Primary care mx of allergic rhinitis: first-line treatments + environment contro

First-line treatments for allergic rhinitis in primary care include intranasal corticosteroids and antihistamines (intranasal or non-sedating oral antihistamines), used alone or in combination, depending on severity and persistence of symptoms ¹.

Intranasal corticosteroids are considered the most effective treatment for allergic rhinitis, with options such as mometasone furoate, fluticasone furoate, or fluticasone propionate, which have minimal systemic absorption

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Intranasal antihistamines like azelastine have a rapid onset (within minutes) but are less effective than corticosteroids

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For mild, intermittent allergic rhinitis, especially in children, an antihistamine (intranasal or oral non-sedating) is suggested, while in adolescents and adults, any first-line treatment may be offered

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In cases of moderate to severe or persistent allergic rhinitis, an intranasal corticosteroid or a combination of intranasal corticosteroid with an intranasal antihistamine is recommended

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Environmental control measures include allergen avoidance techniques such as washing pets twice weekly, using synthetic bedding, keeping windows closed during high pollen seasons, and avoiding outdoor activities during peak pollen times

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Additional measures include nasal irrigation with saline, avoiding drying outdoor washing, and monitoring pollen counts to reduce exposure

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