What this protocol covers
The allergy that arrives in spring, or all year: telling it from a cold, what fits the symptom that bothers them most, and when there is asthma behind it.
1. What to ask
- What bothers them most: sneezing, itching, a watery runny nose, a blocked nose or the eyes?
- Does it happen at the same time every year, or all year round? Have they been diagnosed with an allergy?
- Do they cough at night, wheeze or get short of breath?
- Do they drive or operate machinery?
- How old are they? Are they pregnant or breastfeeding?
2. Refer if any of these appear
- Wheezing, a night-time cough or shortness of breath: there may be asthma.
- A red eye with pain, blurred vision or strong sensitivity to light.
- Symptoms on one side of the nose only, or repeated nosebleeds.
- No improvement after two weeks of correct treatment.
- Pregnancy: the treatment is decided by their doctor.
3. If there are no red flags
Sneezing, itching and a watery runny nose
- A second-generation oral antihistamine (cetirizine, loratadine, ebastine, bilastine…), once a day.
- Taking it regularly through the season works better than taking it when needed.
A blocked nose bothers them most
- An intranasal corticosteroid is the most effective option for congestion and needs several days of regular use. Check which ones need a prescription.
- Saline nasal rinses.
Eyes
- Rinsing with saline and cold compresses.
- Antihistamine eye drops if needed.
Always
- Windows closed at peak pollen times, showering and changing clothes on getting home, sunglasses.
4. Adjust to who will take it
- Pregnancy
- Saline rinses first. If an antihistamine is needed, their doctor chooses it.
- Breastfeeding
- Rinses and avoiding exposure. Antihistamines after asking: the less sedating ones are preferred.
- Children
- Children's formulations from the minimum age in each product's information, at the dose for their weight or age.
- Older people
- Avoid first-generation antihistamines: confusion, falls and urinary retention.
- Asthma
- Poorly controlled hay fever makes asthma worse: if there are chest symptoms, their doctor should review it.
What not to recommend
- First-generation antihistamines (dexchlorpheniramine, diphenhydramine) for someone who drives.
- Two oral antihistamines at once.
- A nasal decongestant as long-term treatment: it causes rebound congestion.
What to say at the counter. Take it every day while the pollen lasts, not only on bad days. And if you wheeze or cough at night, see the doctor: sometimes the allergy reaches the lungs.
Pharmacy Pills · conveniodefarmacia.com
Patient sheet: hay fever
To print and hand over. It carries only what the patient needs at home.
- Take the antihistamine every day during the pollen season.
- Rinse your nose with saline and keep windows closed at peak pollen times.
- When you get home, shower and change your clothes.
- See your doctor if you cough at night, wheeze or get short of breath.
Self-assessment
Three questions. When you check your answers you will see the explanation for each one.
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First-generation antihistamines cause drowsiness and impair driving.
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A night-time cough and wheezing suggest asthma, which is diagnosed and treated by a doctor.
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Regular treatment during exposure controls symptoms better than taking it when needed.
Training content. It does not replace the summary of product characteristics or clinical judgement.