1. Avoid exposure to allergen
2. If there are excessive secretions and sneezing add:

• Finallerg 10mg tab10mg tab once daily

3. If there is nasal obstruction add :

• Sinomarin nasal spray 1puff 4-6 times daily

4. In more sever cases add:

• Motrinex 10mg once daily at bed time
• Rhinocort 32mcg/dose nasal spray one spray in each nostril once a day

Corticosteroids nasal spray (Budesonide)

Available forms:

• Rhinocort :32mcg/dose,64mcg/dose

 Indications:

• corticosteroid indicated for the management of thenasal symptoms of perennial nonallergic rhinitis in adult and pediatric patients aged  6years and older. 

Dose:

• Rhinocort :32mcg/dose For intranasal use only.

Starting dosage:

Adult and children >6 years:

• 64 mcg (one spray per nostril ) once daily. 

Maximum dosages:

• Adults: 256 mcg (four sprays per nostril of Rhinocort :32mcg/dose) once daily. 
• Pediatric patients (6 to <12 years of age): 128 mcg (two sprays per nostril Rhinocort :32mcg/dose) once daily.

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)

Sinomarin (sea water)

• 100% natural, clinically proven nasal spray that relieves nasal congestion naturally, thins mucus and cleanses the nasal cavities effectively, helping to protect from infections. It is ideal both for regular nasal hygiene and congestion relief.

Use in cases of

• Infectious rhinitis (common cold & flu)
• Allergic rhinitis (seasonal hay fever or year-long)
• Other causes of rhinitis (e.g. pregnancy
• Sinusitis
• Regular nasal hygiene
• Nasal hydration

Dose:

• 1puffs 4-6 times daily

Pregnancy and lactation:

• Save

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