Hello
No doubt you are having allergic rhinitis or allergic bronchitis , but allergy is the predisposing cause of your problem. Since fluticasone + azelastin is the drug of choice prophylaxis and treatment of allergic rhinitis.
But this is a steroid treatment .
When such patient visit I advise my patient to take montelukast+ levoceterizine tablet one or two in day ( according to severity of symptoms i.e sneezing).
When patient also feels breathlessness ( not uncommon in this type of patient ) I advise them to take montelukast+ bambuterole tablet once or twice in day .
Avoid , fine dusting powder, mite , pollen , mold , sudden change in temperature , hay , fodder as these are predisposing factors for allergy .
Hope this will help you.
Steam inhalation also help.

Hello.

Thank you for asking at HCM.

I went through your history and understand your concern.

I would like to make following suggestions to you:

1. For allergic rhinitis (nose allergy), most of the medications (sprays, tablets, etc) usually "control" the symptoms of allergy like sneezing, nasal congestion, etc but do not treat allergy itself.

Basically allergy is an abnormal functioning of immune system and medications do not work on immune system.

2. Were I treating you, I would agree with your doctor that you need to take spray as long as you have symptoms and there are very high chances that symptoms would return upon stopping the spray/drug.

3. As an Allergist-Immunologist, I would suggest you allergy testing. This will help you identify the substances you may be allergic to and also to know the measures to avoid them.

As you have early morning symptoms, I would first think of house dust mites, indoor molds, cockroach proteins and animal dander proteins (if you have a pet in home) as possible allergy causing substances ("allergens").

4. Avoidance of allergens causing allergies to you is the best measure to treat allergies.

Also, based on allergy test results, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to gradually improve your allergy symptoms over a long time.

5. In general, I would also suggest you to avoid exposure to dusts, smokes and air pollution.

6. Regular breathing exercises and a healthy diet rich in vitamins & minerals (adequate amounts of green leafy vegetables, fruits, sprouts, etc) will also help you in a long run by improving your lung capacity and immunity respectively.

Hope above suggestions will be helpful to you.

SHould you have any further query, please feel free to ask at HCM.

Wish you the best of the health.

Thank you & Regards.