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Treatments and drugs
By Mayo Clinic staffTreatment of nonallergic rhinitis depends on how much it bothers you. For mild cases, home treatment and avoiding triggers may be enough. For more bothersome symptoms, certain medications may provide relief, including:
- Saline nasal sprays. Use an over-the-counter nasal saline spray or homemade saltwater solution to flush the nose of irritants and help thin the mucus and soothe the membranes in your nose.
- Corticosteroid nasal sprays. If your symptoms aren't easily controlled by decongestants or antihistamines, your doctor may suggest a prescription corticosteroid nasal spray, such as fluticasone (Flonase) or mometasone (Nasonex). Corticosteroid medications help prevent and treat inflammation associated with some types of nonallergic rhinitis. Possible side effects include indigestion, nausea, headache and bodily pains.
- Antihistamine nasal sprays. Try a prescription antihistamine spray such as azelastine (Astelin) and olopatadine hydrochloride (Patanase). While oral antihistamines don't seem to help nonallergic rhinitis, antihistamine in the form of a nasal spray may reduce symptoms of nonallergic rhinitis. Side effects may include a bitter taste in your mouth, headache and fatigue.
- Anti-drip anticholinergic nasal sprays. The prescription drug ipratropium (Atrovent) is often used as an asthma inhaler medication. But it's now available as a nasal spray and can be helpful if a runny, drippy nose is your main symptom. Side effects may include a bitter taste in your mouth and drying of the inside of your nose.
- Oral decongestants. Available over-the-counter or by prescription, examples include pseudoephedrine-containing drugs (Actifed, Sudafed, others) and phenylephrine (Neo-Synephrine, others). These medications help narrow the blood vessels, reducing congestion in the nose. Possible side effects include high blood pressure, insomnia, loss of appetite, heart pounding (palpitations), anxiety and restlessness.
- Decongestant nasal sprays. These include oxymetazoline (Afrin, others). Don't use these medications for more than three or four days, as they can cause congestion to come back with even worse symptoms when you stop using them. Other possible side effects include headache, insomnia and feeling nervous.
Over-the-counter oral antihistamines, such as diphenhydramine (Benadryl), clemastine (Tavist) and loratadine (Claritin), typically don't work nearly as well for nonallergic rhinitis as they do for allergic rhinitis.
In rare cases, surgical procedures may be an option to treat complicating problems, such as a deviated nasal septum or persistent nasal polyps.
Some studies have shown repeated applications to the inside of the nose of capsaicin, the ingredient responsible for the heat in hot peppers, to be effective. But the use of capsaicin to treat nonallergic rhinitis hasn't been approved.
- Lieberman PL. Chronic nonallergic rhinitis. http://www.uptodate.com/home/index.html. Accessed May 6, 2010.
- Fletcher RH, et al. Patient information: Nonallergic rhinitis (runny or stuffy nose). http://www.uptodate.com/home/index.html. Accessed May 11, 2010.
- Tips to remember: Rhinitis. American Academy of Allergy Asthma & Immunology. http://www.aaaai.org/professionals/resources/pdf/rhinitis1998.pdf. Accessed May 11, 2010.
- Groves M, et al. Diseases of the head and neck. In: Bope E, et al. Conn's Current Therapy. St. Louis, Mo.: Saunders; 2010. http://www.mdconsult.com/book/player/book.do?method=display&type=bookPage&decorator=header&eid=4-u1.0-B978-1-4160-6642-2..00003-X--sc0060&uniq=200610332&isbn=978-1-4160-6642-2&sid=996342451. Accessed May 11, 2010.
- Balkissoon RC, et al. Allergic and nonallergic rhinitis. In: Mason. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa.: Elsevier; 2010. http://www.mdconsult.com/das/book/body/100043154-3/727557488/1288/368.html#4-u1.0-B0-7216-0327-0..50043-4--cesec4_2479. Accessed May 13, 2010.
- Naegleria FAQs. Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/naegleria/faqs.html. Accessed Dec. 30, 2011.
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