Seasonal allergic rhinitis - OTC
RAG rating
Document type
Position statement
Hertfordshire and West Essex ICB
Output type
Pharmacy / Prescribing


Position statement on the prescribing of treatment for seasonal allergic rhinitis on prescription


Hertfordshire and West Essex Integrated Care Board (HWE ICB) does not support the prescribing of antihistamines (solid and liquid preparations), nasal sprays and eye-drops for treatment of intermittent seasonal allergic rhinitis on prescription.


  • Seasonal allergic rhinitis (e.g., hay fever) normally occurs at particular times in the year, while perennial allergic rhinitis occurs throughout the year. Both can vary in persistence, with symptoms also ranging from mild to severe1.


  • Seasonal allergic rhinitis can be managed by avoiding trigger factors or taking Over the Counter (OTC) medication2.
  • If treatment is required for relief of seasonal allergic rhinitis (intermittent), patients should be advised to seek support from their community pharmacist. These patients will also be expected to purchase their treatment.
  • In line with national Over-the-Counter (OTC) medicines policy, seasonal allergic rhinitis is classed as a ‘self-care’ condition, therefore general exceptions to self-care would apply. Examples of exceptions to the above when a clinician may consider prescribing include:

patients who have been diagnosed as having perennial allergic rhinitis (persistent), therefore require regular treatment throughout the year, as this may be considered as a long-term condition,

cases where there are serious safe-guarding concerns around the decision not to prescribe,

licensing restriction on OTC medicines (see the OTC when to prescribe for more information).

A full list of general exceptions can be found in national OTC policy.


  • Current expenditure on the local NHS is unsustainable, therefore treatments on the NHS should be prioritised in an efficient manner so that scarce resources are utilised correctly.
  • Patients have a responsibility to look after themselves and their children where possible and should be encouraged to manage self-limiting and self-care conditions at home, with support from their local pharmacy if needed.
  • In general, OTC treatments are more expensive to the NHS when prescribed compared to when they are purchased in pharmacies or supermarkets3.


  1. Patient UK, Allergic Rhinitis’. Available at (accessed 24th March 2023).
  2. NICE Clinical Knowledge Summaries Allergic Rhinitis. Available at (accessed 24th March 2023).
  3. PrescQIPP B134 August 2018 "Self care for common conditions”. Available at (accessed 24th March 2023).


Version number
Developed by
Hassan Oppal, Medicines Optimisation Pharmacist, HWE ICB; Thayera Khan, Pharmaceutical Advisor, HWE ICB. Adapted from, ‘Position statement on the prescribing of antihistamines and nasal sprays for hay fever on prescription’ written by Richmond CCG.
Approved by
Date approved / updated
May 2023
Review date
The recommendation is based upon the evidence available at the time of publication. This recommendation will be reviewed upon request in the light of new evidence becoming available.
Superseded version
v1.1 November 2018; v1.0 February 2018 (Medicines Optimisation Clinical Leads group); v1.1 November 2018; v1.0 March 2018 (Primary Care Commissioning Committee)