### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My mom is having a very hard time with allergy but is afraid to take anything because she takes so many other medicines. She takes Metoprol Tartrate (50 mg.) Hydroxyurea (500 mg.) Folic Acid (1 mg.) and an aspirin. Can she take a Zertec or Zertec D? My email is YYYY@YYYY

### output:

Hello, Thank you for asking at Chat Doctor. I went through your mothers history and would like to make suggestions for her as follows:1. There are so many types of allergies, so I would like to know more about your mothers symptoms as well as details of the other medications as well as medical disorders. This will help me to make more specific suggestions.2. As you have asked about Zyrtec D (use for allergic rhinitis - nose allergies), I assume your mother has nose allergies - nose obstruction, running nose, sneezing etc. 3. Zyrtec (Cetirizine) usually does not interact with the mentioned medications. However, Zyrtec D contains a decongestant medicine which may not be desirable for heart patients. As your mother taking Metoprolol and aspirin, I assume she might be having some heart-related problem. So, Zyrtec would be safer for her rather than Zyrtec D.4. If your mother has kidney or liver problem, then Zyrtec can cause more side effects. So in that case, necessity as well as dose of Zyrtec should be discussed with your doctor before taking it.5. Another option is to use local nose sprays. Intranasal antihistamine (Elastane) as well as intranasal corticosteroid (Fluticasone propionate or mometasone) are available in market. They act more locally, on nose membrane. As very small portion of these spray enter blood, they usually do not interact with other medications. They have less generalized side effects also.6. If your mother has severe nose congestion, please get her nose examined by an ENT surgeon as long term aspirin use can cause nose polyps. Also, metoprolol can cause nose congestion in some patients. Please discuss these possibilities with your mothers' physician who will review her history and complaints in detail and then decide accordingly.7. Please do not reduce/stop metoprolol and aspirin by yourself as it could be dangerous.8. I would also suggest your mother allergy testing for common air-borne allergens such as house dust mites, pollen, molds, insect proteins, animal dander, etc. This will help her to identify the substances causing allergies to her as well as to know the measures to avoid them.9. In general, I would suggest her to avoid exposure to dusts, smokes and air pollution as much as possible.10. Regular breathing exercises and steam inhalation would also help her in a long run for nose symptoms. Hope above suggestions will be helpful to your mother. Should you have any further query, please feel free to ask at Chat Doctor. Wish your mother the best of the health ahead. Thank you & Regards.