02.More treatment options
While antihistamines and corticosteroids are the mainstays of treatment, there are more options which may suit some, including immunotherapy:
Anticholinergic nasal spray
Ipratropium bromide blocks the action of the neurotransmitter acetylcholine, which when applied in a nasal spray acts on the mucus glands to reduce the secretion of mucus. So while it helps stop a runny nose, it may not help with congestion or other hayfever symptoms such as sneezing.
Helps stop a runny nose.
Decongestant nasal sprays
Decongestant sprays, such as Otrivin, Vicks Sinex, or Dimetapp, that help when you have a cold can also help with hayfever.
How to use them
Used for more than a few days they can make congestion worse, so their usefulness for hayfever is limited to short episodes only. Oral decongestants (pseudoephedrine) can be used for longer than the spray. On the other hand, sprays are faster acting than tablets because tablets need to be absorbed into the blood stream from the stomach and make their way to where they’re needed, whereas sprays are quickly absorbed into the blood vessels in the nose.
Can help relieve congestion when fast relief is required, but only for a few days.
If your hayfever is so severe it dramatically impacts on your quality of life (if the symptoms are debilitating or keeping you at home, for example), your doctor may recommend immunotherapy. This means taking regular doses of the allergens that affect you, starting with very small doses and getting larger over time.
The doses are usually given by injection, though there are also drops or tablets that are placed under the tongue. Injections are less expensive, and may be more effective, but are less convenient: it means going to the doctor’s surgery once a fortnight (or possibly once a week, getting less frequent over time), having the injection and waiting around for 30 minutes or so to ensure there’s no severe reaction (such as anaphylaxis).
The therapy takes three to five years, and you may need maintenance injections at the beginning of allergy season thereafter. You’ll need to continue your other medications while taking it, and while it will make symptoms more manageable, it probably won’t completely resolve the problem.