My recurrent cough and sneeze do not go away even after Seretide oral spray. What to do?

Q. I get recurrent mild cough at night and sneeze in the morning. Why?

Answered by
Dr. Shyam Kalyan. N
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Apr 04, 2020 and last reviewed on: May 24, 2023

Hi doctor,

I am a 33-year-old male. I would like to consult about my recurring mild cough during night time, and sneeze and runny nose in the morning that usually go away before lunchtime. I recently consulted a pulmonary doctor due to a severe cough she gave me antibiotics, an anti-histamine in the morning, Seretide oral spray, and medicine that uses a nebulizer. I have finished it, and the cough, as well as sneezing, and runny nose, went away for a couple of days. Suddenly the mild cough, sneezing, and runny nose came back. I also mentioned the recurring allergic attack to the pulmonary doctor which is why she gave me the anti-histamine because she told me that the cough might be an allergic reaction.

I just take vitamin C tablets and ginger daily. I do not use any medications right now. Last night I experienced a mild cough again, I resorted to using the Seretide oral spray because I experience slight discomfort in breathing. I have no idea what I could be allergic to. I have no food allergies. I usually have a jacket when I sleep because we sleep with the air conditioning on. It is fine if it is just me but I sleep with my partner and a 2-year-old kid in a room. I do not have a fever or any symptoms of Coronavirus. I can no longer consult an allergologist near me due to the lockdown in our area. I hope you can put an end to this recurring problem. Thanks.



Welcome to

Please continue the antihistaminic. Preferably pair it up with the tablet Montelukast. Take the medicine at 6 PM in the evening. You need a steroidal nasal spray like Mometasone as well. Take an Albuterol inhaler SOS and a Budesonide inhaler twice daily for a week. Avoid exposure to cold air from the AC. Keep the blower of the Aircon away from you. Keep an optimum temperature of 25 degrees. Do not lie down directly under the fan. Keep all surfaces extremely clean and tidy. Wipe all areas with a wet cloth every few days. Keep carpets, curtains, upholsteries, puffed toys, etc., very clean and dust free. Wash your bedding twice a week with warm water.

Thank you doctor,

Is it possible to get a proper prescription? Apparently, I lost my previous prescription list from the pulmonary doctor. Kindly include how long will I use the steroidal nasal spray and others?



Welcome back to

I have included my prescription in the treatment plan. Go through it. If you need any modification please let me know and I shall do it.

Investigations to be done:

Skin prick test.

Probable diagnosis:

Allergic rhinitis.

Treatment plan:

Tablet Montelukast 10 mg take one tab in the morning for two weeks, Levocetirizine 5 mg take one tablet in the evening at 6 PM daily for two weeks,

Fluticasone furoate nasal spray take two puffs in each nostril after a meal twice daily for two weeks,

Budesonide inhaler take two puffs twice daily for one week followed by two puffs once daily for the next week and then stop. Albuterol inhaler take two puffs SOS whenever there is breathing difficulty or wheezing.

Preventive measures:

Avoid smoke, dust pollution, cold drinks, and refrigerated items. Drink plenty of water.

Regarding follow up:

Review after two weeks.

Hi doctor,

Thank you for the reply.

You forgot to mention the concentration of the nasal spray, it has several. Also, we do not have Budesonide inhalers and Albuterol inhalers in my local drug store. Kindly indicate the mg/concentration of the nasal spray. And provide an alternative to Budesonide and Albuterol with complete specs and mg/concentration. We have a nebulizer that we can use if inhalers are not available.

Am I going to stop using the Seretide 25 mcg metered dose inhaler suspension? Or it can be used as an alternative to Budesonide? It is the one I am using in case I experience difficulty in breathing. Seemed like my asthma is coming back after some time because of the mild cough and sneezing. I need to puff once at least daily w/ seretide. As of now, I have not had an attack yet.



Welcome back to

Take Fluticasone furoate 27.5 micrograms dosage nasal spray as told. If taking Mometasone take 50 micrograms or 0.05 %. Instead of Budesonide, take Seretide metered inhaler suspension. For Albuterol, you can take Salbutamol 100 micrograms per dose or Levosalbutamol 50 micrograms per dose. Either one is enough.

Hello, doctor,

I believe the treatment was quite effective since just after three days, I have not experienced any symptoms of the allergy anymore. I have not had the chance to use the nebulizer, because Seretide is enough. I also have not used the nasal spray since I did not have a chance to buy it because of the lockdown. But just a day after completing the medicines (ten days) I began having a runny nose in the morning again. Last night I experienced a mild cough with a bit runny nose but no difficulty breathing. Today, I experienced a runny nose and sneezing again. It went away after a while but is back up again. I did not take any cold drinks and no direct air from AC. I also changed bedding every week.

Thank you.



Welcome to

You must continue the Montelukast 10 mg, Levocetirizine 5 mg, and Fluticasone nasal spray for another two weeks. Thereafter you need to reduce the frequency of medicines which we will review then because the problem is not completely cured. Do you have mometasone furoate nasal spray instead of the fluticasone spray? You need a nasal spray for a long duration, the spray should continue even after the tablets get stopped so that the problem does not recur. Is there any offending agent in your house? Any new pet or new habit? Are there any thick curtains or upholsteries in the house?

Thank you.

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