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