By vgreene, 14 April, 2017 ✓technique. Consider combo tx, trigger avoidance, immune-tx, referral, surgical tx for comorbid conditions
By vgreene, 14 April, 2017 Complementary: WHO-ARIA advises against acupuncture,16 while AAO says it may be considered.17 Don’t use homeopathy, butterbur/other herbs, phototherapy, or other complementary tx16,18
By vgreene, 14 April, 2017 If severe allergic rhinitis/conjunctivitis: steroids (not parenteral) may be used x5-10 days14,15
By vgreene, 14 April, 2017 If ocular sx/conjunctivitis: may require ophthalmic med; dual action antihistamine/mast-cell stabilizers (azelastine, epinastine, ketotifen, olopatadine) most effective12,13
By vgreene, 14 April, 2017 If pregnant, use select oral antihistamines (cetirizine, chlorpheniramine, clemastine, loratadine), intransasal steroids, montelukast, cromolyn10,11
By vgreene, 14 April, 2017 Consider combo tx: intranasal steroids + short-term (≤3-10 days) topical decongestant (eg, oxymetazoline) to ↑ delivery of INS.4-7 Intranasal steroids + intranasal antihistamine isn’t recommended no better than INS mono-tx: INS + oral AH, INS + monte
By vgreene, 14 April, 2017 ✓for proper intranasal steroid technique.1 Various steroids have similar efficacy1-3
By vgreene, 14 April, 2017 Peer reviewed & based on multiple guidelines/recommendations from specialty societies/government agencies
