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Dr. Andrew Rynne

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Have cough and cold. Getting phlegm with metallic taste. On steroids. Proper medication?

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Dr. Sujoy Khan

Allergist and Immunologist

Practicing since :1999

Answered : 584 Questions

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Posted on Sat, 15 Dec 2012 in Asthma and Allergy
Question: I have metallic tasting phlegm, white/clear, runny, no yellow/green. Constant drainage down the back of the throat, with severe cough for over a month. Started with first cold front, then allergies, then cold/flu. Tried a number of over the counter medicine to dry up the drainage. Doctor put me on powerful steriod in capsule form with instructions for each dose for day and time of day, moderate help. The only thing that works is cough drops like Ricola but I cannot take this all day it upsets my stomach after several hours.

YYYY@YYYY
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Answered by Dr. Sujoy Khan 33 minutes later
Hello XXXXXXX
Thanks for writing to us.
Your symptoms would fit in with a perennial rhinitis, that is usually secondary to allergens present all year round. These include house dust mite, animal dander - more relevant if you have pets at home or work with animals.
The constant drainage down the back of your throat is called post nasal drip, that causes an irritating dry cough and disturbed sleep. Fatigue when you wake up in the morning makes you irritable, just affecting performance at work.
You will need to get allergy testing done in the form of skin prick testing or specific IgE blood test so that you're in a better position to avoid the triggers (once they are identified)

Long-acting antihistamines such as Tab. Fexofenadine 180 mg in the morning followed by Nasonex 2 sprays per nostril twice a day to start with (then once daily and on spray per nostril after 4 weeks) is the standard first line treatment.
You must know how to use the nasal spray for best relief.
The spray must be used for 3 months for slightly long term relief. For dust mite allergy, I would recommend that this be taken for 6 months.
You can take an extra Tab. Cetirizine (antihistamine) 10mg tablet later on in the day on top of the Fexofenadine if you need.

I hope this helps.

Best Wishes.

Above answer was peer-reviewed by : Dr. Aparna Kohli
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