What is the treatment for rhinorrhea and sneezing lasting one week?

From the Guidelines

Treatment for rhinorrhea and sneezing lasting one week is typically managed with intranasal corticosteroids or oral antihistamines.

Options for Treatment

• Intranasal corticosteroids are the most effective medication class for controlling sneezing, itching, rhinorrhea, and nasal congestion, the 4 major symptoms of allergic rhinitis 1.
• Oral antihistamines are generally effective in reducing rhinorrhea, sneezing, and itching associated with allergic rhinitis but have little objective effect on nasal congestion 1.
• Intranasal antihistamines may be useful alternatives to oral antihistamines and can reduce symptoms of allergic rhinitis in some patients 1.

Key Considerations

• The approach to rhinitis management must be individualized, considering factors such as the patient’s age, symptoms, tolerability of route of administration, overall clinical condition, comorbidities, and concomitant medication 1.
• Intranasal corticosteroids are typically the most effective medication class for controlling symptoms of allergic rhinitis and may be useful in some forms of nonallergic rhinitis 1.
• Oral antihistamines have a limited role in treating nonallergic rhinitis syndromes and are generally less effective than intranasal corticosteroids for nasal congestion 1.

Medication Selection

• Second-generation antihistamines, such as fexofenadine, loratadine, and desloratadine, are generally preferred over first-generation antihistamines due to their lower risk of sedation and anticholinergic effects 1.
• Intranasal corticosteroids should be used at the lowest effective dose, especially in children, and patients should be instructed to direct sprays away from the nasal septum to minimize the risk of nasal irritation and bleeding 1.

From the Research

Treatment Options for Rhinorrhea and Sneezing

The treatment for rhinorrhea and sneezing lasting one week can be managed through various options, including:

• Allergen avoidance 2, 3, 4, 5
• Pharmacotherapy, such as:
  • Second-generation H1 antihistamines (e.g., cetirizine, fexofenadine, desloratadine, loratadine) 2, 4, 5
  • Intranasal antihistamines (e.g., azelastine, olopatadine) 2, 3
  • Intranasal corticosteroids (e.g., fluticasone, triamcinolone, budesonide, mometasone) 2, 3, 4, 5
• Immunotherapy, which is generally reserved for patients unresponsive to therapy or unable to take medications 5, 6

Classification of Rhinitis

Rhinorrhea and sneezing can be symptoms of either allergic or nonallergic rhinitis. The classification of rhinitis is important in determining the appropriate treatment:

• Allergic rhinitis: occurs when an allergen is the trigger for the nasal symptoms 2, 3, 4, 5
• Nonallergic rhinitis: occurs when obstruction and rhinorrhea occur in relation to nonallergic, noninfectious triggers 3

Severity and Frequency of Symptoms

The treatment for rhinorrhea and sneezing should be selected based on the severity and frequency of symptoms:

• Mild intermittent or mild persistent allergic rhinitis: may be treated with second-generation H1 antihistamines or intranasal antihistamines 2
• Persistent moderate to severe allergic rhinitis: should be treated initially with an intranasal corticosteroid, either alone or in combination with an intranasal antihistamine 2