What is Allergic Rhinitis?
Allergic rhinitis causes the familiar symptoms of nasal congestion, sneezing, runny nose, itchy nose, and itchy, watery eyes. These symptoms come about because of inflammation within the nose in response to allergy triggers, such as pets and pollens. The effective management of allergic rhinitis involves the appropriate use of three categories of treatment.

These categories are:

• environmental control;
• medications; and
• if needed, allergen immunotherapy (allergy shots).

This discussion focuses upon the medication choices that are available for the management of allergic rhinitis, including a new class of medications, leukotriene modifiers, which may be helpful in controlling allergic rhinitis.

Available Medication Options
Medications for allergic rhinitis, in general, reduce an allergy sufferer’s sensitivity to allergy triggers. This discussion will not mention eye drops for eye symptoms, but, instead, will focus on oral and nasal medications for allergic rhinitis. Choices include oral and nasal antihistamines, nasal inhaled corticosteroids, decongestants and leukotriene modifiers. It is important to understand how the different medications work and their strengths and weaknesses.

Oral and Nasal Antihistamines
Description	Blocks histamine, one of the most important mediators of the allergic response, and its release leads to many allergy symptoms, including itching of the eyes and nose, runny nose and sneezing.
Advantage	Blocks what histamine does in the nose and eyes of allergy sufferers.
Disadvantage	They are not very helpful for congestion.

Nasal inhaled corticosteroids
Description	Reduces and controls the impact of all or most of the mediators that can cause inflammation in the nose.
Advantage	It improves all of the nasal symptoms of allergic rhinitis, including itching, runny nose and congestion.
Disadvantage	Lack of effectiveness for eye symptoms and the potential for nasal irritation.

Decongestants
Description	These medications are important in the care of allergic rhinitis because congestion is, for the majority of patients with allergic rhinitis, the most troublesome symptom.
Advantage	May lead to vasoconstriction (narrowing of the blood vessels) in the nose, which directly reduces mucus volume.
Disadvantage	May lead to difficulty sleeping, anxiety, and increased heart rate.

Leukotriene modifiers
Description	Blocks the action of leukotrienes, a mediator of allergy symptoms and of inflammation.
Advantage	Ability to block both the early response to allergic triggers (itching and sneezing) as well as the delayed response to allergic triggers (congestion). Medication is mild and has few side effects.
Disadvantage	Drug class does not have much of a track record in the treatment of allergic rhinitis; more clinical research needs to be published about the use of this medication for this condition.

Allergic rhinitis affects millions of people and causes a great deal of misery. Millions of work and school days are lost every year due to allergic rhinitis. Fortunately, there are also effective treatments available for this condition. By carefully and thoughtfully using available treatments for allergic rhinitis, including antihistamines, nasal corticosteroids, decongestants, and leukotriene modifiers, most people can achieve excellent control of their symptoms.