The primary rule to manage allergies is avoidance. If the patient knows what causes their nose to start itching and sneezing, then the cause would have to be avoided. However, this is easier said than done. After all, it is not possible to control the environment wherever we go.

For this reason, the use of pharmacotherapy is useful even though the majority of drug options surround the relief of allergy symptoms.


The current most commonly used medications as suggested by WAO for nasal allergies are as listed along with their side effects profile.

Drug types Side effects
Antihistamines Drowsiness, dry mouth, dizziness, nausea, vomiting, restlessness, trouble urinating, blurred vision and confusion
Decongestants Irritability, dizziness, headache, tremor, and insomnia, as well as tachycardia and hypertension
Leukotriene receptor antagonists Recent neuropsychiatric side effects warnings by Food and Drug Administration (FDA) andTherapeutic Goods Administration (TGA)
Agitation, aggression, anxiousness, hallucinations, depression, insomnia, irritability, restlessness, suicidal thinking and behavior and tremor
Bronchodilators Trembling, particularly in the hands, nervous tension, headaches, suddenly noticeable faster heartbeats, muscle cramps
Anticholinergics Dry mouth and related dental problems, blurred vision, tendency toward overheating (hyperpyrexia)
Disodium cromoglycate and nedocromil sodium Blurred vision, Stinging and irritation, coughing, irritation inside nose (after administration)
Glucocorticosteroids Pharyngitis, nasal burning, nasal irritation, nasal ulceration, headache, bleeding from the nose, nasal dryness, throat dryness, throat irritation

Although useful in countering the symptoms of allergies after an attack, conventional medicines cannot prevent the allergy from worsening nor prevent another attack from happening.


Allergen-specific immunotherapy (ASI) is a unique therapy for allergic rhinitis because it modifies the allergic disease by targeting the underlying immunologic mechanisms. Subcutaneous (SCIT) and Sublingual (SLIT) immunotherapy are the two most commonly prescribed routes for administering ASI.

The mechanisms of action of specific immunotherapy are multiple and complex and result in a modification of the immunological responses to allergens, with subsequent reduction of the allergic inflammatory reaction.

Subcutaneous (SCIT) immunotherapy involves administration of allergen by subcutaneous injection by gradually increasing the doses of an allergen. It is done on a weekly basis over a period of months until the maintenance dose is achieved. Patients having SCIT need to visit the clinic every week to receive the injection. Some patients find it troublesome as they have to take time off to visit the clinic on a weekly basis. Since many patients have a strong aversion to weekly allergy shots, they are far less likely to complete the three-year SCIT. In fact, only about 40% complete their immunotherapy when required to visit an allergist.

Sublingual (SLIT) immunotherapy involves administering the allergens in a liquid or tablet form under the tongue on a daily basis. SLIT is administered at home. Although more convenient compared to SCIT, it does run a risk of adverse reactions happening without direct medical supervision. Patients should, therefore receive clear guidance from allergists on managing adverse reactions and should know when to consult the prescribing allergist.

The treatment is effective only for the allergen contained in SLIT or SCIT. If the patient develops a new allergy, he or she will need to undergo a new SLIT or SCIT treatment.

ASI is a costly form of treatment and therefore not accessible to the masses.

Herbal Immunotherapy

Lectranal® presents an alternative way of dealing with nasal allergy problems through modulating the immune system in a safe and natural way. Evidence does show that Lectranal® may offer longer-term immunotherapy benefits although more studies will be required to confirm this positive observation.