Nasal Allergy Treatment

Nasal allergy treatment:  What was old, is now new.

Allergic nasal symptoms, also known as allergic rhinitis, is one of the most chronic conditions in the U.S. affecting 40 million people.  The symptoms of nasal allergy include:  sneezing, runny nose, nasal stuffiness and mucus dripping in the throat and can be seasonal or year round.  Treatment options include allergen avoidance, anti-histamines, nasal steroid sprays and/or allergy injections for desensitization.

In the past year, two new nasal steroids have been FDA approved and are available.  Nasal steroids, not to be confused with anabolic steroids that some athletes have used illegally, are regarded as the most effective first line therapy for treatment of moderate to severe nasal allergies.  Nasal steroids that you may be familiar with are Flonase(fluticasone), Nasacort(triamcinolone), Naseral(flunisolide), Nasonex(mometasone), Omnaris(ciclesonide), Rhinocort(budesonide), and Veramyst(fluticasone).  All these medications show comparable effectiveness and safety, so your preference and satisfaction  are related to sensory attributes like smell, taste, or feeling the medication in your throat.

Many of you may recall aerosol, or "dry" nasal steroid sprays such as Beconase(beclomethasone), Nasacort(triamcinolone), Rhinocort(budesonide) and Vancenase(beclomethasone).  These medications were removed from the market, not because of adverse events, but due to the shrinking market of "dry" nasal sprays and the World Health Organization's mandate to remove certain propellants from all aerosol sprays, not just ones used in medications.

Now, there are two new "dry" nasal steroid sprays:  

Q Nasl(beclomethasone) and Zetonna(ciclesonide).  They are indicated for allergic nasal symptoms in 12 year olds and up, and are administered once daily.  Side effects are similar to the "wet" sprays and include:  burning sensation, nosebleeds, potential for nasal septal perforation and thrush( nasal or oral yeast infection).

Dry versus Wet.  What is your preference?  Please discuss these new allergic nasal treatment options with your physician at your next visit.

© JHAAC 2012