Drugs acting on the nose

In seasonal allergic rhinitis (eg hay fever), treatment should begin 2 to 3 weeks before the season commences and may have to be continued for several months. Nasal preparations containing corticosteroids have a useful role in the treatment of allergic rhinitis. If monotherapy with antihistamine or corticosteroid is insufficient, consider a 2 month trial of Dymista® for the relief of symptoms of moderate to severe seasonal and perennial allergic rhinitis.

The risk of systemic effects may be greater with nasal drops than metered nasal sprays; drops are administered incorrectly more often than sprays. Fluticasone nasal drops may be considered for the treatment of severe nasal polyps and severe rhinitis [off-label] on the advice of an ENT specialist. Refer to guidance on ‘Nasal blockage’ and ‘Nasal discharge’

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