Tom is a 19 year old biomedical student who has come to see you as he is troubled with nasal problems. He reports that every year about this time (Spring) he develops a runny nose, sneezes a lot and finds his nose very itchy. His symptoms are more prominent when out running. He has managed his symptoms in the past with nasal douching, but this year it is particularly bad and he has some very important university exams in a few weeks so would like some medication. Tom informs you he also has mild Eczema but is otherwise fit and well. He is a non-smoker and does not drink any alcohol.

Tom requests a medication to take ‘as and when’, as his symptoms are predictable and he does not want regular medication.

What is the most appropriate first line treatment option?

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