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Intranasal steroids are the preferred treatment for moderate-to-severe allergic rhinitis (AR) but do not provide complete relief in about 40% of patients. Oxymetazoline (OXY; over-the-counter Afrin and generics) is an α-agonist that causes vasoconstriction of nasal mucosa blood vessels and relieves congestion within minutes. However, prolonged use has been associated with rhinitis medicamentosa with rebound congestion lasting as long as 1 week.
Sixty adults with perennial rhinitis (dander, dust, or mold allergy) were randomized to receive placebo, fluticasone furoate (FF; Veramyst), OXY, or FF plus OXY nightly for 4 weeks, followed by a 2-week washout phase. The primary outcome was nasal congestion; other nasal symptoms, quality of life, and…