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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Sunday, November 8, 2009
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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Sunday, November 8, 2009
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Allergies |
Length of Effectiveness11/29/1998 |
Will the continued use of Zyrtec, Flonase, or Claritin diminish their effectiveness?
The answer depends upon what type of nasal condition in being treated. If you have allergic nasal inflammation (allergic rhinitis) caused by inhaled aeroallergens such as pollen or mold, then antihistamines such as Claritin or Zyrtec can be less effective if allergic nasal symptoms become chronic lasting weeks, months or years. The reason these become less effective is that they are antihistamines and treat mainly the nasal and eye symptoms caused by release of histamine in the nasal tissues but do little to treat the chonic nasal blockage or congestion that is caused by development of cellular inflammation, an important feature of chronic allergic nasal disease. Nasal topical steroids drugs such as Flonase are anti-inflammatory and very effective for the nasal blockage associated with allergic rhinitis. Thus, it is not unusual for a patient with pure allergic rhinitis to require treatment with both an antihistamine to treat histamine mediated symptoms as well as a nasal steroid to treat nasal congestion caused by nasal tissue inflammation. It should be noted that these agents are not very effective unless taken on a regular, daily basis.If both antihistamines and nasal steroids together are ineffective, other nasal conditions should be considered including a nasal anatomical problem, non-allergic rhinitis, infectious rhinitis or sinusitis, and use of medications that can cause nasal symptoms. Failure to respond to a good trial of antihistamines and a nasal steroid should prompt consultation with a specialist who can evaluate these other possibilities. It is common to see patients who do not have allergic rhinitis but rather non-allergic rhinitis. Their main symptoms are nasal congestion and post-nasal drip and they are less responsive to nasal steroids and anti-histamines. They may do better with oral decongestant medications (such as pseudoephedrine).
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David I. Bernstein, MD Professor of Medicine Division of Immunology and Allergy Department of Internal Medicine College of Medicine University of Cincinnati |
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