Allergic rhinitis or conjunctivitis
Non-allergic (vasomotoric) rhinitis
Various treatment options are available for the different types of rhinitis. Which medicines are most effective depends on which symptoms are predominant (runny or blocked nose) and the degree to which they occur. The ARIA recommendations suggest the following to ensure that a treatment is chosen that reflects the severity of the symptoms.
Treatment using antihistamines should be the first choice. Topically administered antihistamines such as Azelastine can be used even in the case of mild and short-term symptoms. Depending on the extent of the disease, additional treatment with drops or tablets can be considered.
Topically administered antihistamines - i.e. those applied directly to the nasal mucous membrane or into the eyes - have a fast onset of action, and a very rapid relief of symptoms such as sneezing and itching. The active ingredient Azelastine is a modern antihistamine of the group known as H1-blockers with the advantage of acting quickly (within 10-15 minutes) for fast relief of symptoms and less exposure to the organism.
The advantage of using drops or a spray in comparison to swallowing tablets is that absorption via the mucous membranes of the nose and via the eyes is quick and causes less exposure to the organism. The drug is then also able to treat the inflammation in the very place where it occurs. Oral medication is metabolized via the intestines and it takes much longer for the agent to get to its place of activity.
Hay fever symptoms can also be tackled by using mast cell stabilisers (cromoglicic acid and nedocromil). These kinds of drugs require a regular use for effective relief of symptoms and the treatment needs to be started minimum two weeks before the exposure to allergens.
Cortisone preparations have a pronounced anti-inflammatory effect but do not act as quickly as antihistamines and require in contrast to antihistamines a regular and consequent use for treatment of symptoms. Modern cortisones applied topically in the form of nasal sprays are well tolerated. According to the ARIA recommendations, they are recommended for use of moderate or severe perennial symptoms.
When acute symptoms occur the additive use of corticosteroids and modern antihistamines with anti-inflammatory properties may provide additional benefit to the patients.
There are various drugs available for the treatment of non-allergic (vasomotoric) rhinorrhea, such as antihistamines or cortisone. The antihistamine Azelastine (nasal spray) has shown favourable results in the treatment of non-allergic (vasomotoric) rhinorrhea. Here, the patients benefit more from the anti-inflammatory properties of the drug than from its anti-allergic properties, but at the same time avoid the disadvantages of cortisone.