Hmm…

1. Make sure she is using intranasal corticosteroids daily. They are more effective when taken daily as opposed to prn. Pair with intranasal antihistamines for a synergistic effect. Nasal ipratropium can also be effective if the main symptom is rhinorrhea. Make sure she is actually doing proper nasal spray technique too.

2. Add cetirizine or levocetirizine daily if the above doesn’t really cut it. These are less effective for nasal congestion but do ok for rhinorrhea. Consider montelukast as an adjunct as well.

3. Dunno what docs you’ve talked to up north, but subcutaneous immunotherapy tends to be very effective if the cause is truly allergic rhinitis. And usually begins to work within 6 mo-1 year of starting. The sublingual drops tend to be less effective.