Materiały źródłowe

• #1 Chronic Nonallergic Rhinitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0801/p171.html

  Chronic nonallergic rhinitis encompasses a group of rhinitis subtypes without allergic or infectious etiologies. […] Treatment is symptom-driven and similar to that of allergic rhinitis. Patients should avoid known triggers when possible. First-line therapies include intranasal corticosteroids, intranasal antihistamines, and intranasal ipratropium. […] An intranasal corticosteroid or intranasal antihistamine alone should be the initial treatment for nonallergic rhinitis if symptoms are not rhinorrhea-predominant. […] Combination therapy with an intranasal corticosteroid and intranasal antihistamine is better than either treatment alone. […] Intranasal ipratropium should be the initial treatment for rhinorrhea in patients with gustatory nonallergic rhinitis. […] An intranasal corticosteroid plus intranasal ipratropium is more effective than either treatment alone for rhinorrhea.

• #1 Allergic & Nonallergic Rhinitis NYC | Mount Sinai – New York

  https://www.mountsinai.org/care/ent/services/nasal-sinus-allergy/conditions/rhinitis

  Rhinitis is described as inflammation and irritation of the mucous membrane lining the nose. This condition can be caused by bacteria, allergens, pollen, air pollutants, certain foods and beverages, smoke, hormonal changes or viruses. […] At Mount Sinai, the rhinologists in the Department of Otolaryngology – Head and Neck Surgery have vast expertise treating this condition, not only with the various over-the-counter (OTC) and prescription medications, minimally invasive surgery but also with novel techniques and procedures targeting the cause of many of the symptoms. Working together with you, we can customize a treatment plan, based on your medical history and address any anatomical issues with minimal impact on your lifestyle to improve your overall quality of life. […] Non-pharmacologic treatments include avoidance of triggers: the first line in the treatment armamentarium and often overlooked! This can be an efficient and effective method to reduce symptoms. Environmental controls: removal of pets (pet free rooms/sanctuary), bed covers, HEPA filters, and laundering sheet in hot water.

• #1 What is Rhinitis? | Causes, Symptoms & Treatment | BENADRYL® UK

  https://www.benadryl.co.uk/allergy-types/rhinitis

  Non-allergic rhinitis can be triggered by environmental or occupational irritants, weather changes, infections, foods and beverages, certain odours or irritants in the air, hormonal changes, tobacco smoke, frequent use of decongestant nasal sprays, certain medications, exercise, and conditions such as an underactive thyroid. […] Recommendations to treat non-allergic rhinitis include identifying and avoiding your triggers and seeing a doctor for suitable treatment. A healthcare professional can help you to discover what’s causing your symptoms and advise you on treatment. […] Treatment advice for non-allergic rhinitis is mostly the same as for allergic rhinitis. Avoiding triggers, taking antihistamines, and cleaning the nasal passageways are often the most effective treatments. […] You may also want to avoid potential irritants, such as household sprays, perfumes and other harsh chemicals, tobacco smoke and anything else you believe triggers your symptoms.

• #1 Patient education: Nonallergic rhinitis (runny or stuffy nose) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/nonallergic-rhinitis-runny-or-stuffy-nose-beyond-the-basics

  Patient education: Nonallergic rhinitis (runny or stuffy nose) (Beyond the Basics) […] NONALLERGIC RHINITIS TREATMENT […] Treatment of nonallergic rhinitis includes trigger avoidance, medications, and/or nasal rinsing or irrigation. […] Trigger avoidance — Exposure to tobacco smoke can be reduced if household members stop smoking or smoke only outside of the home. […] Nasal rinsing and irrigation — Simply rinsing the nose with a salt water (saline) solution one or more times per day is helpful for many patients with nonallergic rhinitis, as well as for other rhinitis conditions. […] Medications that may help symptoms — Daily use of a nasal glucocorticoid (steroid) and/or an antihistamine nasal spray can be helpful for people with nonallergic rhinitis. […] Nasal antihistamines — A prescription nasal antihistamine spray, such as azelastine (eg, Astelin, Astepro) or Patanase, can relieve symptoms of postnasal drip, congestion, and sneezing.

• #1 Non-allergic rhinitis

  https://www.nhs.uk/conditions/non-allergic-rhinitis/

  Non-allergic rhinitis happens when the inside of your nose becomes irritated, causing a blocked or runny nose. It can be treated with medicines from a pharmacist or GP. […] You can often treat it without seeing a GP. […] A pharmacist can advise you about medicines that can help, such as: antihistamines, nasal sprays to unblock your nose, salt water nasal sprays or solutions to rinse out the inside of your nose. […] Non-allergic rhinitis often gets better on its own without any treatment. […] If needed, a GP may prescribe stronger medicine, such as prescription nasal sprays. […] They may also change any medicine you’re taking if they think it may be causing your symptoms. […] You may be referred to a specialist for further tests and treatment if it’s not clear what’s causing your symptoms or they’re severe.

• #1 Chronic Nonallergic Rhinitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0801/p171.html

  Decongestants effectively manage congestion regardless of etiology. […] Nasal irrigation with saline or hypertonic saline may be helpful in the treatment of nonallergic rhinitis. […] Further investigation is needed for irrigation and intranasal capsaicin in the treatment of nonallergic rhinitis. […] Surgery is an option for select patients whose symptoms are not adequately controlled with traditional therapies and may be most effective in patients with significant obstructive symptoms.

• #1 Nonallergic Rhinitis Information & Treatment

  https://www.columbiadoctors.org/health-library/condition/nonallergic-rhinitis/

  Rhinitis symptoms can be long-lasting, or they can come and go. They may include a runny nose, a stuffy nose, or sneezing. Drainage down the back of the throat (postnasal drip) from the nose and sinuses may also occur. […] You can take simple measures to help relieve your symptoms of nonallergic rhinitis. […] Try to avoid things that trigger your symptoms. […] Use saline (salt water) to rinse your nasal passages once or twice a day. Then blow your nose. You can use: A saline nasal spray. It’s easy and quick to use, and you can find it in any drugstore. […] Use a prescription or over-the-counter nasal medicine, as recommended by your doctor. Different types that might be helpful include antihistamine, corticosteroid, decongestant, and capsaicin nasal sprays. […] If your doctor recommends medicine to relieve symptoms, make sure to take it exactly as prescribed. For example, take a decongestant spray for no more than 3 or 4 days. Longer use can make symptoms worse. Call your doctor if you think you are having a problem with your medicine.

• #1 Nonallergic Rhinitis – Ear, Nose, and Throat Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/ear-nose-and-throat-disorders/nose-and-paranasal-sinus-disorders/nonallergic-rhinitis

  Rhinitis is classified as allergic or nonallergic. […] Treatment includes humidification of room air, sympathomimetic amines, and antihistamines. Bacterial superinfection requires appropriate antibiotic treatment. […] For viral rhinitis, decongestants, antihistamines, or both. […] For atrophic rhinitis, topical treatment with antibiotics, estrogens, and vitamin A and D. […] For vasomotor rhinitis, humidification and sometimes topical corticosteroids and oral pseudoephedrine. […] Treatment of atrophic rhinitis is directed at reducing the crusting and eliminating the odor with nasal irrigation, topical antibiotics (eg, mupirocin), topical or systemic estrogens, and vitamins A and D. […] Treatment of vasomotor rhinitis is by trial and error and is not always satisfactory. Patients benefit from humidified air, which may be provided by a humidified central heating system or a vaporizer in the workroom or bedroom. Topical corticosteroids (eg, mometasone 2 sprays twice a day) and nasal antihistamines can be of some benefit.

• #1 Treating Chronic Rhinitis | Lockey, Fox, Ledford & Glaum MDs PA

  https://www.allergytampa.com/2021/10/20/treating-chronic-rhinitis/

  Some chronic rhinitis sufferers benefit from using a humidifier in their homes and workspaces. Humidifiers add moisture to the air, lubricating nasal passages and relieving inflammation. […] Capsaicin has been used as a treatment for non-allergic rhinitis and is available in a nasal spray. Research on its effectiveness is limited, and you should only try it with your doctor’s permission.

• #1 Management of Rhinitis: Allergic and Non-Allergic

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3121056/

  Nonallergic rhinitis (NAR) is generally described as chronic nasal symptoms, such as obstruction and rhinorrhea that occur in relation to nonallergic, noninfectious triggers such as change in the weather, exposure to caustic odors or cigarette smoke, barometric pressure differences, etc. […] The mainstay of treatment for NAR are intranasal corticosteroids. Topical antihistamines have also been found to be efficacious. Topical anticholinergics such as ipratropium bromide (0.03%) nasal spray are effective in treating rhinorrhea symptoms. Adjunct therapy includes decongestants and nasal saline. Investigational therapies in the treatment of NAR discussed include capsaicin, silver nitrate, and acupuncture. […] Intranasal corticosteroids have been found to be effective in nonallergic rhinitis, especially in vasomotor rhinitis and NARES. Fluticasone propionate and beclomethasone are the only topical corticosteroids approved by the FDA in the US for the treatment of NAR.

• #1 Patient education: Nonallergic rhinitis (runny or stuffy nose) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/nonallergic-rhinitis-runny-or-stuffy-nose-beyond-the-basics

  Nasal glucocorticoids (steroids) — Nasal glucocorticoids (steroids) have been shown to be effective for symptoms of nonallergic rhinitis. […] Nasal ipratropium (Atrovent nasal spray) — A runny nose with profuse, watery discharge from the nose (rhinorrhea) can be treated with ipratropium (0.03 percent or 0.06 percent) nasal spray. […] Combination nasal antihistamine and nasal glucocorticoid (steroid) — There is a nasal spray (Dymista) that contains both azelastine and fluticasone. […] Decongestants — Oral decongestant medications (like pseudoephedrine or phenylephrine) help to relieve symptoms of congestion (stuffiness) in some people. […] How long will I need treatment? — The dose or frequency of medications can be reduced in some patients over time. However, in most patients, symptoms are lifelong, and some medication is usually needed on a daily and long-term basis.

• #1 Nonallergic rhinitis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nonallergic-rhinitis/diagnosis-treatment/drc-20351235

  Treatment of nonallergic rhinitis depends on how much it bothers you. Home treatment and staying away from triggers might be enough for mild cases. Medicines may ease worse symptoms. These include: […] Antihistamine nasal sprays. Antihistamines treat many health problems, including allergies. An antihistamine nose spray may ease the symptoms of nonallergic rhinitis too. Your provider may write you a prescription that lets you buy this type of spray at a pharmacy. […] Ipratropium nose spray. This prescription spray can ease a runny, drippy nose. Side effects can include nosebleeds and dryness inside the nose. […] Steroids. These medicines help prevent and treat swelling linked with some types of nonallergic rhinitis. Side effects can include a dry nose or throat, nosebleeds, and headaches. Your provider may suggest a steroid nose spray if decongestants or antihistamines don’t control your symptoms.

• #1 Treatment of nonallergic perennial rhinitis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/14984552/

  Nonallergic perennial rhinitis (also commonly referred to as vasomotor rhinitis) is a chronic non-IgE-mediated condition that is characterized by symptoms which are similar to those seen in allergic rhinitis, but which persist for over nine months each year. […] Although treatment of vasomotor rhinitis involves the use of either intranasal corticosteroids or antihistamines, the corticosteroids are generally not effective in treatment of all the symptoms of vasomotor rhinitis and have generally been shown to be effective in patients with eosinophilia. […] With the exception of azelastine, the only topical antihistamine to be approved by the FDA for the treatment of nonallergic rhinitis, the antihistamines have also produced inconsistent results. […] While clinical studies of azelastine have demonstrated that this drug is highly efficacious in the treatment of all the symptoms of vasomotor rhinitis, mechanistic studies have demonstrated that azelastine has potent anti-inflammatory effects (in particular attenuation of the expression and synthesis of pro-inflammatory cytokines, leukotrienes, and cell adhesion molecules), which are likely to contribute to its clinical efficacy.

• #1 Nonallergic (Vasomotor) Rhinitis: Symptoms, Causes and Treatment

  https://www.webmd.com/allergies/nonallergic-rhinitis

  Nonallergic rhinitis can’t be cured, but its symptoms can be controlled by: […] Using home remedies such as nasal irrigation […] Taking over-the-counter and prescription medications […] Using a bioelectronic sinus device. […] Allergy shots (immunotherapy) are not used to treat nonallergic rhinitis. […] Medications for nonallergic rhinitis include: […] Prescription products such as azelastine (Astelin) and olopatadine (Patanase) can relieve symptoms of postnasal drip, congestion, and sneezing within minutes. […] Daily use of medications such as budesonide (Rhinocort Allergy), fluticasone (Flonase), or triamcinolone (Nasacort Allergy 24HR) may help relieve symptoms. […] Ipratropium bromide (Atrovent) is considered the best treatment for the watery nasal discharge that comes from eating and drinking certain foods and beverages.

• #1 Pharmacotherapy for Nonallergic Rhinitis: Overview, Distinguishing Types of Nonallergic Rhinitis, Pharmacotherapy

  https://emedicine.medscape.com/article/874171-overview

  Therapy is guided at symptomatic care and treatment of the underlying disease. […] Normal nasal function should recover within 7-21 days after sympathomimetics are discontinued. […] A wide variety of etiologies are involved in nonallergic rhinitis. Therefore, treatment options should not be implemented randomly. Instead, they should be primarily aimed at resolving the underlying causative physiology. […] Ipratropium is ideal for patients presenting with only rhinorrhea. […] Clinical studies showed that ipratropium reduces the duration and severity of rhinorrhea by 33% and 29%, respectively, compared with placebo. […] Nasal corticosteroids are believed to permit smooth-muscle relaxation, reduce airway hyperresponsiveness, and reduce the quantity and activity of inflammatory mediators.

• #1 Chronic Nonallergic Rhinitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0801/p171.html

  Decongestants may be used in the treatment of nonallergic rhinitis, but only in the short term because of adverse effects. […] Nasal irrigation may be used for nonallergic rhinitis. […] Intranasal corticosteroids are first-line therapy for nonallergic rhinitis. […] Intranasal antihistamines are effective for nonallergic rhinitis, likely because of their actions as anti-inflammatory and neuroinflammatory blockers. […] Although there is more evidence for using intranasal corticosteroids combined with intranasal antihistamines to treat allergic rhinitis, this combination is also beneficial in patients with nonallergic rhinitis whose symptoms are not adequately controlled with either therapy alone. […] Intranasal ipratropium has been proven effective in decreasing rhinorrhea and is a reasonable monotherapy for patients who have rhinorrhea as a predominant symptom.

• #1 Nonallergic rhinitis

  https://www.mymlc.com/health-information/diseases-and-conditions/n/nonallergic-rhinitis/

  Decongestants. Available over-the-counter or by prescription, examples include pseudoephedrine-containing drugs (Sudafed 12 Hour) and phenylephrine (Neo-Synephrine, others). These medications help narrow the blood vessels, reducing congestion in the nose. […] In some cases, surgical procedures might be an option to treat complicating problems, such as a deviated nasal septum or persistent nasal polyps. […] Try these tips to help reduce discomfort and relieve the symptoms of nonallergic rhinitis: Rinse your nasal passages. Use a specially designed squeeze bottle — such as the one included in saline kits — a bulb syringe or a neti pot to irrigate your nasal passages.

• #1 Nonallergic rhinitis // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/nonallergic-rhinitis

  Treatment of nonallergic rhinitis depends on how much it bothers you. Home treatment and staying away from triggers might be enough for mild cases. Medicines may ease worse symptoms. These include: […] Antihistamine nasal sprays. Antihistamines treat many health problems, including allergies. An antihistamine nose spray may ease the symptoms of nonallergic rhinitis too. Your provider may write you a prescription that lets you buy this type of spray at a pharmacy. […] Ipratropium nose spray. This prescription spray can ease a runny, drippy nose. Side effects can include nosebleeds and dryness inside the nose. […] Decongestants. These medicines help narrow the blood vessels in the nose and lessen congestion. Side effects can include high blood pressure, heart pounding and feeling restless. Decongestants can be bought off store shelves or with a prescription.

• #1 Pharmacotherapy for Nonallergic Rhinitis: Overview, Distinguishing Types of Nonallergic Rhinitis, Pharmacotherapy

  https://emedicine.medscape.com/article/874171-overview

  Capsaicin use has been targeted to patients presenting with congestion, rhinorrhea, sneezing, or a combination of these symptoms. […] A randomized, double-blind, placebo-controlled study by Veskitkul et al indicated that in children with nonallergic rhinitis suffering from recurrent acute rhinosinusitis (RAR), azithromycin can successfully be used prophylactically to decrease the number of RAR episodes. […] Surgical therapy should be considered a possible adjuvant to continued medical therapy.

• #1 Capsaicin for non-allergic rhinitis | Cochrane

  https://www.cochrane.org/CD010591/ENT_capsaicin-non-allergic-rhinitis

  Is capsaicin applied into the nose (intranasal) effective in the management of non-allergic rhinitis compared with no therapy, placebo or other topical or systemic medications? […] Capsaicin, the active component of chili peppers, delivered intranasally, is considered a treatment option for non-allergic rhinitis. […] Given that many other options do not work well in non-allergic rhinitis, capsaicin is a reasonable option to try under physician supervision. […] Capsaicin may be an option in the treatment of idiopathic non-allergic rhinitis. It is given in the form of brief treatments, usually during the same day. It appears to have beneficial effects on overall nasal symptoms up to 36 weeks after treatment, based on a few, small studies (low-quality evidence). Well-conducted randomised controlled trials are required to further advance our understanding of the effectiveness of capsaicin in non-allergic rhinitis, especially in patients with non-allergic rhinitis of different types and severity, and using different methods of capsaicin application.

• #1 Nonallergic rhinitis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nonallergic-rhinitis/diagnosis-treatment/drc-20351235

  Your health care provider may suggest surgery to treat other problems that can happen with nonallergic rhinitis. For example, growths in the nose called polyps may need to be removed. Surgery also can fix a problem where the thin wall between the passages in the nose is off-center or crooked. This is called a deviated septum.

• #1 Allergic & Nonallergic Rhinitis NYC | Mount Sinai – New York

  https://www.mountsinai.org/care/ent/services/nasal-sinus-allergy/conditions/rhinitis

  Nasal corticosteroids: this is the gold standard for non-allergic and allergic rhinitis; they are effective in treating most rhinitis cases, reducing inflammation and nasal symptoms (congestion, itching, nasal drip, sneezing). […] There is no surgical treatment specifically for allergic or nonallergic rhinitis. Surgical treatment revolves around ameliorating symptoms, such as nasal drip and nasal congestion/obstruction. Addressing anatomical abnormalities (deviated septum, inferior turbinate enlargement, and nasal valve collapse) can help with obstruction. […] Allergic and nonallergic rhinitis can be overwhelming, as symptoms are often chronic and can cause distress in many people’s lives. The treatment of these symptoms can feel daunting, but we here at Mount Sinai can help you navigate the treatment steps and help you select the treatment that both improves your quality of life and enjoy living again.

• #1 Rhinitis – La Crosse, Wisconsin – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/locations/la-crosse/services-and-treatments/otorhinolaryngology/nose-conditions-and-treatment/rhinitis

  Nonallergic rhinitis occurs when no obvious irritant or allergen is present and can seem to start with no apparent cause. […] Treatment of nonallergic rhinitis depends on how much it bothers you. For mild cases, home treatment and avoiding triggers may be enough. For more-bothersome symptoms, certain medications may provide relief including nasal sprays and decongestants. […] In some cases, surgical procedures may be an option to treat complicating problems. […] Cryotherapy, or cold therapy, is an innovative, minimally invasive treatment for rhinitis. Cryotherapy uses an endoscope and cryotherapy device to freeze nerves in your nasal passages. When the cold temperature hits the nerves, the nerve signals are interrupted and no longer tell the nose to swell, drip and run. The interruption of the nerve signals provides long-lasting relief from runny or stuffy nasal symptoms. Cryotherapy can provide patients with symptom relief for up to a year or longer.

• #1 CHRONIC RHINITIS REQUIRES COMPREHENSIVE TREATMENT

  https://rhinaer.com/hcp/

  RhinAer has been demonstrated to provide lasting relief of chronic rhinitis. […] Many in-office treatments for rhinitis are not comprehensive, while surgical options like septoplasty, turbinate reduction, or other ablative technologies yield mixed patient responses and may not address all symptoms. […] RhinAer is the only non-invasive, in-office solution that targets the multiple sources of chronic rhinitis, offering lasting relief from runny nose, post-nasal drip, and congestion for both allergic and non-allergic patients. […] Treatment of the PNN using RhinAer has been shown to be an effective, patient-friendly option to treat both chronic allergic and non-allergic rhinitis. Its exciting that otolaryngologists have a safe, non-invasive treatment option that can be performed in the clinic under local anesthesia and that provides long-term benefits for our patients.

• #1 Allergic and Non-Allergic Rhinitis Houston The Woodlands TX

  https://premiersinus.com/services/allergic-non-allergic-rhinitis/

  Non-allergic rhinitis symptoms may result from a physical abnormality, such as nasal polyps or a deviated septum. […] When patients come to Dr. Allen for ongoing rhinitis symptoms, they have typically already tried front-line treatments such as over-the-counter decongestants, antihistamines, and nasal sprays. Dr. Allen may prescribe corticosteroid medication, which is effective in many cases. For chronic allergic rhinitis, he may recommend immunotherapy (allergy shots or drops). For cases that do not respond to medication, and for cases in which the nasal passages are physically blocked, he may recommend endoscopic nasal or sinus surgery or a non-surgical treatment for rhinitis such as posterior nasal nerve ablation (Clarifix).

• #1 Non-allergic rhinitis: An expert guide

  https://www.topdoctors.co.uk/medical-articles/non-allergic-rhinitis-an-expert-guide

  Coblation (controlled ablation) plasma technology is a cutting-edge technique used to treat turbinate hypertrophy in which soft tissue inside the turbinates is both removed and shrunk in order to remove the obstruction within the nasal airway. […] In more severe nasal obstructions, both an enlargement of a bony part of the inferior turbinates and a swelling of the mucous are often at play. In these cases, a procedure known as microdebrider assisted turbinoplasty may be required. […] Although some patients experience slight discomfort in the nose following surgery for non-allergic rhinitis, over-the-counter pain killers are usually adequate to manage this in the days following the procedure.

• #1 Vasomotor Rhinitis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17950-nonallergic-rhinitis

  There isn’t a cure for nonallergic rhinitis. Most people manage symptoms with self-care measures, changes to their environment and medicine. […] If your condition results from exposure to triggers like perfumes, treatment may be as simple as avoiding the trigger. In those cases where avoiding the trigger is impossible, you can put measures in place to ease symptoms, try over-the-counter medications or get a prescription from a healthcare provider. […] Prescribed medications can decrease nasal inflammation and manage your symptoms. These medications may include: Decongestant nasal sprays to relieve nasal congestion. Antihistamine nasal sprays that reduce nasal inflammation. Corticosteroid nasal sprays (like fluticasone) to reduce nasal inflammation (first-line treatment for nasal congestion). Anticholinergic nasal sprays (like ipratropium bromide) to help with a runny nose. […] Surgery may be an option if the medications aren’t helping or if another condition is intensifying the problem, like a deviated septum or nasal polyps.

• #1 Nonallergic rhinitis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/nonallergic-rhinitis/

  Atrophic rhinitis is managed differently from other types of NAR. […] Conservative management options to reduce nasal crusting include: Nasal saline irrigation, Glycerin drops, Emollients, Antibiotics targeting specific pathogens, Nasal estradiol. […] Surgical options to decrease the volume of the nasal cavity: e.g., modified Young procedure, prostheses. […] There is no standard treatment algorithm for the management of NAR. […] The following approach primarily applies to nonpregnant patients. […] Avoid triggers when possible; see Types of NAR. […] Start monotherapy with either of the following: Intranasal antihistamines (INAH): azelastine (off-label except for VMR), Intranasal corticosteroids (INCS): fluticasone or beclomethasone (off-label except for VMR). […] Consider adding the following: Intranasal saline as needed for symptom control [1].

• #1 Nonallergic Rhinitis, With a Focus on Vasomotor Rhinitis Clinical Importance, Differential Diagnosis, and Effective Treatment Recommendations | World Allergy Organization Journal | Full Text

  https://waojournal.biomedcentral.com/articles/10.1097/WAO.0b013e318196ca1e

  Ipratropium bromide (IB) is a potent intranasal anti-cholinergic with utility in the treatment of rhinorrhea in AR and NAR. […] Both oral and topical decongestants effectively treat congestion regardless of cause; however, none have been studied for NAR. […] Although NAR effects many patients, very few medications have been adequately studied for the treatment of this condition. […] Nonallergic rhinitis is an underrecognized and inadequately treated condition affecting many subjects. […] Nonallergic rhinitis tends to require chronic medical management, and use of topical NCCSs and nasal antihistamines, used alone or in combination, is very effective in most patients. […] Thus, recognizing that the combination of both NCCSs and nasal antihistamines effectively treat AR, VMR, and mixed rhinitis, this combination of medications seems to be a useful first-line treatment for the overwhelming majority of rhinitis patients.

• #1 Vasomotor Rhinitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0915/p1057.html

  Potential risks versus benefits should be considered in the use of FDA-approved topical anticholinergics (pregnancy category B), topical antihistamines (pregnancy category C), and topical corticosteroids (pregnancy category C). […] Three types of nonallergic rhinitis commonly occur in older patients. […] All three types respond well to ipratropium nasal spray. […] Although no single agent is uniformly effective in controlling the many and varied symptoms of vasomotor rhinitis, available evidence supports a stepwise application of several agents after a careful history and physical examination. […] Additional therapies, for which AHRQ felt there was no strong evidence base, may be tried if the approved approaches fail.

• #2 Vasomotor Rhinitis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17950-nonallergic-rhinitis

  There isn’t a cure for nonallergic rhinitis. Most people manage symptoms with self-care measures, changes to their environment and medicine. […] If your condition results from exposure to triggers like perfumes, treatment may be as simple as avoiding the trigger. In those cases where avoiding the trigger is impossible, you can put measures in place to ease symptoms, try over-the-counter medications or get a prescription from a healthcare provider. […] Prescribed medications can decrease nasal inflammation and manage your symptoms. These medications may include: Decongestant nasal sprays to relieve nasal congestion. Antihistamine nasal sprays that reduce nasal inflammation. Corticosteroid nasal sprays (like fluticasone) to reduce nasal inflammation (first-line treatment for nasal congestion). Anticholinergic nasal sprays (like ipratropium bromide) to help with a runny nose. […] Surgery may be an option if the medications aren’t helping or if another condition is intensifying the problem, like a deviated septum or nasal polyps.

• #2 Patient education: Nonallergic rhinitis (runny or stuffy nose) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/nonallergic-rhinitis-runny-or-stuffy-nose-beyond-the-basics

  Patient education: Nonallergic rhinitis (runny or stuffy nose) (Beyond the Basics) […] NONALLERGIC RHINITIS TREATMENT […] Treatment of nonallergic rhinitis includes trigger avoidance, medications, and/or nasal rinsing or irrigation. […] Trigger avoidance — Exposure to tobacco smoke can be reduced if household members stop smoking or smoke only outside of the home. […] Nasal rinsing and irrigation — Simply rinsing the nose with a salt water (saline) solution one or more times per day is helpful for many patients with nonallergic rhinitis, as well as for other rhinitis conditions. […] Medications that may help symptoms — Daily use of a nasal glucocorticoid (steroid) and/or an antihistamine nasal spray can be helpful for people with nonallergic rhinitis. […] Nasal antihistamines — A prescription nasal antihistamine spray, such as azelastine (eg, Astelin, Astepro) or Patanase, can relieve symptoms of postnasal drip, congestion, and sneezing.

• #2

• #2 Nonallergic Rhinitis Information & Treatment

  https://www.columbiadoctors.org/health-library/condition/nonallergic-rhinitis/

  Rhinitis symptoms can be long-lasting, or they can come and go. They may include a runny nose, a stuffy nose, or sneezing. Drainage down the back of the throat (postnasal drip) from the nose and sinuses may also occur. […] You can take simple measures to help relieve your symptoms of nonallergic rhinitis. […] Try to avoid things that trigger your symptoms. […] Use saline (salt water) to rinse your nasal passages once or twice a day. Then blow your nose. You can use: A saline nasal spray. It’s easy and quick to use, and you can find it in any drugstore. […] Use a prescription or over-the-counter nasal medicine, as recommended by your doctor. Different types that might be helpful include antihistamine, corticosteroid, decongestant, and capsaicin nasal sprays. […] If your doctor recommends medicine to relieve symptoms, make sure to take it exactly as prescribed. For example, take a decongestant spray for no more than 3 or 4 days. Longer use can make symptoms worse. Call your doctor if you think you are having a problem with your medicine.

• #2 Nonallergic Rhinitis | The Children’s Hospital at Montefiore

  https://www.cham.org/health-library/article?id=abs1066

  Rhinitis symptoms can be long-lasting, or they can come and go. They may include a runny nose, a stuffy nose, or sneezing. Drainage down the back of the throat (postnasal drip) from the nose and sinuses may also occur. […] You can take simple measures to help relieve your symptoms of nonallergic rhinitis. […] Try to avoid things that trigger your symptoms. […] Use saline (salt water) to rinse your nasal passages once or twice a day. Then blow your nose. You can use: A saline nasal spray. It’s easy and quick to use, and you can find it in any drugstore. A neti pot or squeeze bottle to stream salt water into one nostril and out the other. (To make a saline rinse, add 1 teaspoon of non-iodized salt and 1 teaspoon of baking soda to 2 cups of distilled or boiled and cooled water.) […] Use a prescription or over-the-counter nasal medicine, as recommended by your doctor. Different types that might be helpful include antihistamine, corticosteroid, decongestant, and capsaicin nasal sprays. […] If your doctor recommends medicine to relieve symptoms, make sure to take it exactly as prescribed. For example, take a decongestant spray for no more than 3 or 4 days. Longer use can make symptoms worse. Call your doctor if you think you are having a problem with your medicine.

• #2 Treating Chronic Rhinitis | Lockey, Fox, Ledford & Glaum MDs PA

  https://www.allergytampa.com/2021/10/20/treating-chronic-rhinitis/

  Some chronic rhinitis sufferers benefit from using a humidifier in their homes and workspaces. Humidifiers add moisture to the air, lubricating nasal passages and relieving inflammation. […] Capsaicin has been used as a treatment for non-allergic rhinitis and is available in a nasal spray. Research on its effectiveness is limited, and you should only try it with your doctor’s permission.

• #2 Management of Rhinitis: Allergic and Non-Allergic

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3121056/

  Nonallergic rhinitis (NAR) is generally described as chronic nasal symptoms, such as obstruction and rhinorrhea that occur in relation to nonallergic, noninfectious triggers such as change in the weather, exposure to caustic odors or cigarette smoke, barometric pressure differences, etc. […] The mainstay of treatment for NAR are intranasal corticosteroids. Topical antihistamines have also been found to be efficacious. Topical anticholinergics such as ipratropium bromide (0.03%) nasal spray are effective in treating rhinorrhea symptoms. Adjunct therapy includes decongestants and nasal saline. Investigational therapies in the treatment of NAR discussed include capsaicin, silver nitrate, and acupuncture. […] Intranasal corticosteroids have been found to be effective in nonallergic rhinitis, especially in vasomotor rhinitis and NARES. Fluticasone propionate and beclomethasone are the only topical corticosteroids approved by the FDA in the US for the treatment of NAR.

• #2 Nonallergic rhinitis

  https://www.mymlc.com/health-information/diseases-and-conditions/n/nonallergic-rhinitis/

  Corticosteroid nasal sprays. If your symptoms aren’t easily controlled by decongestants or antihistamines, your doctor might suggest a nonprescription corticosteroid nasal spray, such as fluticasone (Flonase Allergy Relief) or triamcinolone (Nasacort Allergy 24 Hour). Prescription nasal sprays also are available. […] Antihistamine nasal sprays. Try a prescription antihistamine spray such as azelastine (Astelin, Astepro) or olopatadine hydrochloride (Patanase). While oral antihistamines don’t seem to help nonallergic rhinitis, nasal sprays containing an antihistamine might reduce symptoms. […] Anti-drip anticholinergic nasal sprays. The prescription drug ipratropium is often used as an asthma inhaler medication. But it’s now available as a nasal spray and can be helpful if a runny, drippy nose is your main complaint.

• #2 Allergic & Nonallergic Rhinitis NYC | Mount Sinai – New York

  https://www.mountsinai.org/care/ent/services/nasal-sinus-allergy/conditions/rhinitis

  Nasal corticosteroids: this is the gold standard for non-allergic and allergic rhinitis; they are effective in treating most rhinitis cases, reducing inflammation and nasal symptoms (congestion, itching, nasal drip, sneezing). […] There is no surgical treatment specifically for allergic or nonallergic rhinitis. Surgical treatment revolves around ameliorating symptoms, such as nasal drip and nasal congestion/obstruction. Addressing anatomical abnormalities (deviated septum, inferior turbinate enlargement, and nasal valve collapse) can help with obstruction. […] Allergic and nonallergic rhinitis can be overwhelming, as symptoms are often chronic and can cause distress in many people’s lives. The treatment of these symptoms can feel daunting, but we here at Mount Sinai can help you navigate the treatment steps and help you select the treatment that both improves your quality of life and enjoy living again.

• #2 Chronic Nonallergic Rhinitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0801/p171.html

  Decongestants may be used in the treatment of nonallergic rhinitis, but only in the short term because of adverse effects. […] Nasal irrigation may be used for nonallergic rhinitis. […] Intranasal corticosteroids are first-line therapy for nonallergic rhinitis. […] Intranasal antihistamines are effective for nonallergic rhinitis, likely because of their actions as anti-inflammatory and neuroinflammatory blockers. […] Although there is more evidence for using intranasal corticosteroids combined with intranasal antihistamines to treat allergic rhinitis, this combination is also beneficial in patients with nonallergic rhinitis whose symptoms are not adequately controlled with either therapy alone. […] Intranasal ipratropium has been proven effective in decreasing rhinorrhea and is a reasonable monotherapy for patients who have rhinorrhea as a predominant symptom.

• #2 Pharmacotherapy for Nonallergic Rhinitis: Overview, Distinguishing Types of Nonallergic Rhinitis, Pharmacotherapy

  https://emedicine.medscape.com/article/874171-overview

  A study by Kirtsreesakul et al, however, found that although patients with nonallergic rhinitis experienced improvement from nasal steroid therapy, it was to a lesser extent than in patients with allergic rhinitis. […] Antihistamines are useful in relieving rhinorrhea, sneezing, and nasal pruritus. […] Some nasal antihistamines, such as azelastine, have a labeled indication for the treatment of vasomotor rhinitis. […] Nasally applied sympathomimetics are imidazoline derivatives that cause local vasoconstriction through alpha 2-adrenergic agonistic properties, ultimately reducing nasal edema and obstruction. […] In June 2019, dupilumab became the first drug approved by the US Food and Drug Administration for the treatment of chronic rhinosinusitis with nasal polyps (CRSwNP) that has not otherwise been sufficiently controlled.

• #2 Nonallergic rhinitis – Wikipedia

  https://en.wikipedia.org/wiki/Nonallergic_rhinitis

  However, intranasal corticosteroids probably increase risk of nosebleeds. […] Astelin (azelastine) „is indicated for symptomatic treatment of vasomotor rhinitis including rhinorrhea, nasal congestion, and post nasal drip in adults and children 12 years of age and older.” […] Reduction of hypertrophied turbinates, correction of nasal septum deviation, removal of polyps, sectioning of the parasympathetic secretomotor fiber to nose (vidian neurectomy) for controlling refractory excessive rhinorrhea.

• #2 Treatment of nonallergic perennial rhinitis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/14984552/

  Nonallergic perennial rhinitis (also commonly referred to as vasomotor rhinitis) is a chronic non-IgE-mediated condition that is characterized by symptoms which are similar to those seen in allergic rhinitis, but which persist for over nine months each year. […] Although treatment of vasomotor rhinitis involves the use of either intranasal corticosteroids or antihistamines, the corticosteroids are generally not effective in treatment of all the symptoms of vasomotor rhinitis and have generally been shown to be effective in patients with eosinophilia. […] With the exception of azelastine, the only topical antihistamine to be approved by the FDA for the treatment of nonallergic rhinitis, the antihistamines have also produced inconsistent results. […] While clinical studies of azelastine have demonstrated that this drug is highly efficacious in the treatment of all the symptoms of vasomotor rhinitis, mechanistic studies have demonstrated that azelastine has potent anti-inflammatory effects (in particular attenuation of the expression and synthesis of pro-inflammatory cytokines, leukotrienes, and cell adhesion molecules), which are likely to contribute to its clinical efficacy.

• #2 Management of Rhinitis: Allergic and Non-Allergic

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3121056/

  The only topical anticholinergic medication approved in the United States for topical application is ipratropium bromide. Ipratropium bromide (0.03%) nasal spray is recommended when rhinorrhea is the predominant or only symptom, as in the case of gustatory rhinitis. […] Currently there are no specific studies looking at the effectiveness of oral decongestants in the treatment of NAR. Thus, they should be considered adjunctive therapy, which is used on an as needed basis for nasal congestion that is not responsive to intranasal corticosteroids, topical antihistamines, or a combination of both. […] After 6-12 months of failed medical therapy (intranasal corticosteroid with azelastine and/or decongestants and/or ipratropium bromide) then surgical options may be considered.

• #2 Patient education: Nonallergic rhinitis (runny or stuffy nose) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/nonallergic-rhinitis-runny-or-stuffy-nose-beyond-the-basics

  Nasal glucocorticoids (steroids) — Nasal glucocorticoids (steroids) have been shown to be effective for symptoms of nonallergic rhinitis. […] Nasal ipratropium (Atrovent nasal spray) — A runny nose with profuse, watery discharge from the nose (rhinorrhea) can be treated with ipratropium (0.03 percent or 0.06 percent) nasal spray. […] Combination nasal antihistamine and nasal glucocorticoid (steroid) — There is a nasal spray (Dymista) that contains both azelastine and fluticasone. […] Decongestants — Oral decongestant medications (like pseudoephedrine or phenylephrine) help to relieve symptoms of congestion (stuffiness) in some people. […] How long will I need treatment? — The dose or frequency of medications can be reduced in some patients over time. However, in most patients, symptoms are lifelong, and some medication is usually needed on a daily and long-term basis.

• #2 Chronic Nonallergic Rhinitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0801/p171.html

  Decongestants effectively manage congestion regardless of etiology. […] Nasal irrigation with saline or hypertonic saline may be helpful in the treatment of nonallergic rhinitis. […] Further investigation is needed for irrigation and intranasal capsaicin in the treatment of nonallergic rhinitis. […] Surgery is an option for select patients whose symptoms are not adequately controlled with traditional therapies and may be most effective in patients with significant obstructive symptoms.

• #2 Nonallergic (Vasomotor) Rhinitis: Symptoms, Causes and Treatment

  https://www.webmd.com/allergies/nonallergic-rhinitis

  Oral decongestant medications, such as pseudoephedrine, may help relieve congestion. […] Many people with nonallergic rhinitis benefit from performing nasal irrigation. […] In some cases, surgery to remove nasal polyps or correct a deviated septum can improve the way medications for nonallergic rhinitis work.

• #2 Nonallergic Rhinitis | Haydel Asthma and Allergy Clinic | Houma Louisiana

  https://www.haydelasthma.com/services/nonallergic-rhinitis

  If your symptoms are more bothersome, your doctor may recommend saline nasal sprays or prescribe oral decongestants, decongestant nasal sprays, antihistamine nasal sprays or corticosteroid nasal sprays. […] Over-the-counter antihistamines such as Benadryl and Claritin generally do not relieve nonallergic rhinitis symptoms as effectively as they treat hay fever. […] You can effectively relieve nonallergic rhinitis symptoms at home by rinsing your nasal passages to remove irritants, setting up a humidifier to help loosen mucus and clear stuffiness, carefully and regularly blow your nose if irritants or mucus are present, and drinking plenty of liquids, including water, juice or caffeine-free tea. […] There is really no way you can avoid the underlying conditions causing nonallergic rhinitis. But, if you already have it, getting an effective treatment plan, avoiding your triggers, and not overusing nasal decongestants can bring you some relief and prevent flare-ups.

• #2 Capsaicin for non-allergic rhinitis | Cochrane

  https://www.cochrane.org/CD010591/ENT_capsaicin-non-allergic-rhinitis

  Is capsaicin applied into the nose (intranasal) effective in the management of non-allergic rhinitis compared with no therapy, placebo or other topical or systemic medications? […] Capsaicin, the active component of chili peppers, delivered intranasally, is considered a treatment option for non-allergic rhinitis. […] Given that many other options do not work well in non-allergic rhinitis, capsaicin is a reasonable option to try under physician supervision. […] Capsaicin may be an option in the treatment of idiopathic non-allergic rhinitis. It is given in the form of brief treatments, usually during the same day. It appears to have beneficial effects on overall nasal symptoms up to 36 weeks after treatment, based on a few, small studies (low-quality evidence). Well-conducted randomised controlled trials are required to further advance our understanding of the effectiveness of capsaicin in non-allergic rhinitis, especially in patients with non-allergic rhinitis of different types and severity, and using different methods of capsaicin application.

• #2 Your Runny Nose Could Be Non-Allergic Rhinitis | North Atlanta ENT & Allergy

  https://naenta.com/your-runny-nose-could-be-non-allergic-rhinitis/

  Excessive production of clear, watery drainage in the nose is an annoying problem that is frequently presented by patients. This is called non-allergic rhinitis, and more than 24 million people in the US suffer from this condition. […] If you are constantly suffering from rhinorrhea or post-nasal drip, there are treatments available. For some patients, we recommend using nasal saline irrigation and nasal steroid sprays (Flonase, Nasacort). Some patients respond to Atrovent (ipratropium bromide) nasal spray, which works by blocking a certain part of the nervous system innervation to the nose. However, many patients do not respond well to these conservative treatment options, and until recently, we did not have a viable alternative. […] A new procedure called ClariFix was recently FDA approved for nasal drainage and is being implemented into our practice as an in-office treatment for chronic nasal drainage. ClariFix uses a cooling technology to reduce nasal drainage.

• #2 New Breakthrough in the Treatment of Chronic Rhinitis (Runny Nose) – Dr. Schneiderman

  https://www.drschneiderman.com/blog/new-breakthrough-in-the-treatment-of-chronic-rhinitis-runny-nose/

  Chronic rhinitis is a condition we see all too often at Schneiderman ENT. In fact, symptoms of this condition are among the most common problems reported to physicians. […] If you have used allergy medications and nasal sprays, but your symptoms are not improving over time, you may have chronic rhinitis. […] At Schneiderman ENT, we have seen firsthand the toll chronic rhinitis can take on patients lives, affecting sleep, daily functioning, productivity and overall happiness. Thats why were excited to announce theres now a better way to achieve lasting relief. […] RhinAer is an innovative, new treatment that provides lasting relief from chronic rhinitis. Schneiderman ENT now offers this convenient, effective, and non-invasive procedure and were excited about the numerous benefits it provides patients.

• #2 Chronic Nonallergic Rhinitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0801/p171.html

  Chronic nonallergic rhinitis encompasses a group of rhinitis subtypes without allergic or infectious etiologies. […] Treatment is symptom-driven and similar to that of allergic rhinitis. Patients should avoid known triggers when possible. First-line therapies include intranasal corticosteroids, intranasal antihistamines, and intranasal ipratropium. […] An intranasal corticosteroid or intranasal antihistamine alone should be the initial treatment for nonallergic rhinitis if symptoms are not rhinorrhea-predominant. […] Combination therapy with an intranasal corticosteroid and intranasal antihistamine is better than either treatment alone. […] Intranasal ipratropium should be the initial treatment for rhinorrhea in patients with gustatory nonallergic rhinitis. […] An intranasal corticosteroid plus intranasal ipratropium is more effective than either treatment alone for rhinorrhea.

• #2 Nonallergic rhinitis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/nonallergic-rhinitis/

  Consider alternative monotherapy (preferred). […] Add or switch to a symptom-specific agent. […] Consider combination intranasal therapy of INAH + INCS; see First-line treatment for dosages. […] Refer to ENT for oral pharmacotherapy options and/or surgery (e.g., vidian neurectomy for VMR, turbinectomy).

• #2 Nonallergic Rhinitis, With a Focus on Vasomotor Rhinitis Clinical Importance, Differential Diagnosis, and Effective Treatment Recommendations | World Allergy Organization Journal | Full Text

  https://waojournal.biomedcentral.com/articles/10.1097/WAO.0b013e318196ca1e

  Most patients will ultimately respond to the use of combinations of nasal sprays plus an oral medication. […] Once under control, stepping the therapy down to the lowest effective dose of medications is suggested. […] Nasal corticosteroids treat inflammatory conditions regardless of etiology. […] In VMR, the scent of fluticasone is sometimes a negative feature in patients for whom scent is a trigger. […] Thus, for the treatment of NAR, NCCSs are considered a first-line therapy. […] Clinical experience suggests that antihistamine/decongestant combinations are somewhat effective in VMR. […] On the basis of both published clinical studies and extensive clinical experience, the use of azelastine (and possibly olopatadine) alone and in combination with NCCS is a preferred first-line treatment of VMR/NAR as well as AR.

• #2 Non-allergic rhinitis

  https://www.nhs.uk/conditions/non-allergic-rhinitis/

  Non-allergic rhinitis happens when the inside of your nose becomes irritated, causing a blocked or runny nose. It can be treated with medicines from a pharmacist or GP. […] You can often treat it without seeing a GP. […] A pharmacist can advise you about medicines that can help, such as: antihistamines, nasal sprays to unblock your nose, salt water nasal sprays or solutions to rinse out the inside of your nose. […] Non-allergic rhinitis often gets better on its own without any treatment. […] If needed, a GP may prescribe stronger medicine, such as prescription nasal sprays. […] They may also change any medicine you’re taking if they think it may be causing your symptoms. […] You may be referred to a specialist for further tests and treatment if it’s not clear what’s causing your symptoms or they’re severe.

• #3 Management of Rhinitis: Allergic and Non-Allergic

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3121056/

  Nonallergic rhinitis (NAR) is generally described as chronic nasal symptoms, such as obstruction and rhinorrhea that occur in relation to nonallergic, noninfectious triggers such as change in the weather, exposure to caustic odors or cigarette smoke, barometric pressure differences, etc. […] The mainstay of treatment for NAR are intranasal corticosteroids. Topical antihistamines have also been found to be efficacious. Topical anticholinergics such as ipratropium bromide (0.03%) nasal spray are effective in treating rhinorrhea symptoms. Adjunct therapy includes decongestants and nasal saline. Investigational therapies in the treatment of NAR discussed include capsaicin, silver nitrate, and acupuncture. […] Intranasal corticosteroids have been found to be effective in nonallergic rhinitis, especially in vasomotor rhinitis and NARES. Fluticasone propionate and beclomethasone are the only topical corticosteroids approved by the FDA in the US for the treatment of NAR.

• #3 Non-Allergic Rhinitis – Australasian Society of Clinical Immunology and Allergy (ASCIA)

  https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/non-allergic-rhinitis

  Non-allergic rhinitis cannot be cured but many people find relief by avoiding or minimising triggers, and using treatments, which include: […] Saline (salt water) treatments such as nasal sprays or rinses are safe and effective, and help to moisten and wash irritants and mucus from the nose. […] Intranasal corticosteroid sprays (INCS) reduce inflammation and work best when used regularly and correctly. […] Antihistamine nasal sprays can give quick relief and may be used as needed or regularly. […] Combination sprays (INCS and antihistamine) offer the combined advantages of both medications. […] Anticholinergic nasal sprays combined with decongestant can dry the nose but should only be used short term (3-5 days).

• #3 Allergic & Nonallergic Rhinitis NYC | Mount Sinai – New York

  https://www.mountsinai.org/care/ent/services/nasal-sinus-allergy/conditions/rhinitis

  Nasal corticosteroids: this is the gold standard for non-allergic and allergic rhinitis; they are effective in treating most rhinitis cases, reducing inflammation and nasal symptoms (congestion, itching, nasal drip, sneezing). […] There is no surgical treatment specifically for allergic or nonallergic rhinitis. Surgical treatment revolves around ameliorating symptoms, such as nasal drip and nasal congestion/obstruction. Addressing anatomical abnormalities (deviated septum, inferior turbinate enlargement, and nasal valve collapse) can help with obstruction. […] Allergic and nonallergic rhinitis can be overwhelming, as symptoms are often chronic and can cause distress in many people’s lives. The treatment of these symptoms can feel daunting, but we here at Mount Sinai can help you navigate the treatment steps and help you select the treatment that both improves your quality of life and enjoy living again.

• #3 Pharmacotherapy for Nonallergic Rhinitis: Overview, Distinguishing Types of Nonallergic Rhinitis, Pharmacotherapy

  https://emedicine.medscape.com/article/874171-overview

  A study by Kirtsreesakul et al, however, found that although patients with nonallergic rhinitis experienced improvement from nasal steroid therapy, it was to a lesser extent than in patients with allergic rhinitis. […] Antihistamines are useful in relieving rhinorrhea, sneezing, and nasal pruritus. […] Some nasal antihistamines, such as azelastine, have a labeled indication for the treatment of vasomotor rhinitis. […] Nasally applied sympathomimetics are imidazoline derivatives that cause local vasoconstriction through alpha 2-adrenergic agonistic properties, ultimately reducing nasal edema and obstruction. […] In June 2019, dupilumab became the first drug approved by the US Food and Drug Administration for the treatment of chronic rhinosinusitis with nasal polyps (CRSwNP) that has not otherwise been sufficiently controlled.

• #3 Management of Rhinitis: Allergic and Non-Allergic

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3121056/

  The only topical anticholinergic medication approved in the United States for topical application is ipratropium bromide. Ipratropium bromide (0.03%) nasal spray is recommended when rhinorrhea is the predominant or only symptom, as in the case of gustatory rhinitis. […] Currently there are no specific studies looking at the effectiveness of oral decongestants in the treatment of NAR. Thus, they should be considered adjunctive therapy, which is used on an as needed basis for nasal congestion that is not responsive to intranasal corticosteroids, topical antihistamines, or a combination of both. […] After 6-12 months of failed medical therapy (intranasal corticosteroid with azelastine and/or decongestants and/or ipratropium bromide) then surgical options may be considered.

• #3 Treatment of nonallergic perennial rhinitis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/14984552/

  Furthermore, pharamacokinetic studies have suggested that since azelastine has a more rapid onset of action, compared to most other antihistamines and intranasal corticosteroids, then azelastine nasal spray may be considered as primary therapy for patients with symptoms of both allergic and/or vasomotor (nonallergic perennial) rhinitis.

• #3 Vasomotor Rhinitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0915/p1057.html

  According to the AHRQ report, there has been only one study regarding the use of oral antihistamines, and that study used an antihistamine-decongestant combination product, so the benefit of individual components could not be determined. […] Certain nasal corticosteroids, such as mometasone furoate (Nasonex), are approved by the U.S. Food and Drug Administration (FDA) for children older than two years and improve the symptoms of congestion and nasal obstruction. […] Cromolyn sodium (Intal) can be used to manage symptoms of sneezing and congestion in children older than two years. […] Topical antihistamines, topical corticosteroids, and topical anticholinergics are treatments permitted by the U.S. Olympic Committee and the International Olympic Committee. […] Vasomotor rhinitis in pregnancy responds well to intranasal saline instillation.

• #3 Nonallergic Rhinitis, With a Focus on Vasomotor Rhinitis Clinical Importance, Differential Diagnosis, and Effective Treatment Recommendations | World Allergy Organization Journal | Full Text

  https://waojournal.biomedcentral.com/articles/10.1097/WAO.0b013e318196ca1e

  Most patients will ultimately respond to the use of combinations of nasal sprays plus an oral medication. […] Once under control, stepping the therapy down to the lowest effective dose of medications is suggested. […] Nasal corticosteroids treat inflammatory conditions regardless of etiology. […] In VMR, the scent of fluticasone is sometimes a negative feature in patients for whom scent is a trigger. […] Thus, for the treatment of NAR, NCCSs are considered a first-line therapy. […] Clinical experience suggests that antihistamine/decongestant combinations are somewhat effective in VMR. […] On the basis of both published clinical studies and extensive clinical experience, the use of azelastine (and possibly olopatadine) alone and in combination with NCCS is a preferred first-line treatment of VMR/NAR as well as AR.

• #3 Frontiers | Multifaceted Treatment Options for Nonallergic Rhinitis

  https://www.frontiersin.org/research-topics/68159/multifaceted-treatment-options-for-nonallergic-rhinitisundefined

  Complementary to these pharmacological agents is Saline Irrigation, which aids in clearing nasal passages of irritants and mucus, thus mitigating nasal congestion. An adjunctive treatment option, Decongestants, offers immediate relief from nasal stuffiness, though they must be used judiciously to avoid the risk of rebound congestion. Capsaicin Sprays, though unconventional, have demonstrated their worth by desensitizing nasal nerves and decreasing congestion and runny nose symptoms with regular use. […] Further from the mainstream, Oral Leukotriene Antagonists like montelukast have shown promise, particularly for those NAR patients who also suffer from asthma, hinting at overlapping therapeutic pathways that could benefit multiple conditions. Emerging alternative therapies such as acupuncture and homeopathy are under investigation with initial studies pushing for more rigorous research to validate their effectiveness fully. […] Given the heterogeneity of Nonallergic Rhinitis and its impact on quality of life, there is a continuous need for tailored, multi-modal treatment strategies that cater not only to symptom relief but also to the nuanced needs of individual patients.

• #3 Chronic Nonallergic Rhinitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0801/p171.html

  Decongestants effectively manage congestion regardless of etiology. […] Nasal irrigation with saline or hypertonic saline may be helpful in the treatment of nonallergic rhinitis. […] Further investigation is needed for irrigation and intranasal capsaicin in the treatment of nonallergic rhinitis. […] Surgery is an option for select patients whose symptoms are not adequately controlled with traditional therapies and may be most effective in patients with significant obstructive symptoms.

• #3 Non-allergic rhinitis: An expert guide

  https://www.topdoctors.co.uk/medical-articles/non-allergic-rhinitis-an-expert-guide

  Persistent symptoms of sneezing, a runny nose or itchy eyes are often related to allergies or a viral infection. In some cases, however, the symptoms have a non-allergic and non-infectious cause and require different treatment. […] The best course of treatment for non-allergic rhinitis depends on the extent and duration of the swelling of the inferior turbinates, known as turbinate hypertrophy. In some cases, corticosteroid sprays or tablets may be used to treat rhinitis depending if allergies are present. Surgery, such as a turbinoplasty, may be required if the patient experiences persistent symptoms which cannot be resolved with other types of treatment. […] The principal surgical treatment methods for non-allergic rhinitis are: coblation turbinoplasty and endoscopic turbinate reduction.

• #3 Your Runny Nose Could Be Non-Allergic Rhinitis | North Atlanta ENT & Allergy

  https://naenta.com/your-runny-nose-could-be-non-allergic-rhinitis/

  ClariFix Cryotherapy goes to the root of the problem the inflamed nasal tissue and the underlying nerves, for long-term chronic rhinitis symptom relief. […] In a clinical study, four out of five people reported long-lasting improvement with the ClariFix device, including a reduction in a runny nose and congestion. […] Most patients begin to see improvement between 7 days and 30 days post-treatment. Chronic rhinitis symptoms (including runny, stuffy nose) improved 56% at 90 days and IMPROVEMENT WAS MAINTAINED AT ONE YEAR.

• #3 New Breakthrough in the Treatment of Chronic Rhinitis (Runny Nose) – Dr. Schneiderman

  https://www.drschneiderman.com/blog/new-breakthrough-in-the-treatment-of-chronic-rhinitis-runny-nose/

  Most patients begin to see improvement between two and six weeks following treatment, with clinical results demonstrating meaningful, lasting benefits. On average, patients treated reported a 58% decrease in chronic rhinitis symptoms, including runny nose, congestion, itching and sneezing at one year post treatment. […] At Schneiderman ENT, we strive to provide our patients with the highest quality of care, and we are thrilled to add RhinAer to the treatments available in our office.

• #3

• #3 Vasomotor Rhinitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0915/p1057.html

  Vasomotor rhinitis affects millions of Americans and results in significant symptomatology. […] Topical anticholinergics should be used for rhinorrhea caused by vasomotor rhinitis. […] Azelastine (Astelin) may be used for vasomotor rhinitis associated with rhinorrhea, sneezing, postnasal drip, and nasal congestion. […] Topical corticosteroids may be used for vasomotor rhinitis associated with nasal obstruction and congestion. […] Cromolyn sodium (Intal) may be used for vasomotor rhinitis associated with sneezing and congestion in patients older than two years. […] Once a working diagnosis of vasomotor rhinitis has been made, the patient can be empowered to avoid known environmental triggers as much as possible. […] A stepwise pharmacologic approach may then be employed, choosing the initial intervention based on the patients predominant symptoms.

• #3 Vasomotor Rhinitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0915/p1057.html

  Potential risks versus benefits should be considered in the use of FDA-approved topical anticholinergics (pregnancy category B), topical antihistamines (pregnancy category C), and topical corticosteroids (pregnancy category C). […] Three types of nonallergic rhinitis commonly occur in older patients. […] All three types respond well to ipratropium nasal spray. […] Although no single agent is uniformly effective in controlling the many and varied symptoms of vasomotor rhinitis, available evidence supports a stepwise application of several agents after a careful history and physical examination. […] Additional therapies, for which AHRQ felt there was no strong evidence base, may be tried if the approved approaches fail.

• #3 Nonallergic Rhinitis, With a Focus on Vasomotor Rhinitis Clinical Importance, Differential Diagnosis, and Effective Treatment Recommendations | World Allergy Organization Journal | Full Text

  https://waojournal.biomedcentral.com/articles/10.1097/WAO.0b013e318196ca1e

  Ipratropium bromide (IB) is a potent intranasal anti-cholinergic with utility in the treatment of rhinorrhea in AR and NAR. […] Both oral and topical decongestants effectively treat congestion regardless of cause; however, none have been studied for NAR. […] Although NAR effects many patients, very few medications have been adequately studied for the treatment of this condition. […] Nonallergic rhinitis is an underrecognized and inadequately treated condition affecting many subjects. […] Nonallergic rhinitis tends to require chronic medical management, and use of topical NCCSs and nasal antihistamines, used alone or in combination, is very effective in most patients. […] Thus, recognizing that the combination of both NCCSs and nasal antihistamines effectively treat AR, VMR, and mixed rhinitis, this combination of medications seems to be a useful first-line treatment for the overwhelming majority of rhinitis patients.

• #4 Nonallergic Rhinitis, With a Focus on Vasomotor Rhinitis Clinical Importance, Differential Diagnosis, and Effective Treatment Recommendations | World Allergy Organization Journal | Full Text

  https://waojournal.biomedcentral.com/articles/10.1097/WAO.0b013e318196ca1e

  Ipratropium bromide (IB) is a potent intranasal anti-cholinergic with utility in the treatment of rhinorrhea in AR and NAR. […] Both oral and topical decongestants effectively treat congestion regardless of cause; however, none have been studied for NAR. […] Although NAR effects many patients, very few medications have been adequately studied for the treatment of this condition. […] Nonallergic rhinitis is an underrecognized and inadequately treated condition affecting many subjects. […] Nonallergic rhinitis tends to require chronic medical management, and use of topical NCCSs and nasal antihistamines, used alone or in combination, is very effective in most patients. […] Thus, recognizing that the combination of both NCCSs and nasal antihistamines effectively treat AR, VMR, and mixed rhinitis, this combination of medications seems to be a useful first-line treatment for the overwhelming majority of rhinitis patients.

• #4 Best Vasomotor Rhinitis Treatment in Los Angeles

  https://www.drdaneshrad.com/ent-conditions/nasal-conditions/vasomotor-rhinitis

  Its estimated that up to one out of every 10 Americans suffers from intermittent episodes of sneezing or a congested, runny nose for no apparent cause. […] Dr. Daneshrad, widely considered the best ENT in Los Angeles, diagnoses and treats constantly running noses and the irritating symptoms of vasomotor rhinitis at our two locations in Santa Monica and Torrance. […] While mild cases may benefit from home remedies like nasal irrigation or over-the-counter sprays, more severe symptoms often require a lasting solution. ClariFix is a breakthrough cryotherapy treatment that targets the root cause of vasomotor rhinitis overactive nerves. […] ClariFix is a minimally invasive, more effective, long-term solution with an in-office procedure that uses cryotherapy to calm the overactive nasal nerves responsible for symptoms.

• #4 Vasomotor Rhinitis | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0915/p1057.html

  If the presenting symptom is solely rhinorrhea, a topical anticholinergic is the logical first step. […] With nasal congestion and obstruction only, topical corticosteroids would be a wise starting point for therapy. […] If the patient presents with the full range of symptoms including rhinorrhea with sneezing, postnasal drip, and congestion, a topical antihistamine may be initiated. […] Exercise, beneficial for overall health, may be a useful treatment addition because it produces decreased airway resistance and assists natural nasal decongestion by I-adrenergic-mediated mechanisms. […] Traditional oral antihistamines have no established beneficial effect in patients with vasomotor rhinitis and may be associated with sedation. […] Newer, less-sedating antihistamines also have no proven effectiveness for vasomotor rhinitis, and their administration delays proper treatment while incurring significant cost and burden to the health care system.

• #5 Best Vasomotor Rhinitis Treatment in Los Angeles

  https://www.drdaneshrad.com/ent-conditions/nasal-conditions/vasomotor-rhinitis

  Unlike medications that only manage symptoms, ClariFix targets the underlying cause, providing lasting relief for up to a year or more. […] If you are struggling with persistent nasal issues, contact the best vasomotor rhinitis doctor in Los Angeles today to schedule a consultation to get lasting relief.

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