What are the first-line treatment options for allergic rhinitis in adults according to current UK guidelines?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

The first-line treatment options for allergic rhinitis in adults, according to current UK guidelines, are intranasal corticosteroids and antihistamines (intranasal or non-sedating oral antihistamines), used either alone or in combination .

Intranasal corticosteroids are considered the most effective treatment for allergic rhinitis .

Options include intranasal mometasone furoate, fluticasone furoate, or fluticasone propionate, which have minimal systemic absorption .

For mild, intermittent allergic rhinitis, an antihistamine (intranasal or oral non-sedating antihistamine) is suggested, especially in children, while any first-line treatment may be offered to adolescents and adults .

In cases of moderate to severe or persistent allergic rhinitis, an intranasal corticosteroid or a combination of intranasal corticosteroid with an intranasal antihistamine is recommended .

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