Intranasal glucocorticoid sprays (eg, fluticasone, mometasone, budesonide) are the most effective agents for allergic rhinitis. Their anti-inflammatory effects may provide relief within hours, although chronic untreated symptoms may require several days or weeks of treatment for maximal improvement. Nasal saline rinses are also helpful as adjunctive therapy, as they hydrate the nasal mucosa and can protect from the glucocorticoid side effect of epistaxis. Patients who do not tolerate glucocorticoid sprays or do not have adequate relief can also be given oral antihistamines, although these may also cause significant adverse effects (especially sedation with first-generation antihistamines).