1. Avoid exposure to allergen
2. Panadol cold and flu 1-2 tablet 2 times daily
3. In more sever cases add:

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

Panadol cold and flu

Ingredients:

• Active Ingredients: Paracetamol 500 mg, Pseudoephedrine Hydrochloride 30 mg, Chlorphenamine Maleate 2 mg.
• Other non-active ingredients: Silicon dioxide, Stearic acid, Sodium benzoate, Povidone, Pregelatinised starch, Maize starch, Talc.

used for:

• This product consists of three active ingredients: paracetamol, chlorpheniramine and pseudoephedrine hydrochloride.
• Paracetamol is a medication that belongs to a class of medications known as analgesics (pain relievers) and antipyretics (fever reducers).
• Chlorpheniramine is an antihistamine that acts by decreasing the effects of histamine in your body and therefore helps in relieving allergy signs and symptoms, like, sneezing, watery eyes, itching, and runny nose. 
• Pseudoephedrine is a medication that belongs to a class of medicines known as “decongestants” and acts by decreasing nasal stuffiness that you may experience during cold and flu.
• It is used for the night time relief from cold and flu symptoms.

It is used for the relief of the following indications:

• Headache
• Congestion and sinus pain
• Sneezing
• Body aches
• Itchy and watery eyes
• Blocked and runny nose
• Fever

Contraindication:

• In allergy to Paracetamol, or Chlorpheniramine, or Pseudoephedrine Hydrochloride, other antihistamines or any of the ingredients in this medicine.  
• In  taking other paracetamol containing products or other antihistamines or cough or cold and flu medications or decongestants. Make sure not to exceed the dose.
• In  high blood pressure or severe kidney or heart problems.

Possible side effects:

• allergic reaction, like rash and itching, signs of breathing problems like difficulty breathing.
• Other side effects include drowsiness or sleepiness, difficulty sleeping, fatigue, headache, hallucinations, twitching or jerking muscles, nervousness, blurred vision, difficulty concentrating, excitability, dizziness, nausea, indigestion or vomiting, restlessness, dry mouth nose and throat, rapid heart rate, loss of coordination, nervousness and irritability.

Dose:

Adults and children aged 12 years and over:

• 1 to 2 tablets every 4 to 6 hours as needed. not to exceed 8 tablets within 24 hours.
• not more than 4 doses in 24 hours. Doses should be spaced by at least 4 hours.

Children under 12 years:

• not given to children below 12 years of age.

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.

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