title: Allergic rhinitis: pharmacotherapy in pregnancy and old age.
abstract: BACKGROUND
  Allergic rhinitis (AR) affects 20-30% of women in reproductive age and may worsen during pregnancy. About 10% of the elderly suffer from AR, and it could be under-diagnosed in these patients. Many drugs are currently available, however AR treatment during pregnancy and old age represents a challenging issue.
  
  
  METHODS
  A review of the literature on the topic has been performed. Expert commentary: In pregnancy, drug avoidance should be carefully balanced with the need for AR optimal control. Topical drugs are suggested as a first approach. The safety and tolerability profile of second-generation antihistamines is well supported. If allergen immunotherapy (AIT) is ongoing and well tolerated, there is no reason for stopping it. AIT initiation in pregnancy is not recommended. For elderly patients, no specific concerns have been highlighted regarding topical treatments, except from nasal decongestionants. Second generation antihistamines are generally well tolerated. Old age should not preclude AIT.
authors.affiliation: a Clinical and Experimental Medicine , University of Parma , Parma , Italy.
authors.forename: E
authors.initials: E
authors.lastname: Ridolo
authors.affiliation: b Allergy Unit and Asthma Center , Verona University Hospital , Verona , Italy.
authors.forename: M
authors.initials: M
authors.lastname: Caminati
authors.affiliation: a Clinical and Experimental Medicine , University of Parma , Parma , Italy.
authors.forename: I
authors.initials: I
authors.lastname: Martignago
authors.affiliation: a Clinical and Experimental Medicine , University of Parma , Parma , Italy.
authors.forename: V
authors.initials: V
authors.lastname: Melli
authors.affiliation: c Department of Molecular Medicine , University of Pavia , Pavia , Italy.
authors.forename: C
authors.initials: C
authors.lastname: Salvottini
authors.affiliation: d Allergy Unit , Azienda Ospedaliera Universitaria Careggi , Firenze , Italy.
authors.forename: O
authors.initials: O
authors.lastname: Rossi
authors.affiliation: b Allergy Unit and Asthma Center , Verona University Hospital , Verona , Italy.
authors.forename: A
authors.initials: A
authors.lastname: Dama
authors.affiliation: b Allergy Unit and Asthma Center , Verona University Hospital , Verona , Italy.
authors.forename: M
authors.initials: M
authors.lastname: Schiappoli
authors.affiliation: e Medical Direction , Verona University Hospital , Verona , Italy.
authors.forename: C
authors.initials: C
authors.lastname: Bovo
authors.affiliation: f Allergy/Pulmonary Rehabilitation , ICP Hospital , Milano , Italy.
authors.forename: C
authors.initials: C
authors.lastname: Incorvaia
authors.affiliation: b Allergy Unit and Asthma Center , Verona University Hospital , Verona , Italy.
authors.forename: G
authors.initials: G
authors.lastname: Senna
mesh_terms: D000287:Administration, Topical; D000368:Aged; D003888:Desensitization, Immunologic / Q000009:adverse effects / Q000379:methods; D005260:Female; D006633:Histamine Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D014663:Nasal Decongestants / Q000008:administration & dosage; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000276:immunology; D065631:Rhinitis, Allergic / Q000188:drug therapy* / Q000276:immunology
chemical_list: D006633:Histamine Antagonists; D014663:Nasal Decongestants
keywords: Allergic rhinitis; allergen immunotherapy; antihistamines; elderly; intranasal steroids; pregnancy