Allergic Rhinitis

[etabetac]

I am one of those off the wall allergy sufferers. I have been sneezing pretty much non-stop for the last few days. Everything else seems ok and it's not a sinus exacerbation. My question for those of you with allergy-related issues is when should I push for more (i.e. oral steroids) to take care of this because I'm miserable. I am convinced that it will shortly become asthma-related but I don't currently have any symptoms of that (peak flow is fine, breathing sounds the same for me)

Here's my med regimen for allergies -
20 mg Zyrtec (double dose, drying I know but the only thing that even touches allergies)
Singulair
Rhinocort

I've tried allergy shots with very little success. I am allergic to all airborne allergens they test for. I also have an elevated IgE but allergy-related and not ABPA which is what we were originally concerned about.

I am currently on the following meds for asthma --
Advair 500/50
Flovent 110mcg b.i.d.
Albuterol nebulized q 6-8h or as needed.

My asthma is considered controlled but not optimally controlled by pulmo and allergy docs.
I have woods floors, HEPA filters, allergy-proofed bedroom, green cleaning products.

I'd appreciate thoughts on what I could ask for to help make life less miserable.

 

[etabetac]

I am one of those off the wall allergy sufferers. I have been sneezing pretty much non-stop for the last few days. Everything else seems ok and it's not a sinus exacerbation. My question for those of you with allergy-related issues is when should I push for more (i.e. oral steroids) to take care of this because I'm miserable. I am convinced that it will shortly become asthma-related but I don't currently have any symptoms of that (peak flow is fine, breathing sounds the same for me)

Here's my med regimen for allergies -
20 mg Zyrtec (double dose, drying I know but the only thing that even touches allergies)
Singulair
Rhinocort

I've tried allergy shots with very little success. I am allergic to all airborne allergens they test for. I also have an elevated IgE but allergy-related and not ABPA which is what we were originally concerned about.

I am currently on the following meds for asthma --
Advair 500/50
Flovent 110mcg b.i.d.
Albuterol nebulized q 6-8h or as needed.

My asthma is considered controlled but not optimally controlled by pulmo and allergy docs.
I have woods floors, HEPA filters, allergy-proofed bedroom, green cleaning products.

I'd appreciate thoughts on what I could ask for to help make life less miserable.

 

[etabetac]

I am one of those off the wall allergy sufferers. I have been sneezing pretty much non-stop for the last few days. Everything else seems ok and it's not a sinus exacerbation. My question for those of you with allergy-related issues is when should I push for more (i.e. oral steroids) to take care of this because I'm miserable. I am convinced that it will shortly become asthma-related but I don't currently have any symptoms of that (peak flow is fine, breathing sounds the same for me)

Here's my med regimen for allergies -
20 mg Zyrtec (double dose, drying I know but the only thing that even touches allergies)
Singulair
Rhinocort

I've tried allergy shots with very little success. I am allergic to all airborne allergens they test for. I also have an elevated IgE but allergy-related and not ABPA which is what we were originally concerned about.

I am currently on the following meds for asthma --
Advair 500/50
Flovent 110mcg b.i.d.
Albuterol nebulized q 6-8h or as needed.

My asthma is considered controlled but not optimally controlled by pulmo and allergy docs.
I have woods floors, HEPA filters, allergy-proofed bedroom, green cleaning products.

I'd appreciate thoughts on what I could ask for to help make life less miserable.

 

[etabetac]

I am one of those off the wall allergy sufferers. I have been sneezing pretty much non-stop for the last few days. Everything else seems ok and it's not a sinus exacerbation. My question for those of you with allergy-related issues is when should I push for more (i.e. oral steroids) to take care of this because I'm miserable. I am convinced that it will shortly become asthma-related but I don't currently have any symptoms of that (peak flow is fine, breathing sounds the same for me)

Here's my med regimen for allergies -
20 mg Zyrtec (double dose, drying I know but the only thing that even touches allergies)
Singulair
Rhinocort

I've tried allergy shots with very little success. I am allergic to all airborne allergens they test for. I also have an elevated IgE but allergy-related and not ABPA which is what we were originally concerned about.

I am currently on the following meds for asthma --
Advair 500/50
Flovent 110mcg b.i.d.
Albuterol nebulized q 6-8h or as needed.

My asthma is considered controlled but not optimally controlled by pulmo and allergy docs.
I have woods floors, HEPA filters, allergy-proofed bedroom, green cleaning products.

I'd appreciate thoughts on what I could ask for to help make life less miserable.

 

[etabetac]

I am one of those off the wall allergy sufferers. I have been sneezing pretty much non-stop for the last few days. Everything else seems ok and it's not a sinus exacerbation. My question for those of you with allergy-related issues is when should I push for more (i.e. oral steroids) to take care of this because I'm miserable. I am convinced that it will shortly become asthma-related but I don't currently have any symptoms of that (peak flow is fine, breathing sounds the same for me)
<br />
<br />Here's my med regimen for allergies -
<br />20 mg Zyrtec (double dose, drying I know but the only thing that even touches allergies)
<br />Singulair
<br />Rhinocort
<br />
<br />I've tried allergy shots with very little success. I am allergic to all airborne allergens they test for. I also have an elevated IgE but allergy-related and not ABPA which is what we were originally concerned about.
<br />
<br />I am currently on the following meds for asthma --
<br />Advair 500/50
<br />Flovent 110mcg b.i.d.
<br />Albuterol nebulized q 6-8h or as needed.
<br />
<br />My asthma is considered controlled but not optimally controlled by pulmo and allergy docs.
<br />I have woods floors, HEPA filters, allergy-proofed bedroom, green cleaning products.
<br />
<br />I'd appreciate thoughts on what I could ask for to help make life less miserable.

 

[saveferris2009]

A few things - get fexofendadine (Allergra) isntead of zyrtec. I know allergists that use 360mg TID for severe allergies. Because Allegra isn't metabolized by the liver like zyrtec is (be CAREFUL on upping your zyrtec dose.... CFer's aren't known for good livers) you can up the dose. Allergra isn't renaly metabolized either.

AND Allegra doesn't cross the blood brain barrier like Zyrtec so you'll be allowed to drive (in most states it's illegal to drive while impaired - Zyrtec states clearly on the label that it can cause sedation and impairment.... you could get a ticket from the cops or a lawsuit from someone if you get in an accident. read those labels carefully and be more careful if you go off label and double your dose!

Get off the rhinocort - that's the weakest intranasal corticosteroid on the market. the prescribing information talks about titrating UP the dose (it's so weak you can increase the dose) whereas PI info on Nasonex, Flonase and Nasacort AQ talk about titrating down. Many many head to head studies and Rhinocort is the weakest by far. If you like it because it contains no alcohol and no smell, switch to Nasacort or Nasonex (although Nasonex vs Flonase studies show Nasonex is a big weaker).


Get allergy shots. Go get a full skin test work up and get de-sensitized. The inflammation from your severe allergies is recruiting neutrophils to your lungs most likely, and those neutrophils cause permanent lung damange. No good.

Call the allergist 1st thing tomorrow AM and get on this. I hope you feel better soon.

 

[saveferris2009]

A few things - get fexofendadine (Allergra) isntead of zyrtec. I know allergists that use 360mg TID for severe allergies. Because Allegra isn't metabolized by the liver like zyrtec is (be CAREFUL on upping your zyrtec dose.... CFer's aren't known for good livers) you can up the dose. Allergra isn't renaly metabolized either.

AND Allegra doesn't cross the blood brain barrier like Zyrtec so you'll be allowed to drive (in most states it's illegal to drive while impaired - Zyrtec states clearly on the label that it can cause sedation and impairment.... you could get a ticket from the cops or a lawsuit from someone if you get in an accident. read those labels carefully and be more careful if you go off label and double your dose!

Get off the rhinocort - that's the weakest intranasal corticosteroid on the market. the prescribing information talks about titrating UP the dose (it's so weak you can increase the dose) whereas PI info on Nasonex, Flonase and Nasacort AQ talk about titrating down. Many many head to head studies and Rhinocort is the weakest by far. If you like it because it contains no alcohol and no smell, switch to Nasacort or Nasonex (although Nasonex vs Flonase studies show Nasonex is a big weaker).


Get allergy shots. Go get a full skin test work up and get de-sensitized. The inflammation from your severe allergies is recruiting neutrophils to your lungs most likely, and those neutrophils cause permanent lung damange. No good.

Call the allergist 1st thing tomorrow AM and get on this. I hope you feel better soon.

 

[saveferris2009]

A few things - get fexofendadine (Allergra) isntead of zyrtec. I know allergists that use 360mg TID for severe allergies. Because Allegra isn't metabolized by the liver like zyrtec is (be CAREFUL on upping your zyrtec dose.... CFer's aren't known for good livers) you can up the dose. Allergra isn't renaly metabolized either.

AND Allegra doesn't cross the blood brain barrier like Zyrtec so you'll be allowed to drive (in most states it's illegal to drive while impaired - Zyrtec states clearly on the label that it can cause sedation and impairment.... you could get a ticket from the cops or a lawsuit from someone if you get in an accident. read those labels carefully and be more careful if you go off label and double your dose!

Get off the rhinocort - that's the weakest intranasal corticosteroid on the market. the prescribing information talks about titrating UP the dose (it's so weak you can increase the dose) whereas PI info on Nasonex, Flonase and Nasacort AQ talk about titrating down. Many many head to head studies and Rhinocort is the weakest by far. If you like it because it contains no alcohol and no smell, switch to Nasacort or Nasonex (although Nasonex vs Flonase studies show Nasonex is a big weaker).


Get allergy shots. Go get a full skin test work up and get de-sensitized. The inflammation from your severe allergies is recruiting neutrophils to your lungs most likely, and those neutrophils cause permanent lung damange. No good.

Call the allergist 1st thing tomorrow AM and get on this. I hope you feel better soon.

 

[saveferris2009]

A few things - get fexofendadine (Allergra) isntead of zyrtec. I know allergists that use 360mg TID for severe allergies. Because Allegra isn't metabolized by the liver like zyrtec is (be CAREFUL on upping your zyrtec dose.... CFer's aren't known for good livers) you can up the dose. Allergra isn't renaly metabolized either.

AND Allegra doesn't cross the blood brain barrier like Zyrtec so you'll be allowed to drive (in most states it's illegal to drive while impaired - Zyrtec states clearly on the label that it can cause sedation and impairment.... you could get a ticket from the cops or a lawsuit from someone if you get in an accident. read those labels carefully and be more careful if you go off label and double your dose!

Get off the rhinocort - that's the weakest intranasal corticosteroid on the market. the prescribing information talks about titrating UP the dose (it's so weak you can increase the dose) whereas PI info on Nasonex, Flonase and Nasacort AQ talk about titrating down. Many many head to head studies and Rhinocort is the weakest by far. If you like it because it contains no alcohol and no smell, switch to Nasacort or Nasonex (although Nasonex vs Flonase studies show Nasonex is a big weaker).


Get allergy shots. Go get a full skin test work up and get de-sensitized. The inflammation from your severe allergies is recruiting neutrophils to your lungs most likely, and those neutrophils cause permanent lung damange. No good.

Call the allergist 1st thing tomorrow AM and get on this. I hope you feel better soon.

 

[saveferris2009]

A few things - get fexofendadine (Allergra) isntead of zyrtec. I know allergists that use 360mg TID for severe allergies. Because Allegra isn't metabolized by the liver like zyrtec is (be CAREFUL on upping your zyrtec dose.... CFer's aren't known for good livers) you can up the dose. Allergra isn't renaly metabolized either.
<br />
<br />AND Allegra doesn't cross the blood brain barrier like Zyrtec so you'll be allowed to drive (in most states it's illegal to drive while impaired - Zyrtec states clearly on the label that it can cause sedation and impairment.... you could get a ticket from the cops or a lawsuit from someone if you get in an accident. read those labels carefully and be more careful if you go off label and double your dose!
<br />
<br />Get off the rhinocort - that's the weakest intranasal corticosteroid on the market. the prescribing information talks about titrating UP the dose (it's so weak you can increase the dose) whereas PI info on Nasonex, Flonase and Nasacort AQ talk about titrating down. Many many head to head studies and Rhinocort is the weakest by far. If you like it because it contains no alcohol and no smell, switch to Nasacort or Nasonex (although Nasonex vs Flonase studies show Nasonex is a big weaker).
<br />
<br />
<br />Get allergy shots. Go get a full skin test work up and get de-sensitized. The inflammation from your severe allergies is recruiting neutrophils to your lungs most likely, and those neutrophils cause permanent lung damange. No good.
<br />
<br />Call the allergist 1st thing tomorrow AM and get on this. I hope you feel better soon.

 

[etabetac]

I've done the allergy shots (~5 yrs worth of shots). Didn't get much in the way of results except for a small break in the wintertime. I've done both the skin and blood tests for allergies multiple times and in the last year (plus three years ago and five years ago). I am allergic to most of the 60 things they test for.

I'm using Zyrtec per dr's recommendation (I do believe the PDR or some other sourced said it was ok because I remember the doctor verifying it). I have no liver issues to date and it's the only thing that provides any relief. I can't handle the Allegra because of the side effects (mainly intense cramping around menstruation and I do mean intense).

I will ask about Nasacort. I do like Rhinocort b/c of the alcohol-free.

Thanks for the reply.

 

[etabetac]

I've done the allergy shots (~5 yrs worth of shots). Didn't get much in the way of results except for a small break in the wintertime. I've done both the skin and blood tests for allergies multiple times and in the last year (plus three years ago and five years ago). I am allergic to most of the 60 things they test for.

I'm using Zyrtec per dr's recommendation (I do believe the PDR or some other sourced said it was ok because I remember the doctor verifying it). I have no liver issues to date and it's the only thing that provides any relief. I can't handle the Allegra because of the side effects (mainly intense cramping around menstruation and I do mean intense).

I will ask about Nasacort. I do like Rhinocort b/c of the alcohol-free.

Thanks for the reply.

 

[etabetac]

I've done the allergy shots (~5 yrs worth of shots). Didn't get much in the way of results except for a small break in the wintertime. I've done both the skin and blood tests for allergies multiple times and in the last year (plus three years ago and five years ago). I am allergic to most of the 60 things they test for.

I'm using Zyrtec per dr's recommendation (I do believe the PDR or some other sourced said it was ok because I remember the doctor verifying it). I have no liver issues to date and it's the only thing that provides any relief. I can't handle the Allegra because of the side effects (mainly intense cramping around menstruation and I do mean intense).

I will ask about Nasacort. I do like Rhinocort b/c of the alcohol-free.

Thanks for the reply.

 

[etabetac]

I've done the allergy shots (~5 yrs worth of shots). Didn't get much in the way of results except for a small break in the wintertime. I've done both the skin and blood tests for allergies multiple times and in the last year (plus three years ago and five years ago). I am allergic to most of the 60 things they test for.

I'm using Zyrtec per dr's recommendation (I do believe the PDR or some other sourced said it was ok because I remember the doctor verifying it). I have no liver issues to date and it's the only thing that provides any relief. I can't handle the Allegra because of the side effects (mainly intense cramping around menstruation and I do mean intense).

I will ask about Nasacort. I do like Rhinocort b/c of the alcohol-free.

Thanks for the reply.

 

[etabetac]

I've done the allergy shots (~5 yrs worth of shots). Didn't get much in the way of results except for a small break in the wintertime. I've done both the skin and blood tests for allergies multiple times and in the last year (plus three years ago and five years ago). I am allergic to most of the 60 things they test for.
<br />
<br />I'm using Zyrtec per dr's recommendation (I do believe the PDR or some other sourced said it was ok because I remember the doctor verifying it). I have no liver issues to date and it's the only thing that provides any relief. I can't handle the Allegra because of the side effects (mainly intense cramping around menstruation and I do mean intense).
<br />
<br />I will ask about Nasacort. I do like Rhinocort b/c of the alcohol-free.
<br />
<br />Thanks for the reply.

 

[saveferris2009]

I wouldn't stop at "per doc's recommendation." No doctor is perfect, and you owe it to yourself to do further research. PDR i doubt would talk about too many off label doses - but regardless, it's clearly not helping you, so no need to defend the position.

I have to tell you, Allegra has been on the market for years now and I've never heard anything about intense cramping.... how long were you on allegra? i know you will swear up and down it was the allegra but perhaps something else was going on while you were on the drug.

at the very least i'd switch from zyrtec to xyzal then (active metabolite of zyrtec - levoceterizine) so you're not hammering your liver. i know you don't have issues, but you might after taking zyrtec BID if you take tylenol or any other hepatically metabolized med while i bet you do.

have you considered getting a 2nd opinion of another allergist? i know allergy shots don't work for all by any stretch, but it would be worth it considering the issues you are having.

you might want to check out xolair as well.

 

[saveferris2009]

I wouldn't stop at "per doc's recommendation." No doctor is perfect, and you owe it to yourself to do further research. PDR i doubt would talk about too many off label doses - but regardless, it's clearly not helping you, so no need to defend the position.

I have to tell you, Allegra has been on the market for years now and I've never heard anything about intense cramping.... how long were you on allegra? i know you will swear up and down it was the allegra but perhaps something else was going on while you were on the drug.

at the very least i'd switch from zyrtec to xyzal then (active metabolite of zyrtec - levoceterizine) so you're not hammering your liver. i know you don't have issues, but you might after taking zyrtec BID if you take tylenol or any other hepatically metabolized med while i bet you do.

have you considered getting a 2nd opinion of another allergist? i know allergy shots don't work for all by any stretch, but it would be worth it considering the issues you are having.

you might want to check out xolair as well.

 

[saveferris2009]

I wouldn't stop at "per doc's recommendation." No doctor is perfect, and you owe it to yourself to do further research. PDR i doubt would talk about too many off label doses - but regardless, it's clearly not helping you, so no need to defend the position.

I have to tell you, Allegra has been on the market for years now and I've never heard anything about intense cramping.... how long were you on allegra? i know you will swear up and down it was the allegra but perhaps something else was going on while you were on the drug.

at the very least i'd switch from zyrtec to xyzal then (active metabolite of zyrtec - levoceterizine) so you're not hammering your liver. i know you don't have issues, but you might after taking zyrtec BID if you take tylenol or any other hepatically metabolized med while i bet you do.

have you considered getting a 2nd opinion of another allergist? i know allergy shots don't work for all by any stretch, but it would be worth it considering the issues you are having.

you might want to check out xolair as well.

 

[saveferris2009]

I wouldn't stop at "per doc's recommendation." No doctor is perfect, and you owe it to yourself to do further research. PDR i doubt would talk about too many off label doses - but regardless, it's clearly not helping you, so no need to defend the position.

I have to tell you, Allegra has been on the market for years now and I've never heard anything about intense cramping.... how long were you on allegra? i know you will swear up and down it was the allegra but perhaps something else was going on while you were on the drug.

at the very least i'd switch from zyrtec to xyzal then (active metabolite of zyrtec - levoceterizine) so you're not hammering your liver. i know you don't have issues, but you might after taking zyrtec BID if you take tylenol or any other hepatically metabolized med while i bet you do.

have you considered getting a 2nd opinion of another allergist? i know allergy shots don't work for all by any stretch, but it would be worth it considering the issues you are having.

you might want to check out xolair as well.

 

[saveferris2009]

I wouldn't stop at "per doc's recommendation." No doctor is perfect, and you owe it to yourself to do further research. PDR i doubt would talk about too many off label doses - but regardless, it's clearly not helping you, so no need to defend the position.
<br />
<br />I have to tell you, Allegra has been on the market for years now and I've never heard anything about intense cramping.... how long were you on allegra? i know you will swear up and down it was the allegra but perhaps something else was going on while you were on the drug.
<br />
<br />at the very least i'd switch from zyrtec to xyzal then (active metabolite of zyrtec - levoceterizine) so you're not hammering your liver. i know you don't have issues, but you might after taking zyrtec BID if you take tylenol or any other hepatically metabolized med while i bet you do.
<br />
<br />have you considered getting a 2nd opinion of another allergist? i know allergy shots don't work for all by any stretch, but it would be worth it considering the issues you are having.
<br />
<br />you might want to check out xolair as well.