Treatment of Allergic Rhinitis with Intranasal Fluticasone and Loratadine

Recommended Dosage and Efficacy

The American Academy of Allergy, Asthma, and Immunology recommends intranasal fluticasone propionate 200 mcg once daily combined with loratadine 10 mg once daily for allergic rhinitis treatment when symptoms are not adequately controlled with monotherapy 1
Combination therapy with intranasal corticosteroids and oral antihistamines is beneficial for approximately 50% of patients with seasonal allergic rhinitis, providing adequate symptom control 1, 3
The combination of fluticasone propionate and loratadine has shown superior efficacy for some patient-rated symptoms compared to fluticasone propionate alone 1

Intranasal corticosteroids are significantly more effective than oral antihistamines in relieving symptoms of sneezing, nasal congestion, discharge, and itching 1
Fluticasone propionate provided significantly better scores for activity, sleep, practical, and overall domains compared to loratadine when used on an as-needed basis 1
Intranasal fluticasone at recommended doses is not generally associated with clinically significant systemic side effects 1, 5
Second-generation antihistamines like loratadine are preferred to avoid sedation and performance impairment associated with first-generation agents 6

The onset of therapeutic effect of intranasal fluticasone occurs within 12 hours and as early as 3-4 hours in some patients 1, 3
A nasal decongestant spray may be beneficial for several days when initiating intranasal corticosteroid therapy to ensure a patent nasal airway 1