By vgreene, 23 April, 2021 Complementary BSACI advises against acupuncture 4 while AAO HNS says it may be offered 3 No evidence for against homeopathy herbs phototherapy or other complementary tx per AAAAI AAO HNS BSACI
By vgreene, 23 April, 2021 If ocular sx allergic conjunctivitis sx improve w OAH INCS INAH but may require ophthalmic med mast cell stabilizer antihistamine or dual action drug6 7
By vgreene, 23 April, 2021 If pregnant 2 4 nasal saline INCS except triamcinolone OAH nedocromil cromolyn considered safe avoid decongestants esp in 1st trimester per AAAAI
By vgreene, 23 April, 2021 Don t use montelukast as 1st line d t darr efficacy serious neuropsych side effects suicidality other LTRAs also not recommended as 1st line option2
By vgreene, 23 April, 2021 Nasal saline may reduce pt reported dz severity 2 4 amount of pharmaco tx needed 4 is well tolerated2 4
By vgreene, 23 April, 2021 Consider oral steroids not depot injection 2 4 x5 7 days for very severe sx2
By vgreene, 23 April, 2021 Add decongestants initially if edema impairs delivery of intranasal tx oral2 3 not rec d by BSACI or intranasal 2 4 combo PSE 2nd gen OAH is least favored 1st line option by AAAAI don t use 5 days exercise caution in certain pts5
By vgreene, 23 April, 2021 Intranasal corticosteroid is a 1st line option combo w INAH more effective than INCS alone is also 1st line2
