First-line treatment options for adults with allergic rhinitis in primary care include intranasal corticosteroids and antihistamines (intranasal or non-sedating oral antihistamines), used either alone or in combination NICE CKS.
Intranasal corticosteroids are considered the most effective treatment for allergic rhinitis NICE CKS.
Options include intranasal mometasone furoate, fluticasone furoate, or fluticasone propionate, which have minimal systemic absorption NICE CKS.
For mild, intermittent, or both types of allergic rhinitis, antihistamines (intranasal or oral non-sedating) are suggested, especially in children, while adults may be offered any first-line treatment NICE CKS.
In cases of moderate to severe or persistent allergic rhinitis, an intranasal corticosteroid or the combination of an intranasal corticosteroid with an intranasal antihistamine is recommended NICE CKS.
Patients should be advised to start treatment two weeks before known allergen exposure, such as pollen seasons, and to continue until the exposure ends or symptoms resolve NICE CKS.