10
Treatment
Table 9. Medication Recommendations
a
Medication
(Class)
Recommendations for
Symptoms
Recommendations for
Exposure to Allergen
Congestion Rhinorrhea Sneezing
Nasal
Itching Seasonal Perennial Episodic
Intranasal
Steroids (INS)
+++ +++ +++ +++ ++ ++ +
Oral
Antihistamines
(OA)
+ ++ ++ ++ + + +
Intranasal
Antihistamines
(INA)
++ ++ ++ ++ ++ +
b
++
Leukotriene
Receptor
Antagonist
(LTRA)
+ + + + + + No
a
e use of "+" , "++" or "+++" throughout the chart indicates the relative effectiveness for each
medication class for the various symptoms (i.e., most effective for congestion (+++) but also effective
for each of the other symptoms (+).
b
Astepro, one of the intranasal antihistamines available in the United States, is indicated for perennial/
persistent allergic rhinitis.
Table 10. Comparison of Features of SCIT and SLIT
SCIT SLIT
Effectiveness for
allergic rhinitis
Supported by
systematic reviews
of randomized,
controlled trials
Supported by systematic reviews of
randomized, controlled trials
Safety Deaths: 1 per 2.5
million injections
No reported deaths
Rate of systemic
reactions
0.06%-0.9% 0.056%
Dosing Administered in
physician's office
• Administered at home
• SLIT aqueous dosing not standardized
• First dose of SLIT tablet should be
administered in physician's office
