From the Guidelines
Triamcinolone is a recommended treatment option for seasonal allergies, specifically as an intranasal corticosteroid, which should be prescribed as monotherapy for initial treatment in persons aged 12 years or older. According to the 2017 joint task force on practice parameters 1, intranasal corticosteroids are strongly recommended for initial treatment of seasonal allergic rhinitis.
Key Points to Consider
- The dosage for triamcinolone acetonide nasal spray (Nasacort AQ) is typically 2 sprays in each nostril once daily for adults, delivering 55 mcg per spray.
- Treatment should begin 2-4 weeks before allergy season starts when possible and continue throughout the season.
- Children aged 6-11 should use 1 spray in each nostril daily, while children under 6 should only use it under medical supervision.
- Triamcinolone works by reducing inflammation in the nasal passages, decreasing the body's immune response to allergens like pollen, dust, and pet dander.
Potential Side Effects and Administration
- Side effects may include nasal irritation, headache, and nosebleeds.
- The spray should be shaken before use, and patients should clear their nasal passages before administration.
- Improvement typically begins within 12 hours, though full benefit may take several days of consistent use.
Clinical Considerations
- 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, as per the guideline 1.
- Allergen avoidance and specific allergen immunotherapy (subcutaneous or sublingual) are also effective management strategies for patients with seasonal allergic rhinitis.
From the Research
Treatment Options for Seasonal Allergies
- Seasonal allergic rhinitis can be managed with various treatment options, including pharmacotherapy and immunotherapy 2, 3.
- Mild to moderate cases can be managed with either an oral/intranasal second-generation antihistamine or an intranasal corticosteroid alone 2.
- More severe cases may require treatment with an intranasal corticosteroid in combination with various agents 2, 3.
Role of Corticosteroids
- Intranasal corticosteroids, such as triamcinolone, can be used to manage seasonal allergic rhinitis 4, 5.
- Nasal corticosteroids can provide symptomatic relief and improve quality of life in patients with seasonal allergic rhinitis 3, 6.
- Combination therapy of histamine and leukotriene antagonists, including corticosteroids, can produce symptomatic improvement and improved quality of life 4.
Comparison of Treatment Options
- A study compared the efficacy and tolerability of an oral antihistamine/decongestant treatment with intranasal corticosteroids in seasonal allergic rhinitis, and found that the antihistamine/decongestant combination was at least as effective and well-tolerated as intranasal beclomethasone 6.
- The latest guidelines for the treatment of seasonal allergic rhinitis recommend the use of nasal glucocorticoids, nasal and oral antihistamines, and antileukotrienes, and provide rules for the selection of drugs in the therapy of seasonal allergic rhinitis 5.