Allergies · Allergic rhinitis

Allergy care that actually reads your chart before adding another medication.

Clara's AI checks your allergy history and medication interactions, then builds a stepwise plan in seconds.

Eyes itching, sneezing nonstop, congestion since the trees started blooming. Zyrtec helped last year but not now.

Clara

You started cetirizine two weeks ago with tree-pollen sensitivity and mild asthma on file. Intranasal steroids outperform antihistamines for congestion, so adding daily fluticasone 50 mcg (2 sprays each nostril) is the highest-yield next step. Sending to our doctor.

Can I keep taking Zyrtec with the nasal spray?

How it works

Stepwise allergy care that knows what you've already tried.

Describe your allergy pattern

Tell Clara the symptoms, the trigger (seasonal, pet, indoor), when it started, and what you've already tried. Clara auto-pulls your med list, prior allergy diagnoses, and asthma history from 150,000+ connected records.

Chart-aware stepwise plan

Clara's AI works through the allergy ladder (antihistamine, intranasal steroid, antihistamine eye drops, nasal antihistamine, leukotriene modifier) and picks the next step based on what you've already tried, your asthma status, and your interactions.

Clinical sign-off or referral

A licensed physician reviews the plan and signs off on prescriptions. If your pattern suggests allergic asthma that's poorly controlled, or if you'd benefit from allergen immunotherapy, Clara refers you to an allergist.

Treatments

First- and second-line allergy medications, chosen against your history.

Rx · First-line daily

Fluticasone propionate nasal spray

50 mcg per spray, 2 sprays each nostril daily. Intranasal corticosteroids are the single most effective class for allergic rhinitis, outperforming antihistamines on congestion, eye symptoms, and overall quality of life¹. Works in a few days, peaks in 2 weeks.

~50%

Symptom reduction vs placebo (intranasal steroids)¹

OTC · First-line

Second-generation oral antihistamines

Cetirizine (Zyrtec), loratadine (Claritin), fexofenadine (Allegra), or levocetirizine (Xyzal) 10 mg daily. Minimal sedation compared to diphenhydramine. Clara checks your chart for the one you haven't tried yet before recommending a switch.

Daily

Non-drowsy, once-daily dosing

Rx · Add-on

Azelastine nasal spray

Topical antihistamine nasal spray, 1–2 sprays each nostril twice daily. Fast onset (~15 min). Stacks well with fluticasone when a single agent isn't enough. Combo fluticasone + azelastine is an evidence-based maximum-medical-therapy regimen for resistant allergic rhinitis.

15 min

Typical onset of action

OTC · Eye symptoms

Olopatadine eye drops

Antihistamine/mast-cell-stabilizer eye drops for allergic conjunctivitis (itching, redness, watering). Available OTC (Pataday). Works faster than oral antihistamines for eye symptoms alone.

OTC

For itchy, watery eyes specifically

Rx · Adjunct

Montelukast (Singulair)

10 mg daily. Useful when allergic rhinitis coexists with mild asthma, since it treats both. Carries an FDA boxed warning for neuropsychiatric effects; Clara discusses this explicitly before prescribing². Not a first-line monotherapy for rhinitis.

Caution

Boxed warning discussed before Rx

Supportive · Referral

When Clara refers you to an allergist

If year-round symptoms persist on maximum medical therapy, if allergic asthma is poorly controlled, if you want allergen-specific skin or blood testing, or if you're a candidate for sublingual or injection immunotherapy, Clara refers you to an allergist and keeps the plan in sync across providers.

Refer

For testing & immunotherapy

Why Clara

Allergy care that knows what you've already tried, and what not to stack on top of it.

	Clara	Teladoc	CVS MinuteClinic Virtual	Amwell	Your doctor
AI response time	✓ Instant, 24/7	Scheduled video	Clinic hours	Scheduled video	Days–weeks
Reads your chart & prior allergy meds	✓	Intake only	Portions of records	Intake only	If your PCP
Coordinates allergy ↔ asthma care	✓ One AI, one plan	Different visit	Different visit	Different visit	If your PCP
Cost	Free to start; $25/mo membership for Rx & labs	Variable; often through employer	$107–$164 out of pocket	~$80–$100 per visit	$150+ copay
Prescription may be covered by your insurance	✓ Sent to your pharmacy	✓	✓	✓	✓
Referral to an allergist when warranted	✓ Tracked in your chart	Limited	Limited	Limited	✓
Full primary care access	✓ One membership	Separate	Per-visit only	Separate	✓

The AI difference

Allergy care is a ladder. The AI that already knows what rung you're on is the one that matters.

"Here's an antihistamine" is the easy answer. The real question is: which one haven't you tried, does your asthma need to move in step, are you about to stack montelukast on a patient with anxiety, and is there a pattern Clara should spot. That's a data-and-reasoning problem.

Knows the ladder and where you are on it

Clara has your last 3 years of antihistamine refills and your prior fluticasone trial in the chart. Your old doctor might ask "have you tried Zyrtec?" — Clara already knows the answer and the date.

Allergy + asthma as one plan

If your tree-pollen season correlates with an albuterol spike in your chart, that's allergic asthma and the rhinitis plan shouldn't stand alone. Clara coordinates both in one message.

Interaction and warning awareness

Clara will surface the montelukast neuropsych warning, flag first-generation antihistamines in older patients, and check that a nasal steroid doesn't conflict with your glaucoma or other conditions. Drug warnings shouldn't depend on the provider remembering.

Common questions

Allergy questions patients ask.

What does Clara cost?

It's free to connect your medical records and start chatting with Clara. If you want Clara to provide medical advice, prescribe medications, or order labs, plans start at $25/month. All plans are HSA/FSA eligible. The cost of medications and lab work is separate and may be covered by your insurance.

How is Clara different from Teladoc, CVS MinuteClinic, or my regular doctor?

Teladoc and CVS MinuteClinic can both write an allergy prescription, but they don't hold your longitudinal chart. Each visit is a per-encounter intake with whichever provider is online. Your regular doctor can hold your chart but probably can't answer a tree-pollen question at 9pm. Clara is the AI that holds the chart continuously, knows which antihistamines you've already tried, and picks the next step on the allergy ladder. Our doctor signs off on prescriptions. Can your old doctor read your entire chart every time you message them? Clara can.

Should I use an antihistamine or a nasal steroid?

Both have their place. For most people with moderate or severe allergic rhinitis, especially with congestion and eye symptoms, an intranasal corticosteroid like fluticasone is the highest-yield first step¹. A second-generation oral antihistamine can be added if itching or sneezing persists. Clara picks based on your dominant symptoms and what you've already tried.

I already take Zyrtec every day. Why isn't it working anymore?

Antihistamines don't stop working in the classic tolerance sense, but your symptoms can outgrow them as pollen counts climb. Typical next steps are adding a daily intranasal steroid (fluticasone), adding an antihistamine nasal spray (azelastine), or switching to a different second-generation antihistamine. Clara reads your refill history and picks the next rung rather than just doubling the same med.

Are my allergies triggering my asthma?

Often yes. Allergic rhinitis and asthma frequently share triggers, and untreated rhinitis is associated with worse asthma control. If your chart shows albuterol use climbing during pollen season, Clara will ask whether your asthma is flaring and may adjust your asthma plan and your albuterol use in tandem.

Does Clara prescribe montelukast?

Yes, when clinically appropriate. Montelukast carries an FDA boxed warning for neuropsychiatric side effects including anxiety, depression, and suicidal thoughts². Clara discusses that warning explicitly before prescribing, screens for any history of depression or anxiety in your chart, and our doctor reviews every prescription.

Can Clara order allergy testing?

Clara can order allergen-specific serum IgE panels (blood tests) when they're clinically indicated. For skin-prick testing or evaluation for allergen immunotherapy (sublingual tablets or injections), Clara will refer you to an allergist and keep the plan coordinated in your chart.

Is Clara a real medical practice?

Yes. Clara is licensed in all 50 states. Every prescription, lab order, and diagnosis is reviewed and signed off by a licensed physician. Clara's AI handles intake, clinical reasoning, triage, and follow-up; our clinicians provide the medical oversight required by state law.

Can I use Clara for other health issues too?

Yes. Clara is full-service AI-first primary care. One membership covers allergies alongside asthma, colds and sinus infections, acid reflux, chronic conditions, labs, preventive care, and everything else.