1. Avoid exposure to allergen
2. Panadol sinus 2 caplets every 4-6 hours as required
3. If there are excessive secretions and sneezing add:

• Cerin 10mg tab once daily

4. In more sever cases add:

• Singulair 10mg once daily at bed time
• Sinocort 05% nasal spray 2 sprays in each nostril once a day

Montelukast is in the leukotriene receptor antagonist family of Panadol sinus

Ingredients:

Each Panadol Sinus caplet contains:

• Paracetamol 500mg
• Pseudoephedrine Hydrochloride 30mg.

Panadol Sinus is for fast effective relief from:

• Sinus Pain, Nasal Congestion, and Headache.
• Panadol Sinus provides powerful relief from sinus pain and congestion. .

How to Use:

Adults and children over 12 years:

• Take 2 caplets every 4-6 hours as required.

Corticosteroids nasal spray (Mometasone)

• help to relieve inflammation(swelling and irritation of the nose), sneezing, itching and a blocked up or runny nose.

Available forms:

• Nasonex, Tabunex, Sinocort: 05% nasal spray

 Indications:

• to treat the symptoms of seasonal allergic rhinitis (also called hayfever) and perennial (long lasting) rhinitis in adults and children aged 3 and older;
•  to treat nasal polyps in adults aged 18 and over

Dose:

Adult:

• recommended dose is two sprays in each nostril once a day. 
• Once symptoms are controlled, dose reduction to one spray in each nostril may be effective for maintenance.
• may  increase to  the dose; the maximum daily dose is four sprays into each nostril once a day. 

Children aged 3 to 11 years :

• the usual dose is one spray into each nostril once daily. 
• May used some days before the start of the allergy season, as this will help to prevent  allergic rhinitis symptoms from occurring. 
• Prophylaxis must be initiated up to 2-4 weeks prior to the anticipated start of the allergy season.
•  Benefit of treatment may be achieved in the first two days.
•  Maximum benefit is achieved within 1-2 weeks following initiation of treatment. Therefore, patients should continue regular use to achieve full therapeutic benefit. 

For patients who use MOMEX® at regular intervals for treatment of allergic rhinitis,:

• recommended dose is a spray into each nostril once a day. For children between the ages of 2 and 11 years the usual recommended dose is one spray in each nostril once a day.

Cetirizin

Available forms:

• Zyrtic: 10mg tab, 1mg/1ml syrup, 10mg/ml oral drop
• Cerin :10mg tab, 1mg/1ml syrup
• Zertazin : 10mg tab, 5mg/5ml syrup
• Zeran :10mg tab
• Zain :10mg tab
• Siraz : 5mg tab, 5mg/5ml syrup
• Finallerg :10mg tab, 1mg/1ml syrup, 10mg/ml oral drop
• Sezonal :10mg tab
• Omcet : 5mg tab, 5mg/5ml syrup, 10mg/ml syrup

Therapeutic  indication:

• for the relief of nasal and ocular symptoms of seasonal and perennial allergic rhinitis
• for the relief of chronic nettle rash (chronic idiopathic urticaria).

Pregnancy and breast-feeding :

• Cetirizin should be avoided in pregnant women. Accidental use of the medicine by a pregnant
• woman should not produce any harmful effects on the foetus. Nevertheless, the medicine should be only administered if necessary and after medical advice.
• Cetirizine passes into breast milk. Therefore, should not taken during breast feeding 

 How to take Cetirizin Sandoz :

Adults :

• The recommended dose is 10 mg once daily as 1 tablet

Use in children between 6 and 12 years old:

• The recommended dose is 5 mg twice daily as a half tablet twice daily

side effects :

• fatigue
• dry mouth, nausea, diarrhoea
• dizziness, headache
• somnolence (sleepiness)
• pharyngitis (sore throat), rhinitis (swelling and irritation inside the nose)

Montelukast

Available forms :

• Singulair
• Lukast
• Unicast
• Sincast
• Motrinex
• 4mg 5mg, 10mg Chewable tab

Action:

• medications. It works by blocking the action of leukotriene D4 in the lungs resulting in decreased inflammation and relaxation of smooth muscle
• Leukotrienes cause tightening of airway muscles and the production of excess mucus and fluid. These chemicals play a key role in allergies, allergic rhinitis, and asthma, also causing a tightening of your airways, making it difficult to breathe. 

Indications

• Indicated in the treatment of asthma as add-on therapy in adults and adolescents from 15 years of age and older with mild to moderate persistent asthma who are inadequately controlled on inhaled corticosteroids and in whom “as-needed” short acting β-agonists provide inadequate clinical control of asthma. 
• Montelukast Film-coated tablet can also provide symptomatic relief of seasonal allergic rhinitis. 
• Indicated in the prophylaxis of asthma in which the predominant component is exercise-induced bronchoconstriction. 

Pregnancy

• Montelukast may be used during pregnancy only if it is considered to be clearly essential. 

Lactation

• Studies in rats have shown that montelukast is excreted in milk. It is not known if montelukast is excreted in human milk. 
• May be used in breast-feeding only if it is considered to be clearly essential. 
• Side effects:
• Headache
• Abdominal pain
• Upper respiratory infection
• Diarrhea, nausea, vomiting
• Elevated levels of serum transaminases (ALT, AST)
• Rash
• Pyrexia

Dose:

• Adult: 10mg once daily at bed time
• Children 6-14y: 5mg once daily at bed time
• 2-5 y: 4mg once daily at bed time