Primary Symptom Type

• Allergy-dominant: Sneezing, itching, watery eyes, runny nose → Choose Anti-Allergy Medications
• Congestion-dominant: Blocked nose, difficulty breathing, sinus pressure → Choose Nasal Congestion Medications
• Mixed symptoms: Both allergic and congestive → Choose combination formulations

2. Preferred Dosing Frequency

• Once daily: Maximum convenience, consistent coverage
• Twice daily: Balance of convenience and control
• Three times daily: Flexible dosing, faster action

3. Administration Preference

• Oral tablets/capsules: Systemic effect, whole-body coverage
• Chewable tablets: Easy to take, no water needed
• Nasal sprays: Direct local action, minimal systemic effects
• Herbal/irrigation: Natural approaches, complementary therapy

Anti-Allergy Medications (All Frequencies)

• When to Take: Once-daily at same time each day (morning); Twice-daily morning and evening; Three times-daily spread evenly throughout day
• Best Practices: Start before allergy season for preventive effect; Take consistently for best results; Can be used year-round for perennial allergies
• With Food: Can be taken with or without food; Taking with food may reduce stomach upset
• Duration: Safe for long-term use as needed; Continue through allergy season
• Tips: Once-daily formulations maintain more consistent blood levels; Three times-daily offers flexibility for variable symptoms

Nasal Congestion Medications (All Frequencies)

• Duration Limit: Do not use oral decongestants for more than 5-7 consecutive days without medical supervision
• Timing: Avoid taking close to bedtime as decongestants may interfere with sleep
• With Food: Take with food or milk if stomach upset occurs
• Monitoring: Check blood pressure if you have hypertension; Monitor for nervousness or rapid heartbeat
• Important: If congestion persists beyond 7 days, consult healthcare provider

Chewable Medications

• How to Take: Chew tablets thoroughly before swallowing; No water required but can be taken with water if desired
• Portability: Individually wrapped for on-the-go convenience
• Children: Ensure child can chew safely; Follow age-specific dosing carefully
• Storage: Keep in original packaging to protect from moisture

Nasal Sprays

• Proper Technique: Clear nose gently before use; Aim spray toward outer nostril wall, away from septum; Breathe in gently while spraying; Avoid blowing nose immediately after
• Decongestant Sprays: LIMIT TO 3-5 DAYS MAXIMUM to prevent rebound congestion; For short-term acute use only
• Steroid Sprays: Safe for long-term use; May take several days to reach full effect; Use consistently as directed
• Maintenance: Clean spray nozzle regularly; Prime pump before first use

Herbal Medicines and Nasal Irrigation

• Kampo Medicines: Take as directed, often with warm water; May take several weeks for full effect; Safe for long-term use
• Nasal Irrigation: Use only sterile, distilled, or boiled (then cooled) water; Follow device instructions carefully; Perform over sink; Breathe through mouth during irrigation
• Frequency: Can be done 1-2 times daily or as needed; Particularly helpful before bedtime
• Benefits: Removes mucus, allergens, and irritants; Moisturizes nasal passages; Drug-free approach

Pediatric Formulations

• Age Verification: Always confirm child meets minimum age requirement for product
• Weight-Based Dosing: Use weight-based dosing when provided in instructions
• Administration: Chewable tablets for children who cannot swallow pills; Pleasant flavors improve compliance
• Monitoring: Watch for side effects carefully; Keep medication out of children's reach
• School Use: Choose less sedating formulations for daytime use during school

DO NOT use nasal decongestants (oral or spray) if you have:

• Uncontrolled high blood pressure or severe hypertension
• Severe heart disease or coronary artery disease
• Hyperthyroidism
• Taking MAO inhibitors or within 2 weeks of stopping them

Oral Decongestants: Limited Duration Use

• Maximum 5-7 consecutive days without medical supervision
• Prolonged use can cause rebound congestion (rhinitis medicamentosa)
• May cause nervousness, dizziness, or sleep disturbance

Nasal Decongestant Sprays: CRITICAL 3-5 Day Limit

• NEVER exceed 3-5 days of continuous use
• Rebound congestion occurs with overuse and can be severe
• Only for acute, short-term symptom relief

• May cause drowsiness, especially first-generation antihistamines
• Avoid driving or operating machinery if drowsy
• Do not combine with alcohol
• Use caution in elderly patients (increased fall risk from sedation)
• May cause urinary retention in men with prostate enlargement
• Contraindicated in narrow-angle glaucoma

• Always verify minimum age requirements before giving to children
• Never exceed recommended pediatric doses
• Supervise children taking medication
• Store all medications out of reach of children
• Consult pediatrician before giving multiple medications

• Consult healthcare provider before using any rhinitis medication during pregnancy
• Avoid decongestants in first trimester
• Some antihistamines are safer than others during pregnancy
• Medications can pass into breast milk

• Symptoms last more than 10 days without improvement
• Symptoms worsen after initial improvement
• Over-the-counter medications provide no relief

• High fever (over 101.5°F/38.6°C) lasting more than 3 days
• Severe facial pain or headache
• Thick, discolored nasal discharge (green/yellow) with facial pain
• Blood in nasal discharge
• Vision changes or eye swelling
• Severe sore throat or ear pain
• Difficulty breathing or wheezing

• Frequent sinus infections (3+ per year)
• Year-round nasal congestion affecting quality of life
• Chronic post-nasal drip
• Sleep disruption due to nasal symptoms
• Suspected allergies requiring testing

• Side effects from medications
• Rebound congestion from nasal spray overuse
• Need for long-term decongestant use (beyond 7 days)
• Medications not controlling symptoms adequately
• Questions about drug interactions with other medications

• Pregnant or nursing mothers before using any medication
• Individuals with heart disease, high blood pressure, diabetes, or thyroid disorders
• Young children or infants with nasal symptoms
• Elderly patients before starting new medications

Environmental Control

• Keep windows closed during high pollen days
• Use air conditioning with HEPA filters
• Remove carpeting if possible; use washable rugs
• Encase pillows and mattresses in allergen-proof covers
• Wash bedding weekly in hot water
• Keep humidity below 50% to prevent mold

Lifestyle Modifications

• Shower before bed to remove allergens from hair and skin
• Change clothes after outdoor activities during allergy season
• Keep pets out of bedroom if allergic
• Avoid outdoor activities during peak pollen times (early morning)
• Wear sunglasses outdoors to protect eyes from pollen

Nasal Hygiene

• Use saline nasal irrigation regularly
• Apply saline nasal spray to moisturize dry passages
• Use humidifier in bedroom (clean regularly)
• Avoid irritants like cigarette smoke and strong perfumes
• Stay well-hydrated to thin mucus

Dietary Considerations

• Stay hydrated with plenty of water
• Consume anti-inflammatory foods (omega-3 rich fish, turmeric)
• Consider local honey (may help with pollen allergies)
• Avoid foods that trigger symptoms if food allergies present
• Limit dairy if it increases mucus production

Allergic Rhinitis

Cause: Immune system overreaction to allergens (pollen, dust mites, pet dander, mold)

Types:

• Seasonal (Hay Fever): Triggered by outdoor allergens like pollen; worse during specific seasons
• Perennial: Year-round symptoms from indoor allergens like dust mites and pet dander

Best Treatment: Anti-allergy medications, nasal steroid sprays, allergen avoidance

Non-Allergic Rhinitis

Cause: Not related to allergies; triggers include weather changes, irritants, strong odors, stress

Symptoms: Similar to allergic rhinitis but without allergic trigger; often congestion-dominant

Best Treatment: Nasal sprays (steroid or antihistamine), saline irrigation, avoiding triggers

Acute Rhinitis (Common Cold)

Cause: Viral infection of the upper respiratory tract

Duration: Typically 7-10 days

Best Treatment: Symptomatic relief with decongestants, rest, fluids; antibiotics not effective

Chronic Rhinosinusitis

Cause: Inflammation of nasal passages and sinuses lasting 12+ weeks

Symptoms: Persistent congestion, facial pressure, post-nasal drip, reduced sense of smell

Best Treatment: Nasal steroid sprays, saline irrigation, sometimes antibiotics; may require medical evaluation