1. Avoid exposure to allergen
2. In excessive nasal secretions (Rinorrhea,sneezing,itching):

• Klarihist 5mg/5ml syrup one teaspoon (5 ml), once a day, with or without food

3. In nasal obstruction:

• Otrivin 05% spray /drop 1drops in each nostrils up to 3 times daily(>2y)

4. Nasonex 0.05% nasal spray : >3year one spray into each nostril once daily.
5. Singulair 4mg once daily at bed time(>2y)

Loratadine

Available forms:

• Loratan, clara, histal, Klarihist, Loreen, Lorine Lohist, Ramitin:10mg tab, 5mg/5ml syrup
• Tidilor, Claritine, Lorax :10mg tab, 1mg/1ml syrup
• Loratin, Restamine:10mg tab
• Lostamin: 5mg/5ml syrup

Indications:

• Relief of symptoms associated with allergic rhinitis, such as sneezing, nasal discharge (rhinorrhea) as well as ocular itching and burning.
• indicated for the relief of symptoms and signs of chronic urticaria and other allergic dermatologic disorders.

Dose:

• Adults and children 6 years and older who weigh more than 30kg : 1 x tablet once daily
• Adults and children over 12 years of age: 2 teaspoons (10 ml), once a day, with or without food.
• The dosage for children aged 2-12 is by weight:
• Body weight over 30 kg: 2 teaspoons (10 ml), once a day, with or without food.
• Body weight of 30 kg or less: one teaspoon (5 ml), once a day, with or without food.

Pregnancy and breast-feeding :

As a precautionary measure, it is preferable to avoid the use of Loratadine Tablets during pregnancy. Loratadine is excreted in breast milk so preferable to avoid the use in lactation

side effect:

• drowsiness  
• headache
• increased appetite 
• difficulty sleeping.

Otrivine

Otrivine Nasal Spray contains the active ingredient xylometazoline hydrochloride which helps to open up and clear the nasal passages by reducing the excessive nasal secretions and returning the swollen blood vessels to their normal size.

 Used in :

• nasal congestion (blocked nose, including colds)
• allergic rhinitis
• sinusitis.
• Not used>5 days Cause rebound congestion

Pregnancy : not  recommended

Available forms:

• Otrivin 0.1% spray/drop , .05% spray /drop
• Decozal 0.1% spray/drop , .05% spray /drop
• Xylomet 0.1% spray

Dose:

Adult

• 0.1% Nasal drop 2-3 drops in each nostrils up to 3 times daily

Child>6y

• 0.05% Nasal drop 2-3 drops in each nostrils up to 3 times daily

Child 6months-6y

• 0.05% Nasal drop 1drops in each nostrils up to 3 times daily

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 0.05% nasal spray : one spray into each nostril once daily.
• Tabunex 0.05% nasal spray : one spray into each nostril once daily.
• Sinocort 0.05% nasal spray : one spray into each nostril once daily. 

 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.

Montelukast

Available forms :

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

Action:

• Montelukast is in the leukotriene receptor antagonist family of 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