What is the treatment for non-allergic rhinitis related post nasal drip?

From the Guidelines

Treatment for non-allergic rhinitis related post-nasal drip typically includes saline nasal sprays, intranasal corticosteroids, and antihistamines. Start with daily saline nasal irrigation using a neti pot or squeeze bottle to flush mucus and irritants from the nasal passages. For persistent symptoms, try intranasal corticosteroids like fluticasone (Flonase) or mometasone (Nasonex), using 1-2 sprays in each nostril daily, as recommended by 1. These reduce inflammation in the nasal passages that contributes to mucus production.

• Oral antihistamines such as loratadine (Claritin) or cetirizine (Zyrtec) may help, even though non-allergic rhinitis isn't triggered by allergens.
• Ipratropium bromide nasal spray (Atrovent) can reduce watery secretions by blocking nerve signals that stimulate mucus production, as noted in 1. Some key points to consider:
• Avoid environmental irritants like smoke, strong odors, and sudden temperature changes that can trigger symptoms.
• Stay well-hydrated to keep mucus thin and flowing.
• If symptoms persist despite these measures, consult a healthcare provider as prescription medications or evaluation for underlying conditions may be necessary. These treatments work by reducing inflammation, decreasing mucus production, or improving mucus clearance from the nasal passages and sinuses, as discussed in 1.

From the Research

Treatment for Non-Allergic Rhinitis Related Post Nasal Drip

• The treatment for non-allergic rhinitis related post nasal drip can include the use of ipratropium bromide nasal spray, which has been shown to reduce rhinorrhea and postnasal drip in patients with perennial nonallergic rhinitis 2, 3.
• Azelastine nasal spray has also been found to be effective in treating vasomotor (perennial nonallergic) rhinitis, including symptoms such as postnasal drip 4.
• Ipratropium bromide nasal spray has a faster onset of action and can be used alone or in combination with other treatments, such as beclomethasone nasal spray, for the treatment of rhinorrhea in perennial rhinitis 5.
• The use of azelastine nasal spray has been shown to significantly reduce the total vasomotor rhinitis symptom score, including postnasal drip, in patients with vasomotor rhinitis 4.
• Both ipratropium bromide and azelastine nasal sprays have been found to be well-tolerated and effective in reducing symptoms of non-allergic rhinitis, including postnasal drip 2, 4, 3.

Efficacy of Treatments

• Ipratropium bromide nasal spray has been shown to reduce the mean severity and duration of rhinorrhea within the first week of treatment and throughout the 8 weeks of active treatment 2.
• Azelastine nasal spray has been found to significantly reduce the total vasomotor rhinitis symptom score, including postnasal drip, within the first week of treatment and throughout the 21-day treatment period 4.
• The combination of ipratropium bromide and beclomethasone nasal sprays has been shown to be more effective than either active agent alone in reducing the average severity and duration of rhinorrhea 5.

Safety and Tolerability

• Ipratropium bromide nasal spray has been found to be well-tolerated, with no drug-related systemic adverse events and no evidence of nasal rebound on discontinuation of treatment 2, 3.
• Azelastine nasal spray has been found to be well-tolerated, with the most common adverse event being bitter taste 4.
• The combination of ipratropium bromide and beclomethasone nasal sprays has been shown to be well-tolerated, with no increase in adverse events over that seen previously with ipratropium bromide or beclomethasone nasal spray alone 5.