I rotate through the first three of the four that 12131 listed above. When I finish the bottle of one type I'll start the next. An allergy dr. recommended that procedure to me long ago and it seems to work well, but I also went through sinus surgery and did allergy shots for years so those have had a tremendous impact on lessening my allergy issues.

My first allergy test was as a teenager. Starting in the late 80s or early 90s I became a daily allergy pill user - loratadine (Claritin), fexofenadine (Allegra), Cetirizine (Zyrtec), and at least one more back in the 90s.

For peak allergy seasons in March/April and August, I had to add fluticasone propionate (flonase) and/or Olopatadine (pataday eye drops). I've tried azelastine (Astepro) but had miserable nose bleeds.

In 2019, I retested for allergies. My worst allergy was dust mites (i.e. indoor allergy that can be present 365 days a year). The indoor allergies were more severe reaction than seasonal outdoor allergies so my old strategy of minimizing outdoors wasn't wise in light of having actual data.

After the allergy testing, I discussed options with my ENT. Instead of shots, I elected to go with the Asensa allergy drops. It was more expensive, but it reduced office visits by one or two orders of magnitude and avoided their customer unfriendly hours for people who work (i.e. no shots over lunch). The drops were daily sublingual, they progressively increased the strength, and I think once every 8 weeks had to pick-up a new bottle.

I completed the Asensa and life is much different. First, I can't remember the last time I took an allergy pill as it's been years. Second, I can't remember the last time I used flonase as it's been years. Third, I go 4 or more months without having to waterboard myself with a netipot. Fourth, I only use one bottle of OTC pataday in March and one again in August (i.e. my peak allergy season).

Allergies been hard on me this year. For the first time ever, I had to go to the doctor to treat a sinus infection and I rarely go to the doctor for anything.