👂 ENTENT / AllergyStudentInternResident

Allergic Rhinitis

Also known as: hay fever · seasonal rhinitis · perennial rhinitis

IgE-mediated nasal inflammation from allergen exposure — sneezing, itch, watery rhinorrhoea and nasal blockage, often with itchy watery eyes. It is part of the atopic spectrum and strongly linked with asthma.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

Atopic individuals; seasonal (pollens) or perennial (house-dust mite, animal dander, moulds) triggers.

Red flags — escalate / refer

Unilateral symptoms or bleeding, or a nasal mass (exclude other pathology), or poorly controlled coexisting asthma → reassess/refer.

Work-up / diagnosis

1A clinical diagnosis from the pattern and triggers.
2Allergy testing (skin-prick or specific IgE) where the trigger is unclear or immunotherapy is considered; assess for coexisting asthma.

Management — overview

Allergen avoidance where feasible; saline nasal rinses.
Intranasal corticosteroids are the most effective treatment for moderate-severe/persistent disease.
Oral or intranasal antihistamines for milder/intermittent symptoms and for the eyes; consider a leukotriene antagonist as add-on; allergen immunotherapy for selected refractory cases; treat coexisting asthma ('one airway').

In-depthFull dosing & advanced protocol

Drug dosing

Intranasal corticosteroid (± antihistamine)

Persistent/moderate-severe rhinitis

Adult dose: Regular use with correct technique, per protocol
Route: Intranasal

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

Antihistamine / saline / immunotherapy

Milder symptoms; refractory single-allergen disease

Adult dose: Per protocol
Route: Oral / intranasal / SC

WHOWHO Model List of Essential Medicines (electronic EML) (2025 (24th)) ↗

Intranasal steroids beat antihistamines for blockage

Use intranasal steroids regularly with the correct technique for nasal congestion.
Treat the eyes too, and screen/treat coexisting asthma ('united airways').
Consider immunotherapy for refractory single-allergen disease.

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

More protocols

Acute Otitis MediaAn acute middle-ear infection, common in children — ear pain, fever and a bulging, red tympanic membrane. Most are self-limiting; analgesia is the priority.Epistaxis (Nosebleed)Bleeding from the nose — usually anterior (Little's area) and self-limiting, occasionally posterior and serious. First aid controls most; find and treat the cause.Acute Pharyngitis & TonsillitisAcute inflammation of the pharynx/tonsils — sore throat, pain on swallowing, fever and tender neck nodes. Most cases are viral; the key is spotting group-A streptococcal ('strep') throat, which benefits from antibiotics and prevents complications.

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👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Intranasal corticosteroid (± antihistamine)

Antihistamine / saline / immunotherapy

📈 Intranasal steroids beat antihistamines for blockage

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Intranasal corticosteroid (± antihistamine)

Antihistamine / saline / immunotherapy

📈 Intranasal steroids beat antihistamines for blockage

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Intranasal steroids beat antihistamines for blockage

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Intranasal steroids beat antihistamines for blockage

References