| Intranasal corticosteroids | | | Decrease the influx of inflammatory cells and inhibit the release of cytokines; onset of action is less than 30 minutes | Bitter aftertaste, burning, epistaxis, headache, nasal dryness; possible systemic absorption, rhinitis medicamentosa, stinging, throat irritation | |
| Beclomethasone | C | 4 years | | | NA ($150) for 1 inhaler |
| Budesonide (Rhinocort Aqua) | B | 6 years | | | $120 ($160) for 1 nasal spray |
| Ciclesonide (Omnaris) | C | 6 years | | | NA ($210) for 1 nasal spray |
| Flunisolide | C | 6 years | | | $55 (NA) for 1 nasal spray |
| Fluticasone furoate (Veramyst) | C | 2 years | | | NA ($175) for 1 nasal spray |
| Fluticasone propionate (Flonase) | C | 4 years | | | $15 ($15) for 1 nasal spray |
| Mometasone (Nasonex) | C | 2 years | | | NA ($230) for 1 nasal spray |
| Triamcinolone acetonide | C | 2 years | | | $70 ($130) for 1 nasal spray |
| Oral antihistamines | | | Block histamine H1 receptors; onset of action is 15 to 30 minutes | Dry mouth, sedation at higher than recommended doses | |
| Cetirizine (Zyrtec) | B | 6 months | | | $10 ($20) for 30 tablets |
| Desloratadine (Clarinex) | C | 6 months | | | $40 ($210) for 30 tablets |
| Fexofenadine (Allegra) | C | 2 years (allergic rhinitis) | | | $15 ($20) for 30 tablets |
| Loratadine (Claritin) | B | 2 years | | | $13 ($25) for 30 tablets |
| Combination intranasal corticosteroid and antihistamine | | | See intranasal corticosteroids and intranasal antihistamines | See intranasal corticosteroids and intranasal antihistamines | |
| Azelastine/fluticasone (Dymista) | C | 6 years | | | NA ($170) for 1 nasal spray |
| Intranasal antihistamines | | | | | |
| Azelastine (Astelin) | C | 5 years | Block H1 receptors; onset of action is 15 minutes | Bitter aftertaste, epistaxis, headache, nasal irritation, sedation | $50 ($145) for 1 nasal spray |
| Olopatadine (Patanol) [corrected] | C | 6 years | Block H1 receptors; onset of action is 30 minutes | Bitter aftertaste, epistaxis, headache, nasal irritation, sedation | $50 ($250) for 1 nasal sprays |
| Oral decongestants | | | | | |
| Pseudoephedrine | C | 2 years (usually not started until 4 years) | Vasoconstriction; onset of action is 15 to 30 minutes | Headache, elevated blood pressure and intraocular pressure, tremor, urinary retention, dizziness, tachycardia, and insomnia | $5 ($10) for 24 tablets |
| Intranasal cromolyns | | | | | |
| Cromolyn | B | 2 years | Inhibits histamine release | Epistaxis, nasal irritation, sneezing | NA ($18) for 1 nasal spray |
| Intranasal anticholinergics | | | | | |
| Ipratropium (Atrovent) | B | 5 years | Block acetylcholine receptors; onset of action is 15 minutes | Epistaxis, headache, nasal dryness | $30 ($120) for 1 nasal spray |
| Leukotriene receptor antagonists | | | | | |
| Montelukast (Singulair) | B | 6 months | Block leukotriene receptors; onset of action is 2 hours | Elevated levels of alanine transaminase, aspartate transaminase, and bilirubin | $15 ($215) for 30 tablets |
| Immunotherapy | | | Not well understood, believed to shift immune response from immunoglobulin E mediated to immunoglobulin G mediated | Minor local mouth irritation, diarrhea, vomiting; rare anaphylaxis | |
| Sublingual Grastek (timothy grass pollen extract, cross reactive with 6 other grass pollens) | B | 5 years | | | NA ($260) for 30 tablets |
| Sublingual Oralair (5-grass pollen extract) | B | 10 years | | | NA ($345) for 30 tablets |
| Sublingual Ragwitek (short ragweed pollen extract) | C | 18 years | | | NA ($260) for 30 tablets |
| Subcutaneous allergen extracts: several tree, grass, weed pollens; cat and dog dander; dust mites; certain molds; and cockroaches; administered by a physician | Should not be initiated during pregnancy; maintenance therapy is considered safe | Has not been established; usually 5 years so that the child is old enough to cooperate | | Local injection site reactions and, less commonly, systemic allergic reactions | Varies |
