Intranasal antihistamines
Intranasal antihistamines are more effective than oral antihistamines for nasal obstruction caused by allergic rhinitis, and have a faster onset of action. However, they are less effective for other symptoms of allergic rhinitis (eg itch at sites other than the nose), and require good technique to be effective. Instruct patients on how to use nasal sprays correctly; see Patient instructions for using a nasal spray.
Intranasal antihistamines have a fast onset of action, so can be used as required for intermittent symptoms; for persistent symptoms, they should be used regularly.
Use:
1 azelastine (adult or child 5 years or older) 1 mg/mL nasal spray, 1 spray into each nostril, twice daily allergic rhinitis azelastine
OR
1 levocabastine (adult or child 6 years or older) 0.5 mg/mL nasal spray, 2 sprays into each nostril, 2 to 4 times daily. allergic rhinitis levocabastine
Combining oral and intranasal antihistamine therapy does not confer additional benefit.