By vgreene, 14 April, 2017 If pregnant:10,11 selected oral antihistamines, montelukast, cromolyn; oral decongestant recommendations vary
By vgreene, 14 April, 2017 Consider combo tx: intranasal steroids + short-term (≤3-10 days) topical decongestant (eg, oxymetazoline) to ↑ delivery of intranasal steroids;4-7 intranasal steroid + intranasal antihistamine more effective than either agent alone.8,9 However, addin
By vgreene, 14 April, 2017 ✓ for proper intranasal steroid technique.1 Various steroids have similar efficacy1-3
By vgreene, 14 April, 2017 Avoid irritant triggers (eg, smoke, chemical fumes, temp change, perfumes),50,51 occupational triggers (allergic or irritant)52,53
By vgreene, 14 April, 2017 Avoidance of animals effective for animal allergy;41-44 highly pollen-allergic pts should stay indoors during high pollen counts;45 benefit of other environmental measures uncertain46-49
By vgreene, 14 April, 2017 Consider intranasal steroids, which are superior to other meds, effective for sneeze, itch, rhinorrhea, congestion.1-4 Avoid triggers
By vgreene, 14 April, 2017 Complementary: WHO-ARIA advises against acupuncture,39 while AAO says it may be offered.40 Don’t use homeopathy, butterbur/other herbs, phototherapy, or other complementary tx39,40
By vgreene, 14 April, 2017 If ocular sx/allergic conjunctivitis: may require ophthalmic med; dual-action antihistamine/mast-cell stabilizers (azelastine, epinastine, ketotifen, olopatadine) most effective34,35
By vgreene, 14 April, 2017 If pregnant:32,33 intranasal steroids, select oral antihistamines, montelukast, cromolyn; oral decongestant recommendations vary
