Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 0 0 2026 05 19 1 9 Vahid Ghobadi Dana Department of Photodynamic, Medical Laser Research Center, Yara Institute, Academic Center for Education, Culture, and Research (ACECR), Tehran, Iran Seyed Saeed Hashemi Nazari Department of Epidemiology, Prevention of Cardiovascular Disease Research Center, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran Ali Pourvali Department of Pediatrics, School of Medicine, Arak University of Medical Sciences, Arak, Iran Masoud Habibi Department of Photohealing and Regeneration, Medical Laser Research Center, Yara Institute, Academic Center for Education, Culture, and Research (ACECR), Tehran, Iran Mohsen Fateh Department of Lifestyle Medicine, Medical Laser Research Center, Academic Center for Education, Culture, and Research (ACECR), Tehran, Iran Maedeh Arabian Cardiogenic Research Center, Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran Farhad Seif Department of Photodynamic, Medical Laser Research Center, Yara Institute, Academic Center for Education, Culture, and Research (ACECR), Tehran, Iran Ahmad Vosughi Motlagh Department of Pediatrics, North Khorasan University of Medical Sciences, Bojnurd, Iran 2025 07 22 2025 12 01 Allergic rhinitis (AR) is a common inflammatory condition characterized by symptoms such as nasal congestion, rhinorrhea, sneezing, and nasal itching, which significantly impact quality of life. Management includes allergen avoidance, pharmacological therapy, and, in severe cases, immunotherapy. Ipratropium bromide, an anticholinergic agent, is primarily used for managing rhinorrhea by inhibiting acetylcholine-mediated secretion in the nasal mucosa. To evaluate the effects and side effects of ipratropium bromide nasal spray in combination with low-dose budesonide in patients with allergic rhinitis, a double-blind, randomized, placebo-controlled trial was conducted with 126 patients diagnosed with AR. Participants were randomly assigned to receive one of three treatments: Ipranasal 42 μg + budesonide, Ipranasal 21 μg + budesonide, or placebo + budesonide, over a two-week period. Symptom severity was assessed using the ARIA questionnaire and visual analog scale (VAS) for nasal symptoms at baseline and two weeks after the intervention. Significant reductions in rhinorrhea were observed in the Ipranasal groups compared to the placebo group. Mild side effects, including nasal and oral dryness, were transient and non-significant. There were no major differences between the 42 μg and 21 μg groups in terms of efficacy or side effects. Ipratropium bromide nasal spray effectively reduces rhinorrhea in AR patients, with good tolerability. However, it also had moderate effects on nasal congestion. Combination therapy may enhance symptom control, but further studies are needed to assess long-term efficacy and safety. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/4530 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/4530/2340