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It is mid-summer and a young woman presents wanting advice about her hay fever. She tells you that while she gets it every year, she is now pregnant (around 18 weeks) and is experiencing really bad symptoms. She has been prescribed desloratadine tablets by the obstetrician at the antenatal clinic but they do not relieve all the symptoms. She has a lot of discomfort: her eyes feel very itchy and her nose is permanently blocked. She wants to know if you can recommend anything that might help.