Treatments and drugs

By Mayo Clinic Staff

Treatment 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, Astepro) 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 complaint. 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 (Sudafed) and phenylephrine (Afrin, 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) and loratadine (Claritin), typically don't work nearly as well for nonallergic rhinitis as they do for allergic rhinitis.

In some 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 of capsaicin — the ingredient responsible for the heat in hot peppers — to the inside of the nose to be effective. But nasal saline, corticosteroid nasal sprays or antihistamine nasal sprays are the usually recommended initial treatments.

Feb. 19, 2013