From the Guidelines
A combination medication of antihistamine and steroid nasal sprays is Dymista (azelastine hydrochloride and fluticasone propionate), which has been shown to be effective in reducing symptoms of allergic rhinitis 1. This prescription nasal spray combines the antihistamine azelastine, which blocks histamine receptors to reduce allergy symptoms quickly, with the corticosteroid fluticasone, which reduces inflammation for longer-term relief. The typical dosage is one spray in each nostril twice daily. This combination is particularly effective for moderate to severe allergic rhinitis because it addresses both immediate symptoms and underlying inflammation simultaneously. Some key points to consider when using this combination medication include:
- Patients often experience faster and more complete relief than with either medication alone 1.
- Side effects may include nasal irritation, headache, and altered taste sensation.
- For best results, gently shake the bottle before use, clear your nose first if needed, and aim the spray away from the nasal septum.
- Improvement typically begins within hours, but consistent use for several days provides optimal benefit. It's also worth noting that the use of intranasal antihistamines and corticosteroids has been supported by other studies, including one from 2015 that highlighted the effectiveness of combination therapies for allergic rhinitis 1, and another from 2008 that discussed the diagnosis and management of rhinitis, including the use of intranasal corticosteroids and antihistamines 1. However, the most recent and highest quality study, from 2017, provides the strongest evidence for the use of Dymista (azelastine hydrochloride and fluticasone propionate) as a combination medication for allergic rhinitis 1.
From the Research
Combination Medication for Allergic Rhinitis
A combination medication of antihistamine (anti-histamine) nasal sprays and steroid (corticosteroid) nasal sprays is used to treat allergic rhinitis. The combination of azelastine nasal spray and fluticasone propionate nasal spray is an example of such a medication, as seen in the study 2.
Benefits of Combination Therapy
The benefits of combination therapy with azelastine and fluticasone include:
- Enhanced clinical benefit, as the combination reduces symptoms in allergic rhinitis patients more than either agent alone 2
- Greater efficacy in providing relief from both nasal and ocular symptoms, and leads to greater overall relief from nasal symptoms 3
- Faster control of nasal symptoms, with Dymista controlling nasal symptoms up to 6 days faster than fluticasone 3
- Substantial therapeutic benefit for patients with seasonal allergic rhinitis compared to therapy with either agent alone 4
Comparison of Azelastine and Fluticasone
Studies have compared the effects of azelastine and fluticasone nasal sprays in the treatment of allergic rhinitis, finding that: