How to deal with a recurring mild nighttime cough?

Hi doctor,

I am a 33-year-old male seeking advice about a recurring mild cough at night, along with sneezing and a runny nose in the morning that typically resolve by lunchtime. I recently saw a pulmonologist for a severe cough and was prescribed antibiotics, an anti-histamine for the morning, Seretide (Salmeterol and Fluticasone combination) oral spray, and nebulizer medication. After completing the treatment, the cough, sneezing, and runny nose improved for a few days but then returned. The pulmonologist had prescribed the anti-histamine due to concerns about an allergic reaction.

Currently, I am only taking vitamin C tablets and ginger daily, and I am not using any other medications. Last night, I experienced a mild cough again and used the Seretide (Salmeterol and Fluticasone combination) oral spray due to slight breathing discomfort. I am unsure what could be causing my allergic reactions, as I have no known food allergies. I sleep with a jacket due to air conditioning, and I share the room with my partner and a 2-year-old child. I do not have a fever or symptoms of COVID-19. Due to a lockdown in my area, I cannot consult an allergist. I hope you can help resolve this recurring issue.

Kindly help.

Hi doctor,

Thank you for the reply.

Is it possible to get a proper prescription? Apparently, I lost my previous prescription list from the pulmonary doctor. Could you also include how long I should use the steroidal nasal spray and other medications?

Hi doctor,

Thank you for the reply.

You forgot to mention the concentration of the nasal spray, as it comes in several options. Also, Budesonide and Albuterol inhalers are not available at my local drug store. Please specify the concentration of the nasal spray. Additionally, provide alternatives to Budesonide and Albuterol, including their specifications and concentrations. We have a nebulizer that we can use if inhalers are unavailable.

Should I stop using the Seretide (Salmeterol and Fluticasone combination)25 mcg metered-dose inhaler suspension, or can it be used as an alternative to Budesonide? I currently use it when experiencing difficulty in breathing. It seems like my asthma may be returning due to the mild cough and sneezing. I need to puff at least once daily with Seretide (Salmeterol and Fluticasone combination). As of now, I have not had an attack yet.

Hi doctor,

Thank you for the reply.

I believe the treatment was quite effective, as I did not experience any allergy symptoms after just three days. I have not had to use the nebulizer since Seretide (Salmeterol and Fluticasone combination) has been sufficient. I also have not used the nasal spray because I have not had the chance to buy it due to the lockdown. However, just a day after completing the ten-day course of medication, I started experiencing a runny nose again in the morning. Last night, I had a mild cough with a bit of a runny nose but no difficulty breathing. Today, I experienced a runny nose and sneezing again, which initially went away but has returned. I have avoided cold drinks and direct air from the air conditioner, and I change my bedding every week.

Thank you.