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 nonprescription corticosteroid nasal spray, such as fluticasone (Flonase) or triamcinolone (Nasacort). Prescription-only corticosteroid nasal sprays are also available.
Corticosteroid medications help prevent and treat inflammation associated with some types of nonallergic rhinitis. Possible side effects include nasal dryness, nosebleeds, headaches and throat dryness.
- 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, nasal sprays containing an antihistamine may reduce symptoms of nonallergic rhinitis.
- 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 nosebleeds 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, heart pounding (palpitations) and restlessness.
Over-the-counter oral antihistamines, such as diphenhydramine (Benadryl), cetirizine (Zyrtec), fexofenadine (Allegra) 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 small studies have shown repeated applications of capsaicin — the ingredient responsible for the heat in hot peppers — to the inside of the nose can ease nasal congestion. The treatment is often given multiple times on the same day, and relief has been shown to last as long as 36 weeks. But larger studies are needed.