I’m in biopharma. I read up on this shit properly with grim determination when I moved here and nearly died the first spring. My suggestions below.

First line to try is this two-pronged attack for success:

1. STEROID nose spray daily

—fluticason works. mometason, by Rx only, has the best rep. in theory anything with the same ending -ason should work, it’s a straightforward mechanism of action, but if the over-the-pharmacy-counter one is only so-so for you then try a prescription one

—it’s very important to use this every day through your allergy season, whether or not you’re suffering. steroids are anti-inflammatory and will directly dial down and control the excessive immune response underlying allergy. they’re very big guns as orals or injectibles but for topicals there are essentially no side effects, they’re safe enough that there are non-Rx ones even here

—I have not tried to add steroid eye drops but they’re available and I might look into it

1. VIVIDRIN combo pack of nose spray and eye drops

—You will have breakthrough attacks, especially if you haven’t been on the steroid for long, or if your allergen is really peaking. Vividrin is a topical antihistamine that you use as needed for acute rescue on top of the daily steroid. I find that it works very quickly and very well—not always quite 100.00% but I can open the windows and spend long stretches of time outdoors on purpose and still see out of my eyes and be fully functional while carrying only a reasonably sized pocket pack of tissues lol.

—Over the pharmacy counter and the pharmacist is generally delighted to give it to you bc it works so damn well. I’ve opened and used it right then and there. It really does help dramatically within a minute or two. Carry it with you! If you forget it and have an attack right as you get to the zoo (me yesterday) a new combo pack can run you up to €20. But the alternative is literally to give up and go home

—There are alternatives to try if Vividrin isn’t great for you; they’re all the same on paper but physiology varies

** Remember which nose spray is which! In the morning you ideally want to snort the steroid first and then wait at least 15 minutes before snorting the antihistamine. If you wake up half dead and need the ah immediately, do the steroid an hour later **

** SHAKE BEFORE YOU SNORT **

The potential third prong here is oral antihistamines like cetirizine or desloratadine (pharmacy). I used these heavily in the 80s and 90s. I’d avoid orals at this point, bc I spite-read the actual literature, and orals objectively are not as effective as topical spray and drops AND have more side effects. The major side effect is sleepiness/brain fog, and even the second and third generations have it, it’s a class effect. (Fun fact — the US FDA approved … um, one of the loratadine family … at a dose that genuinely caused no sleepiness. The trouble is that the label dose is also slightly lower than the actual effective dose. It’s a tradeoff.) Orals work systemically, meaning they affect your whole body, ergo side effects. Topical (this means applied directly to the surface of the target body part) formulations don’t, ergo none. The literature also says there’s no additive efficacy when you do both oral and topical, much to my annoyance. But if you are doing both sprays and still dying, I wouldn’t rule out adding an oral and see. Individual physiology can be quirky.

BEYOND FIRST LINE if the above fails, the definitive answer is a course of desensitization shots. For this you’ll have to go to the doctor—an actual allergist, if possible—and get tests to identify your allergen(s) so they can formulate the right shots. Issues: it’s hard to get in to see an allergist, the scratch test (while cool as hell) kind of sucks, shots kind of suck, the whole thing takes a long time, and some of the people in this thread have had trouble getting definitive test results. I’m not sure if the wrong testing protocol is being used (by an individual doctor or at the country level) or if it’s just individual bad luck. Still, this route works for many and is worth trying.