American Board of Family Medicine (ABFM) Practice Exam 2025 - Free ABFM Practice Questions and Study Guide

The first-line treatment for allergic rhinitis is intranasal steroids. This class of medications is considered the most effective for reducing inflammation in the nasal passages, which is a core symptom of allergic rhinitis. Intranasal steroids work by directly targeting nasal tissue to decrease swelling, congestion, and other symptoms like sneezing and itching. They are generally well-tolerated and can be used for both seasonal and perennial allergic rhinitis.

While oral antihistamines are commonly used and may alleviate symptoms such as sneezing and itching, they do not address nasal congestion as effectively as intranasal steroids. Decongestants may provide temporary relief for nasal congestion but are not recommended for long-term use due to potential side effects and the risk of rebound congestion. Leukotriene receptor antagonists can help, especially in patients with asthma, but are not typically the first choice for allergic rhinitis management compared to intranasal steroids. Thus, intranasal steroids are recognized as the most effective and first-line treatment for this condition.