Doctor Discussion Guide

From simple lifestyle changes to medicines, there are a number of ways to treat nasal allergy symptoms. Talk to your healthcare professional at your next visit about how you can best manage your symptoms.

 

Use this interactive checklist to create a personalized Doctor Discussion Guide to take to your next appointment. Simply type in your answers to each question below (your answers will not be saved or shared) — when you're done, you can print out your answers or email them to yourself.

If you would rather fill this out on paper, you can download a printable PDF of the Doctor Discussion Guide now.

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I suffer from the following symptoms:
Sneezing
Itchy nose
Stuffy nose (congestion)
Runny nose
Other   
 
I suffer from allergy symptoms during the:
Spring
Summer
Fall
Winter
 
My allergy symptoms are triggered by:
Trees
Weeds
Grass
Mold
Dust
Animals
 
Other family members who suffer from allergies include:
A spouse
A child/children
Other family member
No one else, only me
 
I've used the following prescription allergy medicines:
Allegra®
Clarinex®
Flonase®
Nasacort AQ®
Nasonex®
Rhinocort Aqua®
Singulair®
Veramyst®
Xyzal®
Other (enter product name)   
 
I've used the following over-the-counter medicines:
Afrin®
Benadryl®
Claritin®
Sudafed AQ®
Zyrtec®
Other (enter product name)   
 
Other questions I'd like to ask my healthcare professional:
 



Your answers will not be saved or shared.
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OMNARIS (ciclesonide) Nasal Spray is for the treatment of nasal allergy symptoms associated with seasonal allergic rhinitis (seasonal allergies) in adults and children 6 years of age and older, and with perennial allergic rhinitis (year-round allergies) in adults and adolescents 12 and older.

Important Safety Information

Patients using corticosteroid drugs that weaken the immune system are more susceptible to infection and should avoid exposure to chickenpox or measles. If you have tuberculosis, eye herpes, or untreated infections of any kind, speak to your doctor before using OMNARIS. Yeast infections of the nose and throat may occur.

Patients who have recently had an ulcer in the nose, trauma to the nose or nasal surgery should not use OMNARIS until healing has occurred. Rare instances of nasal irritation and eye problems have been reported following the use of nasal steroids. Talk with your doctor if you have a history of eye problems or experience a change in vision.

Patients taking higher doses of a nasal steroid than recommended, or certain other at-risk individuals, may experience symptoms of a hormonal imbalance, including very rarely changes in menstruation, acne, and weight gain. Like all steroid nasal sprays, OMNARIS may cause slowed growth in children. The growth of children using OMNARIS should be monitored routinely by a healthcare professional.

The most common side effects that may occur with OMNARIS are headache, nosebleed, sore throat and ear pain.

The health information contained on this website is provided for educational purposes only and is not intended to replace discussions with a healthcare professional. The product discussed on this site may have different product labeling in different countries. All decisions regarding patient care must be made with a healthcare professional, considering the unique characteristics of the patient.

For more information, please see the OMNARIS Full Prescribing Information and the OMNARIS Patient's Instructions for Use.

OMNARIS is available by prescription. Ask your healthcare professional if OMNARIS is right for you. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

The health information contained on this website is provided for educational purposes only and is not intended to replace discussions with a healthcare professional. This site is intended for U.S. residents only. The product discussed on this site may have different product labeling in different countries. All decisions regarding patient care must be made with a healthcare professional, considering the unique characteristics of the patient.

©2010 Sepracor Inc.and SEPRACOR are registered trademarks of Sepracor Inc.

OMNARIS is a registered trademark of Nycomed GmbH, used with permission.

Sepracor

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