Table 2.

THERAPY BASED ON SYMPTOM SCORES FOR ALLERGIC RHINITIS

Symptom Frequency/Intensity	Medication to Add
Rare/Intermittent (<3 times/wk)	antihistamine (prn)
Mild (rare sneezing, mild pruritis)	environmental controls
Mild/Recurrent (>3 times/wk)	Nasal corticosteroid
Usually with minor nasal congestion	environmental controls
For ocular pruritis	add antihistamine (prn)
Moderate Continuous/Recurrent (weekly duration)	Nasal corticosteroid with regular use of antihistamine* (start early or preseason)
Seasonal predictability
Severe Continuous/Recurrent	Nasal corticosteroid and antihistamine
Quality of life compromised	Consider immunotherapy especially if oral or parenteral steroids required

^*When tolerance develops to antihistamine affect, consider rotation with other antihistamines at 2-week intervals. May add oral decongestant for moderate or severe persistent congestion.