Examples

Nasal sprays (topical corticosteroid aerosols)

Pill (oral-systemic) corticosteroids

Injected (systemic) corticosteroids

How It Works

In allergic rhinitis, corticosteroids reduce swelling and inflammation in the nose, resulting in fewer symptoms.

When you take pill or injected (systemic) corticosteroids, the medicine travels throughout your body. This can result in serious side effects.

When you use nasal corticosteroids, most of the medicine stays in the nose and does not travel throughout the body. This results in fewer and less serious side effects than pill or injected corticosteroids.

Why It Is Used

You may use nasal corticosteroid sprays if your allergy symptoms are mostly in your nose. Your doctor may suggest them:

• When nasal congestion (obstruction) is a major symptom.
• When other medicines have not helped your symptoms.
• When the side effects of other medicines have become a problem.
• Before the beginning of the pollen season in people who are allergic to pollen. This may reduce their symptoms during the season.

Pill or injected corticosteroids are not used as often as nasal corticosteroids because of the possible side effects. Your doctor may suggest them when:

• You have severe symptoms that other medicines have not helped.
• You need short-term treatment of severe allergic rhinitis, and you cannot use nasal sprays (such as if the nose is completely blocked by congestion or you have nasal polyps).
• You need quick control of symptoms.

How Well It Works

Corticosteroids are the most effective medicine currently available for allergic rhinitis.

• Corticosteroids reduce all symptoms of allergic rhinitis, such as sneezing, itching, runny nose, and stuffy nose.
• Nasal corticosteroid sprays are more effective at reducing allergy symptoms, such as nasal blockage, discharge, and itching, than pill antihistamines.
• Corticosteroids start working quickly, but it may be several weeks before you feel the full effect.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

• Usually the benefits of the medicine are more important than any minor side effects.
• Side effects may go away after you take the medicine for a while.
• If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Callor other emergency services right away if you have:

• Trouble breathing.
• Hives.
• Swelling of your face, lips, tongue, or throat.

Call your doctor if you have:

• Signs of an infection, such as nose, sinus, or sore throat.
• Belly pain, nausea, or vomiting that won't go away.
• Bloody or black, tarry stools.
• Rapid weight gain.
• Changes in your eyes, including blurred vision or eye pain.
• Muscle cramps, pain, or weakness.
• Changes in skin, including acne or reddish purple lines.
• Increased thirst, especially with frequent urination.
• Bloody mucus or unexplained nosebleeds.

Common side effects of oral corticosteroids include:

• Increased appetite.
• Nervousness or restlessness.

Common side effects of inhaled corticosteroids include:

• Burning, dryness, or irritation inside the nose.
• Increase in sneezing.
• Irritation of the throat.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Nasal corticosteroid sprays work best when you take them regularly on a daily basis. They do not cause rebound congestion.

Health professionals disagree on whether nasal corticosteroids should be your first or second treatment option. Some doctors use nasal corticosteroids to treat allergic rhinitis only when other treatment, such as antihistamines, does not work. Other doctors use nasal corticosteroids right away.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

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