Loading condition information
Conditions
AllergicRhinitis
Inflammation of the nasal passages caused by allergens - pollen, dust mites, pet dander, or mould. Causes sneezing, congestion, runny nose, and itchy eyes. Synonymous with hay fever.
Check online review fit
Online care is not suitable for every situation. A doctor decides what fits after assessment.
Symptoms
Common symptoms of Allergic Rhinitis
Symptoms can overlap across conditions. A doctor considers context, red flags, and whether remote review is appropriate.
Frequent sneezing
Runny or blocked nose
Itchy nose, eyes, throat, or roof of mouth
Watery or red eyes
Post-nasal drip
Reduced sense of smell
Fatigue from poor sleep due to congestion
Our Scope
Where online review may fit
Online review can help with some straightforward situations, but it is not a substitute for urgent care, physical examination, or ongoing GP management.
May fit online review
- Prescription-strength nasal sprays (combination steroid/antihistamine)
- Non-sedating antihistamine prescriptions
- Assessment of current management
- Specialist referral for immunotherapy consideration
- Medical certificates when symptoms severely affect work
Needs in-person or urgent care
- Allergy skin prick testing (needs specialist)
- Immunotherapy administration (needs specialist/GP clinic)
- Assessment for severe asthma with allergic triggers
Depending on your situation, an AHPRA-registered doctor may be able to issue a medical certificate or arrange a repeat prescription after reviewing your request online.
Clinical Guidance
When to see a doctor
These indicators suggest you should seek professional medical advice promptly.
Signs you need a doctor
- 1Symptoms not controlled by over-the-counter treatments
- 2Allergic rhinitis affecting sleep or work performance
- 3Need for prescription nasal sprays or antihistamines
- 4Considering immunotherapy (allergy shots/drops)
- 5You need a medical certificate
Seek emergency care if
- Severe allergic reaction with difficulty breathing (anaphylaxis - call 000)
- Facial swelling with breathing difficulty
- Severe asthma attack triggered by allergens
Call 000 or go to your nearest emergency department
Clinical Insight
A doctor's perspective on Allergic Rhinitis
InstantMed Clinical Team
AHPRA-registered medical team · Reviewed 2026-03
Allergic rhinitis is massively undertreated in Australia. Many patients self-treat with oral antihistamines and think that's all there is. In reality, intranasal corticosteroid sprays are significantly more effective for moderate-to-severe symptoms - but they need to be used correctly (aim away from the septum, use daily for 2+ weeks) and consistently. The newest combination sprays (azelastine/fluticasone) are even more effective but require a prescription. What I assess in a telehealth consultation is whether current treatment is adequate, whether symptoms suggest a specific allergen pattern (seasonal vs perennial), and whether the patient might benefit from specialist referral for immunotherapy - the only treatment that actually modifies the underlying allergic disease rather than just suppressing symptoms.
Treatment
Treating Allergic Rhinitis
Intranasal corticosteroid sprays are the most effective first-line treatment for moderate-to-severe allergic rhinitis, superior to oral antihistamines alone per Australian Therapeutic Guidelines. Non-sedating oral antihistamines provide rapid symptom relief and can be combined with nasal steroids. Combination intranasal azelastine/fluticasone (Dymista) provides faster and more complete relief than either agent alone and is available by prescription.
Cetirizine
Zyrtec, Zilarex
Class:Second-generation (non-sedating) antihistamine
Typical dose:10mg once daily
PBS:Available OTC without prescription
- Effective for sneezing, runny nose, and itchy eyes
- Less sedating than first-generation antihistamines (Phenergan, Polaramine)
- Onset within 1-2 hours; effects last 24 hours
- May cause mild drowsiness in some individuals
Fluticasone furoate
Avamys
Class:Intranasal corticosteroid
Typical dose:2 sprays per nostril once daily; reduce to 1 spray once symptoms controlled
PBS:Available OTC without prescription
- Most effective single agent for moderate-severe allergic rhinitis
- Takes 1-2 weeks of daily use for full effect -- do not stop early
- Correct technique: spray toward the outer nostril wall, not the septum
- Minimal systemic absorption at recommended doses
Azelastine/fluticasone
Dymista
Class:Intranasal antihistamine + corticosteroid combination
Typical dose:1 spray per nostril twice daily
PBS:PBS listed for moderate-severe allergic rhinitis inadequately controlled by monotherapy
- Most effective pharmacological option -- faster onset than nasal steroid alone
- Prescription required; appropriate when OTC options are inadequate
- Reduces both early (histamine) and late (inflammatory) phase allergic response
- Suitable for seasonal and perennial allergic rhinitis
Source: Therapeutic Guidelines -- Respiratory, 2024; ASCIA Allergic Rhinitis Guidelines. This information is educational only and does not replace clinical assessment.
Specialist referral: Refer to an allergist/immunologist if symptoms are inadequately controlled despite combination therapy, if allergy skin-prick or specific IgE testing is needed to identify triggers, or to discuss allergen immunotherapy (the only disease-modifying treatment). Referral is also appropriate if symptoms suggest coexisting asthma.
Allergic Rhinitis in Australia
Allergic rhinitis affects approximately 19% of Australians - one of the highest rates in the world
It costs Australian employers an estimated $7 billion per year in 'presenteeism' (working while impaired)
Up to 80% of people with asthma also have allergic rhinitis - they are considered the same disease in different parts of the airway
Immunotherapy (desensitisation) has a 60-90% success rate in carefully selected patients
Recovery
What to expect
Typical recovery timeline and return-to-work guidance for most patients.
Typical recovery
Allergic rhinitis is chronic - the goal is management, not cure. Intranasal steroids take 1-2 weeks of daily use to reach full effect. Antihistamines work within 1-2 hours. Immunotherapy takes 3-5 years but can provide lasting benefit.
Return to work
Most people work with allergic rhinitis, but untreated symptoms reduce concentration and productivity by 30-50%. Severe flares with poor sleep, headache, and eye irritation may warrant a day off.
When to reassess
See a doctor if over-the-counter treatments are not controlling your symptoms, if you are using decongestant sprays for more than 3 consecutive days, if rhinitis is triggering asthma symptoms, or if you want to discuss immunotherapy.
Self-Care
Managing Allergic Rhinitis at home
Evidence-based tips to support your recovery alongside medical treatment.
Start intranasal corticosteroid spray 2 weeks before your allergy season begins - and use it daily, not just when symptomatic
Spray technique matters: aim toward the outer wall of each nostril (away from the septum), breathe in gently
Shower and change clothes when coming inside on high-pollen days - pollen sticks to hair and fabric
Use allergen-proof covers on pillows and mattresses if dust mites are a trigger
Keep windows closed during high-pollen periods and use air conditioning with a HEPA filter if available
Saline nasal irrigation (using a squeeze bottle or neti pot) physically removes allergens and reduces symptoms
FAQ
Common questions about Allergic Rhinitis
Answers to the most common questions from patients.
Intranasal corticosteroid sprays (e.g., Nasonex, Avamys) are more effective than oral antihistamines for moderate-severe symptoms. Use daily during your allergy season, starting 2 weeks before if possible. Non-sedating antihistamines (cetirizine, loratadine) are good add-ons.
If oral antihistamines aren't enough, you likely need an intranasal corticosteroid spray - this is the recommended first-line treatment for moderate-severe allergic rhinitis. Combination sprays (steroid + antihistamine) are available by prescription and are the most effective option.
Testing is useful if you don't know your triggers, if symptoms are year-round (suggesting dust mites or pet dander), or if you're considering immunotherapy. A GP or allergist can arrange skin prick testing or specific IgE blood tests.
Allergic rhinitis and asthma are closely linked - up to 80% of asthma patients also have rhinitis. Treating rhinitis effectively can improve asthma control. If you have both, they should be managed together.
Where online review may fit for Allergic Rhinitis
Remote review is not suitable for every situation. A doctor reviews the information and decides whether online care is appropriate.