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Treating Allergic Rhinitis: A Patient Experiment

Berrylin J. Ferguson, MD, FACS, FAAOA, associate professor of otolaryngology and director of the Division of Sino-Nasal Disorders and Allergy at the University of Pittsburgh School of Medicine in Pittsburgh, Pa., uses the following form to help determine which allergy treatments will work best for each patient.

“Every patient potentially responds differently to a medication,” Dr. Ferguson said. “So we have patients experiment by only changing one variable at a time, that is only change one medication they are taking at a time, and monitor themselves to see if the medication improves their nose or allergy symptoms.”

Try each medicine in order indicated Medication Dose Number of times a day Symptoms which should improve and how long it should take to work Check if sample given
Nasal steroid spray: Generic Flonase, Nasocort, Nasonex, Rhinocort AQ, Veramyst, Omnaris. If any of the above are effective, let us know which is on your ormulary. 1 to 2 puffs each nostril. Direct spray using right hand to spray left nose, and vice a versa to maximize delivery laterally 1 to 2 times, use lowest dose that relieves symptoms Nasal congestion, drainage, allergy symptoms. May take a week to work
SLOW
Antihistamine nasal spray: Astelin, Astepro, Patanase As above. Lean forward and do not sniff x 1 minute to minimize bad taste 2 times, take first dose before bedtime, to see if it makes you sleepy Nasal congestion, drainage, itch. May work in less than 1/2 hour FAST
Singulair 10 mg pill 1 time As above plus cough,
FAST
Antihistamines: Loratadine OTC, Allegra, Xyzal, Zyrtec 1 time As above plus cough,
FAST
Guaifenesin (Mucinex) 600 mg 2 pills 2 times Over the counter, less expensive as generic on the internet
Proton Pump Inhibitor Take ½ to 1 hour before a meal
Antibiotic Eat yogurt, Kefir, or take probiotics or acidophilus tablets (OTC, health food store) while on an antibiotic to replenish good bacteria in your system
Saline nasal rinse: Neil Med, Simply Saline Use saline rinses BEFORE applying prescription nasal sprays
Queen Helene’s Cocoa Butter Cream Apply to front of nose As needed Available at Rite-aid; Wal-Mart and on the Internet.

Source: Berrylin J. Ferguson, MD, FACS, FAAOA