TABLE 1.

Overview of pharmacological treatment options for the treatment of AR. ⁴ , ⁵ , ⁷ , ²⁵ , ⁴⁶ , ¹⁰⁴ , ¹⁰⁵

Treatment option	Route of administration	Including	Effective against	Less effective against	Effect within	Effect lasting	Sufficient for	Position in practice guidelines
Corticosteroids	Intranasal	Beclomethasone dipropionate Budesonide Ciclesonide Fluticasone furoate Fluticasone propionate Mometasone furoate Flunisolide Triamcinolone acetonide	Overall AR symptoms Ocular symptoms Nasal congestion		12 h	24 h	Moderate‐to‐severe symptoms	ARIA: 1st choice for seasonal and persistent AR AAO‐HNSF: For patients with a clinical diagnosis of AR whose symptoms affect their quality of life
	Oral	Predniso(lo)ne			—	—	In a short period (5–7 days) for very severe nasal symptoms	ARIA: A short course for moderate to severe nasal and/or ocular symptoms that are not controlled with other treatments
Antihistamines	Oral (2nd generation)	Acrivastine Bilastine Cetirizine Desloratadine Ebastine Fexofenadine Levocetirizine Loratadine Mizolastine Rupatadine	Rhinorrhoea Sneezing Nasal itching Ocular symptoms	Nasal congestion	1–2 h	12–24 h	Mild‐to‐moderate symptoms	ARIA: 2nd choice for seasonal and persistent AR AAO‐HNSF: For patients with AR and primary complaints of sneezing and itching
	Intranasal	Azelastine Levocabastine	Nasal congestion Nasal itching Sneezing Runny nose		1–2 h	12–24 h	Mild‐to‐moderate symptoms	ARIA: 3rd choice for seasonal AR AAO‐HNSF: For seasonal, perennial, or episodic AR
	Ocular	Azelastine Emedastine Ketotifen Levocabastine Olopatadine	Allergic eye symptoms (conjunctivitis)		3–10 min, sometimes 30 min	4–8‐12 h	Eye symptoms	ARIA: For seasonal and persistent AR with conjunctivitis
Leucotriene antagonist	Oral	Montelukast	Nasal symptoms (alone or in combination with antihistamines)		2 h	—	Not as primary therapy used in patient with both AR and asthma	ARIA: 4th choice for seasonal AR AAO‐HNSF: Not offered as primary therapy for patients with AR
Chromones	Intranasal	Cromolyn sodium	Nasal itching Rhinorrhoea Sneezing	Nasal congestion	Couple of days, sometimes weeks	3–4 h	Adjunct therapy Mild symptoms	ARIA: 5th choice for seasonal and persistent AR
	Ocular	Cromolyn sodium	Allergic eye symptoms (conjunctivitis)		Couple of days	3–4 h	Eye symptoms	ARIA: For seasonal and persistent AR with conjunctivitis
Decongestants/imidazoline derivates	Intranasal	Oxymetazoline Tramazoline Xylometazoline	Nasal congestion		5 min	8–12 h	Adjunct therapy Mild symptoms	ARIA: A very short course for seasonal and persistent AR and severe nasal obstruction with other treatment
	Oral	Pseudoephedrine Phenylephrine	Nasal congestion		—	—		ARIA: Not suggested as therapy regularly
Anticholinergics	Intranasal	Ipratropium	Rhinorrhoea	Nasal symptoms	15 min	4–6 h	Adjunct therapy Mild symptoms	ARIA: For persistent AR with rhinorrhoea

Note: AAO‐HNSF: American Academy of Otolaryngology—Head and Neck Surgery. Clinical Practice Guideline:Allergic Rhinitis. ¹⁰⁴ ARIA: Allergic Rhinitis and its Impact on Asthma. Guidelines: 2010 Revision. ¹⁰⁵