From the Guidelines
The most effective treatment for allergic rhinitis, intranasal corticosteroids, can start working within 3 to 12 hours, with some patients noticing improvement within this timeframe, and reaching maximum effectiveness within 1-2 weeks with consistent use 1.
Medication Onset Times
The time it takes for allergic rhinitis treatments to work varies by medication type.
- Antihistamines like cetirizine (Zyrtec), loratadine (Claritin), or diphenhydramine (Benadryl) typically begin working within 1-2 hours.
- Nasal corticosteroids such as fluticasone (Flonase) or mometasone (Nasonex) require consistent use for 1-2 weeks before reaching maximum effectiveness, though some patients notice improvement within 12 hours 1.
- Decongestants like pseudoephedrine provide relief within 15-30 minutes but should not be used for more than 3-5 days to avoid rebound congestion.
- Leukotriene modifiers such as montelukast (Singulair) may take several days to a week for noticeable improvement.
Treatment Recommendations
For optimal results, start nasal corticosteroids before allergy season begins and use them consistently as prescribed 1.
- The Joint Task Force on Practice Parameters recommends monotherapy with an intranasal corticosteroid as the initial treatment for seasonal allergic rhinitis in persons aged 12 years or older 1.
- For treatment of moderate to severe seasonal allergic rhinitis, the combination of an intranasal corticosteroid and an intranasal antihistamine may be recommended for initial treatment 1. These medications work by reducing inflammation and blocking the release of chemicals that trigger allergy symptoms, with different onset times reflecting their distinct mechanisms of action in the body.
From the FDA Drug Label
In 4 randomized, doubleblind, vehicle placebo-controlled, parallel- group allergic rhinitis studies and 2 studies of patients in an outdoor “park” setting (park studies), a decrease in nasal symptoms in treated subjects compared to placebo was shown to occur as soon as 12 hours after treatment with a 200-mcg dose of Fluticasone Propionate Nasal Spray, USP. Maximum effect may take several days
- Onset of action: as soon as 12 hours after treatment
- Maximum effect: may take several days
- Maintenance dose: after 4 to 7 days, some patients may be maintained on 100 mcg/day 2
From the Research
Treatment Duration for Allergic Rhinitis
The duration it takes for the treatment of allergic rhinitis to work can vary depending on several factors, including the severity of symptoms, type of treatment, and individual patient response.
- Pharmacotherapy: According to 3, first-line treatment for mild intermittent or mild persistent allergic rhinitis may include a second-generation H1 antihistamine or an intranasal antihistamine, whereas patients with persistent moderate to severe allergic rhinitis should be treated initially with an intranasal corticosteroid either alone or in combination with an intranasal antihistamine.
- Treatment Response Time: While the exact time it takes for treatment to work is not specified in the provided studies, 4 mentions that clinical trials have compared the efficacy and tolerability of intranasal corticosteroids and second-generation oral antihistamines, with some studies showing that intranasal corticosteroids can have equal or greater efficacy in reducing nasal symptom scores.
- Factors Influencing Treatment Response: The response to treatment can be influenced by factors such as the severity and frequency of symptoms, patient preference, and comorbidities 5.
- Combination Therapy: Combination therapy of an intranasal corticosteroid and an oral antihistamine may be considered for patients with moderate to severe allergic rhinitis, as it has been shown to have efficacy comparable to that of intranasal corticosteroid alone 4.
- Individual Variability: It is essential to note that individual variability plays a significant role in the response to treatment, and what works for one patient may not work for another 6.
- Real-World Data: Real-world data obtained by mobile technology offer new insights into allergic rhinitis phenotypes and therapy, highlighting the importance of personalized treatment approaches 6.