Post-nasal drip syndrome (upper airway cough syndrome)

2 sprays (100 mcg) into each nostril once daily, preferably in the morning x 2-4 weeks

ACCP Cough Guideline: Upper Airway Cough Syndrome 2006

Intranasal fluticasone reduces inflammation of the nasal and sinus mucosa that drives post-nasal drip and the resulting cough, and is first-line therapy for upper airway cough syndrome.

10 mg once daily x 2-4 weeks

(Children 2-6 years: 2.5 mg twice daily; 6-12 years: 5 mg twice daily)

Alternatives, both second-generation antihistamines. Cetirizine is the cheaper and the more widely stocked.

Egyptian National Drug Formulary - Respiratory System 2026 (cetirizine monograph)

Cetirizine is a second-generation antihistamine that blocks histamine-mediated nasal secretion and drainage; it is used as a second-line or alternative option to intranasal corticosteroids for post-nasal drip, particularly when an allergic trigger is suspected.

5 mg once daily (adults and adolescents 12 years and over) - While symptoms persist; review at 4 weeks and reconsider the diagnosis if there is no improvement

Safety and efficacy of the 5 mg tablet in children under 12 years have not been established. An oral solution exists for younger children with its own age-banded dosing; efficacy data in 12-17 year olds are limited.

eMC SmPC, Neoclarityn 5 mg film-coated tablets (Organon), sections 4.1 and 4.2

35 live products. Upper airway cough syndrome is driven by allergic or non-allergic rhinitis, and the SmPC indication is relief of the symptoms of allergic rhinitis. Once-daily, non-sedating, and the active metabolite of loratadine, so it is a cleaner choice than the cetirizine already listed for a patient who finds cetirizine sedating.