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2017 HCHB_digital

Hay Fever (continued)

Hay Fever (continued) TREATMENT OPTIONS Category Examples Comments Oral antihistamines Topical (nasal and ocular) antihistamines Nasal corticosteroids Other nasal products Decongestants Mast cell stabilisers Saline nasal products Natural / herbal products / supplements Non-sedating [PHARMACY ONLY MEDICINE] eg, cetirizine (Razene, Allerid-C, Arrowcare Zetop, Histaclear, Zyrtec tablets & liquid), desloratadine (Aerius), fexofenadine (Telfast range*, Telfast Oral Liquid, Hayfexo, Fexaclear, Xergic), levocetirizine (Levrix), loratadine (Apo-Loratadine, Loraclear, Lorafix, Lorapaed Liquid, Lora-Tabs) Sedating [PHARMACIST ONLY MEDICINE] eg, dexchlorpheniramine (Polaramine), promethazine (Allersoothe, Phenergan) [PHARMACY ONLY MEDICINE] eg, levocabastine (Livostin Eye Drops*, Livostin Nasal Spray*), naphazoline + pheniramine (Naphcon-A, Visine Allergy), naphazoline + zinc (Clear eyes-A), antazoline + naphazoline (Albalon A Allergy), ketotifen (Zaditen) [PHARMACY ONLY MEDICINE] eg, beclomethasone (Alanase, Beconase Allergy & Hayfever*), budesonide (Butacort), fluticasone (Flixonase*), triamcinolone acetonide (Telnase) eg, cellulose and peppermint powder (Nasaleze) eg, ipratropium bromide (Univent Nasal Spray) eg, protective nasal balm (Botanica Hayfever Gel, HayMax) Topical (nasal) [PHARMACY ONLY MEDICINE] eg, oxymetazoline (Dimetapp 12 Hour Nasal Spray, Drixine No Drip), xylometazoline (Otrivin) Oral eg, phenylephrine + paracetamol [GENERAL SALE] eg, Panadol Sinus Relief PE [PHARMACY ONLY MEDICINE] eg, Sudafed PE Sinus Day & Night Relief (contains chlorpheniramine in night tablet) eg, phenylephrine + loratadine (Dimetapp Elixir, Dimetapp Elixir Colour-free, Maxiclear Hayfever & Sinus Relief*) [PHARMACY ONLY MEDICINE] eg, lodoxamide (Lomide eye drops) eg, sodium cromoglycate (Cromo-Fresh, Rexacrom) [GENERAL SALE] eg, Otrivin Clear Saline Plus, Fess Nasal range, NeilMed Butterbur, pycnogenol, quercetin, saline nasal irrigation, tinospora cordifolia, vitamin C eg, KI Hayfever* Useful for symptoms that persist during the day. May be taken before hay fever occurs to avoid any slight delay in response. All relieve sneezing, itching, and help dry up a runny nose but only levocetirizine has shown to relieve nasal congestion. Although drowsiness with these products is rare, it may still occasionally occur in some people. Always warn customers about driving or operating machinery if feeling drowsy. May not be suitable for children of certain ages. May be useful when symptoms are more problematic at night, to aid sleep. Warn about drowsiness and the risk of driving or operating machinery. Refer people on medications or with certain health conditions to the pharmacist since these products may not be suitable for them. (See Reference section, OTC Medicines – Precautions). Avoid alcohol. Sedating antihistamines are prescription medicines for children under two. Have a localised effect and a rapid onset of action. Contact lenses may need to be removed before applying eye drops – check instructions. Use eye drops combining antihistamines with decongestants short term only (ie, less than three days). Throw drops away one month after opening. Stinging and a bitter taste after application have been reported. Useful for treatment and prevention and as a first-line therapy for moderate-to-severe allergic rhinitis. Use at the start of the hay fever season to prevent symptoms occurring. A decongestant or antihistamine may also be required initially as relief may be delayed two to three days. Cellulose powder is delivered as a fine mist into the nasal passages where it forms an impermeable barrier to allergens. Ipratropium relieves a runny nose but does not treat sneezing or congestion. Protective balms help prevent pollen entering the nasal cavity and lessen allergic reactions. Best reserved for when nasal congestion needs to be treated quickly. Useful for symptom relief while waiting for nasal corticosteroids to take effect. Rebound congestion can occur with extended use. Topical decongestants should not be used for longer than three days. Children’s formulations of intranasal oxymetazoline and xylometazoline are still considered safe to give to children two years of age and older. Combination tablets contain a variety of different ingredients. Refer to the packet for the list of ingredients which may include a decongestant (eg, phenylephrine), analgesic (eg, paracetamol) or antihistamine (to dry up runny noses). (See also Reference section, OTC Medicines – Precautions). Stabilise mast cells to prevent histamine release. Frequent administration (four to six times daily) is needed. Can be used as a preventative up to one week before allergy symptoms occur. Saline thins nasal mucus and moisturises dry nasal passages. It allows mucus to break down faster and washes away pollen, animal dander and dust. May be effective at either stabilising the allergic response or relieving symptoms of hay fever. KI Hayfever contains Rhin-mp, astragalus-membranaceus, ginger, magnolia and quercetin and may help relieve and prevent the symptoms of hay fever. Products with an asterisk have a detailed listing in the Hay Fever section of the OTC Products, starting on page 239. PharmacyToday A part of your everyday Page 86 HEALTHCARE HANDBOOK 2017-2018 Common Disorders

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