The efficacy of nasal antihistamines (NAHs) for allergic rhinitis (AR) is comparable with or better than second-generation oral antihistamines. NAHs have a faster onset of action and greater effect on congestion.
Limited data suggest that NAHs may be equivalent to intranasal corticosteroids at reducing congestion.
Olopatadine. Image source: Wikipedia, public domain.
Fluticasone propionate, Flonase (US and Canada) Flixonase (EU and Brazil). Image source: Wikipedia, public domain.
The efficacy of olopatadine 0.6% nasal spray (2 sprays/nostril b.i.d.) was compared with fluticasone 50 microg nasal spray (2 sprays/nostril q.d.) in a double-blind, randomized trial of 130 patients.
Both treatments reduced nasal and ocular symptoms throughout the 2-week study period.
The nasal symptom score decreased by 45.4% for patients treated with olopatadine and by 47.4% for those treated with fluticasone.
No significant between-treatment differences were determined for for congestion, runny nose, sneezing, itchy nose, and ocular symptoms. But olopatadine had a faster onset of action for reducing all symptoms.
The authors concluded that both olopatadine and fluticasone nasal sprays reduced nasal and ocular SAR symptoms with a faster and greater onset of action with olopatadine.
Medications for Allergic Rhinitis.
Comparison of olopatadine 0.6% nasal spray versus fluticasone propionate 50 μg in the treatment of seasonal allergic rhinitis. Kaliner, Michael A.; Storms, William; Tilles, Stephen; Spector, Sheldon; Tan, Ricardo; LaForce, Craig; Lanier, Bobby Q.; Chipps, Bradley. Allergy and Asthma Proceedings, Volume 30, Number 3, May/June 2009 , pp. 255-262(8).