Many allergy sufferers are plagued with year-round symptoms. Avoidance of most allergens is nearly impossible. What works?
Topical nasal steroids (like Flonase, Nasacort, Rhinocort, Omnaris) work the best. They are very effective anti-inflammatory agents. However, to achieve the maximal effect they take several days of application. The down side to intranasal steroids is that they can be drying to the nasal mucosa, making nose bleeds more likely. Intranasal steroids also increase susceptibility to viral and bacterial upper respiratory infections, which have the potential to lead to lower respiratory infections.
Topical antihistamines (like Astelin) work within 10-30 minutes of application, and are very effective. They too can be drying, making nose bleeds more likely, and they can also predispose to infections.
Leukotriene inhibitors (another type of anti-inflammatory agent, like Singulair) are tablets that work very effectively. Inflammation is caused by multiple pathways, and leukotriene inhibitors block pathways that are not affected by steroids or antihistamines. They are a great addition to an allergy sufferer's regimen if their allergy symptoms are not under control with other agents. They are not usually used as a first line agent because they are expensive, and because more symptoms can be effectively treated with steroids and antihistamines.
Oral antihistamines work great. They are nearly as effective as topical antihistamines, but take a few hours to feel the effect. The main advantage of oral antihistamines is cost. There is a generic version of loratadine (sold originally as Claritin) available at a cost of only pennies per day, compared to $2-5 per day for intranasal steroids or antihistamines. Easy to take pill form is another advantage.
First line treatment for severe allergy sufferers is intranasal steroids. Topical antihistamines and oral antihistamines can be added as needed.
The most affordable option is generic oral antihistamines followed by the addition of intranasal steroids as needed.
Whatever you and your doctor choose, take the medication as directed. If you are a year-round allergy sufferer, you must take precautions every day of the year.