Differences, similarities, and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

Runny nose, itchy, watery eyes—‘tis the season for seasonal allergies. If you suffer from seasonal or perennial allergies, you are not sneezing alone. More than 50 million Americans suffer from allergies each year.

Flonase (fluticasone propionate, or fluticasone) and Nasacort (triamcinolone acetonide, or triamcinolone) are two popular medications used for allergy relief. They are in a class of medications called glucocorticoids, more commonly known as steroids. Nasal steroids work by decreasing swelling and congestion in your nose, improving symptoms. Although both medications are known as steroids, they do have some notable differences, which we will outline below.

What are the main differences between Flonase and Nasacort?

Flonase (fluticasone) and Nasacort (triamcinolone) are both nasal corticosteroids used to treat allergies. Several years ago, both drugs were only available with a prescription, but now are available over-the-counter (OTC). Both drugs are available in adult and children’s formulations.

Flonase still available as a prescription drug, as its generic, fluticasone. Flonase is also available in a “Sensimist,” in adult and children’s formulations, which delivers a more gentle mist. Both drugs can be used in children and adults, but Nasacort can be used in children 2 years and older, while Flonase can be used in children 4 years and older.

Conditions treated by Flonase and Nasacort

Flonase and Nasacort are used to treat symptoms of nasal allergy. Both drugs can be used for seasonal or perennial allergy symptoms. Flonase and Nasacort can also be used off-label for several conditions like nasal polyps and chronic or viral rhinosinusitis (or bacterial rhinosinusitis in addition to antibiotics).

Is Flonase or Nasacort more effective?

A recent study found after 28 days of treatment that Flonase and Nasacort are similarly effective in treating nasal allergy symptoms and are both well-tolerated. Another study showed that Flonase and Nasacort are equally safe, effective, and well-tolerated.

The most effective medication for you should be determined by you, along with your doctor, who can take into account your medical condition(s), history, and other medications you take.

Coverage and cost comparison of Flonase vs. Nasacort

Flonase is typically covered by insurance as well as Medicare Part D in the prescription form of generic fluticasone, but the OTC version is not usually covered. The Medicare Part D copay for generic fluticasone ranges from $0-$20. Flonase can cost over $50 but can be purchased for as low as $12-$29 with a SingleCare pharmacy coupon.

Nasacort is only available OTC and is generally not covered by insurance (some state Medicaid plans may pay for generic) or Medicare Part D. The retail price for Nasacort commonly costs over $20 but you can get it at a participating pharmacy for as low as $13.50 with a SingleCare coupon.

Common side effects of Flonase vs.

Nasacort

Both drugs are well tolerated. The most common symptoms of Flonase are headache, nausea/vomiting, asthma symptoms, and cough. The most common side effects of Nasacort are headache, asthma symptoms, and cough. Other side effects listed for both drugs occurred at around the same frequency as placebo (inactive medication), such as nosebleeds and sore throat.

This is not a complete list of side effects; other side effects may occur. Consult your healthcare provider for a full list of side effects.

Source: DailyMed (Flonase), FDA Label (Nasacort)

Drug interactions of Flonase vs. Nasacort

Flonase is processed by an enzyme called cytochrome-P 450 3A4, otherwise known as CYP3A4. Certain drugs inhibit this enzyme, and slow it down from processing Flonase, leading to a buildup of Flonase, and increased steroid side effects. Therefore, these strong inhibitors should not be taken with Flonase. Nasacort does not have any drug interaction information available. Other interactions may be possible; check with your healthcare provider for medical advice.

Warnings of Flonase and Nasacort

• Localized effects that may occur are nosebleeds, nasal ulceration, local Candida (yeast) infection, nasal septal perforation, and impaired wound healing.
• Steroids may cause glaucoma or cataracts. You should be closely monitored if you have any changes in vision or if you have a history of increased intraocular pressure, glaucoma, and/or cataracts. If you use Flonase or Nasacort long-term or have any eye symptoms, you should follow up regularly with an ophthalmologist.
• If a hypersensitivity reaction occurs (skin symptoms, trouble breathing, facial swelling), discontinue Flonase or Nasacort and seek emergency medical attention.
• Because steroids suppress the immune system, you are more prone to infections while using a steroid nasal spray.
• Children may experience a reduction in growth velocity; growth should be closely monitored. The lowest possible dose, for the shortest duration of time, should be used.
• Rarely, adrenal suppression may occur, and the nasal steroid should be slowly tapered to discontinuation (not stopped abruptly).
• Because there is not enough data about nasal steroids in pregnancy, you should consult with your doctor before taking Flonase or Nasacort if you are pregnant. If you are already taking Flonase or Nasacort and find out that you are pregnant, contact your healthcare provider for guidance.

Frequently asked questions about Flonase vs. Nasacort

What is Flonase?

Flonase is a nasal steroid that can help relieve allergy symptoms. The active ingredient is fluticasone propionate. It is available OTC as a brand and generic, and by prescription in its generic form. It can be used in adults and children ages 4 and older.

What is Nasacort?

Nasacort is a nasal steroid used to help relieve symptoms of allergy. The active ingredient in Nasacort is triamcinolone. It is available OTC in both brand and generic. Nasacort can be used in adults as well as children ages 2 and older.

Are Flonase and Nasacort the same?

Flonase and Nasacort are very similar and have many of the same uses and warnings. However, they have some notable differences, such as in the active ingredient, drug interactions, and price, as outlined above. Other medications in the nasal steroid category you may have heard of include Rhinocort (budesonide), QNasl (beclometasone), and Nasonex (mometasone). Fluticasone is also available as a combination drug in the form of brand-name Dymista, which contains azelastine along with fluticasone.

Is Flonase or Nasacort better?

Both drugs have been found in studies to be very well-tolerated, and effective in improving symptoms. It may take a bit of trial and error to figure out if Flonase or Nasacort is better for you.

Can I use Flonase or Nasacort while pregnant?

There is not enough data, so it is best to discuss your allergy symptoms with your doctor and see what he/she suggests. It may be safe to take Flonase or Nasacort if needed during pregnancy, but it depends on the individual case, so it is safest to ask your doctor.

Can I use Flonase or Nasacort with alcohol?

Flonase or Nasacort are safe to use with alcohol. However, if you are taking other medications for your allergy symptoms, check with your doctor or pharmacist to see if those medications are compatible with alcohol.

Which nasal allergy spray is most effective?

There are a variety of nasal allergy sprays, and some work in different ways. While drugs like Flonase and Nasacort are steroids, some nasal allergy sprays contain other ingredients such as azelastine, which is an antihistamine and works differently than a steroid. Many people like Afrin nasal spray; however, you have to be very careful to use this medication for only 3 days or less, otherwise it can cause rebound congestion. The most effective allergy spray is the one that works best for you, and it may take some trial and error to determine which allergy spray works best.

Is Nasacort good for sinus infection?

While Nasacort may help relieve some of the nasal symptoms caused by a sinus infection, it will not treat the infection itself. If you have a bacterial sinus infection, you will need to take antibiotics prescribed by your doctor.

Does Flonase help sinus pressure?

Flonase can be very helpful in managing sinus symptoms. However, if the sinus pressure is caused by a bacterial infection, Flonase may help the symptoms but will not clear the infection. If you have a bacterial infection, you will need to take prescription antibiotics.

Are Nasal Steroids Safe

“Steroids.” For many people, even the word is enough to make them recoil. They’ve heard stories from friends and family members about the side effects and want to avoid them if possible.

This is something I hear every day from my patients. But there’s no need to be afraid of nasal steroids. When used properly, nasal steroids are extremely safe and don’t have the same side effects as oral steroids. In fact, they’re one of the safest medications available for patients.

Talk to one of our doctors about whether nasal steroids are a good option for treating your allergies.

How do nasal steroids work?

Nasal steroids relieve inflammation in the nasal airway caused by allergies and other irritants. Inflammation can cause the nasal passages to swell. Nasal steroids, like other forms of steroids, have the following benefits:

• Decrease inflammation
• Reduce swelling
• Reduce the upper respiratory system’s production of inflammation-causing chemicals  

Doctors prescribe nasal steroid sprays to help patients breathe through the nose. These nasal steroid sprays are different than saline or other nasal sprays available at the drugstore. Saline sprays rinse and moisturize the interior of the nose, but they don’t treat swelling or inflammation like nasal steroids do.  

We also use nasal steroid sprays to reduce swelling caused by benign, or noncancerous, polyps inside the nose or sinuses. Though we don’t know the exact cause of nasal polyps, they appear to be more likely to develop in people who have long-term swelling from allergies, asthma or infections.

How are nasal steroids different from oral steroids?

I have patients who are afraid to take nasal steroids when I prescribe them. They tell me they have family members or friends who have taken steroids and had problems with them. These patients don’t want that to happen, so they don’t take their prescribed medication, and their allergies continue to bother them.  

Nasal steroids are much safer than oral steroids because they work differently. Oral steroids, or steroids taken by mouth, are what we call systemically active medications. That means they work throughout the whole body, not just where you have a particular condition.  

For example, a doctor may prescribe an oral steroid for a patient with rheumatoid arthritis. The medication works by reducing inflammation and swelling in the patient’s arthritic joints. But oral steroids’ effects work everywhere in the body, not just the problem areas. This can lead to some of the side effects many people associate with steroids, including:

• Decreased healing after injuries
• Easy bruising of the skin
• Increased chances of infections
• Weight gain  

But nasal steroids aren’t systemically active drugs. They’re what we call topical medications. Topical medications are those applied directly to the area being treated. They don’t affect the whole body, like systemically active medications do. Topical medications like nasal steroid sprays work where you put them and nowhere else. 

Flonase vs Nasonex: Differences, Similarities & What’s Best for You – Drug Vs. Friend

Home >> Drug Vs. Friend >> Flonase vs Nasonex: Differences, Similarities & Which is Best for You

Drug Vs. Friend

Drug Overview and Key Differences | Conditions of treatment | Efficiency | Insurance coverage and cost comparison | Side effects | Drug Interactions | Warnings | FAQ

Do you suffer from nasal congestion or runny nose, sneezing, itching and watery eyes? If so, you may be one of the 50 million Americans with allergies each year. Flonase (fluticasone) and Nasonex (mometasone) are two FDA-approved nasal sprays used to treat nasal allergy symptoms. They are known as glucocorticoids or more commonly known as steroids. They reduce inflammation and nasal congestion, thereby relieving allergy symptoms. Both drugs are known as nasal steroids, but there are some notable differences between Flonase and Nasonex, which we describe below.

What are the main differences between Flonase and Nasonex?

Flonase (fluticasone) is a nasal corticosteroid, or more commonly referred to as a nasal steroid. It is available by prescription in generic form, as well as over-the-counter branded and generic versions. The branded over-the-counter product is called Flonase Allergy Relief Spray and is available for both adults and children. It is also available as Flonase Sensimist mild spray for both adults and children. Flonaz can be used in adults and children 4 years of age and older.

Nasonex (mometasone) is also a nasal steroid. It is available in brand-name and generic forms by prescription only. It can be used in adults as well as in children over 2 years of age.

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Main differences between Flonase and Nasonex
	Flonase	Nasonex
Drug class	Nasal corticosteroid	Nasal corticosteroid
Brand/generic status	OTC: brand and generic Rx: Generic	Rx: brand and generic
What is the common name?	Fluticasone propionate	Mometasone furoate
What form(s) does the drug come in?	OTC: Flonase Allergy Relief nasal spray (adults and children) Flonase Sensimist Nasal Spray (adults and children) Prescription: Fluticasone Generic	Nasal Spray
What is the standard dosage?	Adults: 2 sprays (50 mcg per spray) in each nostril per day. or 1 spray in each nostril twice daily Adolescents and children 4 years and older: 1 spray in each nostril per day (may temporarily increase to 2 sprays in each nostril per day and decrease again after symptoms resolve)	Adults: 2 sprays (50 mcg per spray) in each nostril once a day. Children 2 to 11 years: 1 spray in each nostril once a day
How long does a typical treatment last?	Short-term or long-term (depending on symptoms and doctor’s advice) *consult your doctor if your child needs treatment for more than 2 months per year	Short-term or long-term (depending on symptoms and doctor’s advice) * talk to your doctor if your child needs treatment for more than 2 months a year
Who usually takes this medicine?	Adults, adolescents, children 4 years of age and older	Adults, adolescents, children 2 years of age and older

Conditions treated with Flonase versus Nasonex

Flonase is indicated for the treatment of nasal symptoms of seasonal or perennial non-allergic rhinitis (inflammation of the nose) in adults and children 4 years of age and older. Non-allergic rhinitis is a condition in which you have nasal symptoms that resemble allergies or hay fever, but the cause of these symptoms is unknown. Flonase is also used off-label for several other conditions described below.

Nasonex is used to treat the nasal symptoms of seasonal and perennial allergic rhinitis in adults and children 2 years of age and older. It is also used to prevent seasonal allergies in adults and children 12 years of age and older, and to treat nasal polyps in adults and children 18 years of age and older. Nasonex is also used off-label, as discussed below.

Condition	Flonase	Nasonex
Treatment of nasal symptoms of seasonal or perennial non-allergic rhinitis	Yes (4 years and older)	Off label
Treatment of nasal symptoms of seasonal and perennial allergic rhinitis	Off-label	Yes, 2 years and older
Prophylaxis (prevention) of seasonal allergic rhinitis.	Off-label	Yes, ages 12 and over
Treatment of nasal polyps	Off-label	Yes, ages 18 and over
Acute bacterial infections nosinusitis in combination with antibiotics	Off-label	Off label
Relief of symptoms of viral rhinosinusitis	Off label	Off label
Chronic rhinosinusitis	Off label	Off label

Is Flonaz or Nasonex more effective?

In a three-month study comparing flonase and nasonex in 459 patients (age 12-77 years) for chronic rhinitis, both drugs were equally effective and well tolerated.

Another, smaller eight-week study of 75 patients with allergic rhinitis came to the same conclusion: Flonase and Nasonex are equally effective in treating allergy symptoms.

The most effective medicine for you can only be determined by you and your doctor, who can take into account your condition(s) and medical history, as well as other medicines you are taking.

Coverage and Cost Comparison of Flonase and Nasonex

Flonase is generally covered by most insurances and Medicare Part D in its generic form, fluticasone. Various over-the-counter versions of the branded Flonase are generally not covered by insurance. Nasonex is usually covered by most insurance plans and Medicare Part D in its generic mometasone. The brand name of each drug may not be covered or may be covered by a higher copay.

You can get generic Flonase for about $11 and generic Nasonex for just $13.50 with a SingleCare coupon.

	Flonase	Nasonex
Usually covered?	OTC: no Rx: yes	Yes, universal
Usually covered by Medicare Part D?	OTC: no Rx: yes	yes, universal
Standard dosage	1 block	1 block
Typical Medicare Part D copay	$0-20	$15-145
Cost SingleCare	$11-29	$13. 50 and up

Common Side Effects Flonase and Nasonex

Both Flonase and Nasonex are well tolerated by patients. The most common symptoms of both drugs are headache, asthma symptoms, nausea/vomiting, and coughing. Other side effects listed for both drugs occurred with the same frequency as placebo (inactive drugs), such as nosebleeds and sore throats.

Other side effects may occur. Check with your healthcare provider for a complete list of side effects.

	Flonase	Nasonex
34	Applicable?	Frequency	Applicable?	Frequency
Headache	yes	6.6% -16.1%	yes	26%
Nausea/vomiting	yes	yes	2-5%
Cough	yes	3. 6% -3.8%	yes	7%
90 032 Asthma symptoms	yes	3.3% -7.2%	yes	2-5%

Source: DailyMed (Flonase), DailyMed (Nasonex)

Flonase and Nasonex drug interactions

Both Flonase and Nasonex are processed or metabolized by the cytochrome P 450 3A4 enzyme, also known as CYP3A4. This enzyme is involved in the metabolism of many drugs. Some medications can inhibit this enzyme and slow down the processing of the enzyme by flonase or nasonex, which can lead to nasal steroid accumulation and cause an increase in the side effects of steroids. Therefore, strong inhibitors of CYP3A4 should generally not be taken in combination with flonase or nasonex, since together they may increase the side effects of flonase or nasonex.

Other interactions are possible. Consult your physician for medical advice.

Flonase and Nasonex warnings

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Nasal steroids may cause local effects, including epistaxis, nasal ulcers, local Candida (yeast) infections, nasal septal perforation and impaired wound healing.

Adrenal suppression is a rare condition that can occur. If this occurs, the nasal steroid should be tapered off gradually until discontinuation (never stop steroids abruptly).

Frequently asked questions about Flonase and Nasonex

What is flonase?

Flonase is a nasal steroid used to treat nasal allergy symptoms. It can be used in adults and children aged 4 years and older. It is available both by prescription and over-the-counter.

What is Nasonex?

Nasonex is a nasal steroid used to treat nasal allergy symptoms in adults and children 2 years of age and older. It can also be used to treat nasal polyps in patients 18 years of age or older and to prevent allergy symptoms in patients 12 years of age or older. It is available by prescription only.

Are Flonaz and Nasonex the same thing?

Flonase and Nasonex have a lot in common. Both are nasal steroids that are used to treat nasal allergy symptoms. They also have several differences, such as indications for use, availability and price. Other nasal steroids you may have heard of include Nazacort (triamcinolone) and Rhinocort Allergy (budesonide), as well as Dimista, which includes a nasal steroid (fluticasone) as well as an antihistamine (azelastine).

You can compare other allergy medicines on the following pages:

• Flonas vs Nasacort
• Dimista vs Flonase
• Rinocort vs Flonase
• Afrin vs Flonase

9 0447 Which is better: Flonaz or Nasonex?

Flonaz or Nasonex appear to be equally effective in relieving nasal symptoms, both drugs being well tolerated. You can ask your doctor to help you decide which drug might be best for you – sometimes it takes trial and error to figure out which drug is best for you.

Can I use Flonase or Nasonex during pregnancy?

Various. Flonaz or Nasonex may be safe to use during pregnancy, although data are limited. Contact your OB/GYN for advice.

Can I use Flonase or Nasonex with alcohol?

Flonaz or Nasonex may be safer alternatives to traditional oral allergy medications if you want to have a couple of drinks. Check with your healthcare provider to make sure alcohol is compatible with any medications you are taking or any medical conditions you may have.

When is the best time to take Flonaz?

Time of day is not important. You can take your daily dose in the morning or evening. It is best to choose a time at which you will always remember to take Flonase daily.

Is Flonase an antihistamine or decongestant?

Flonase is a nasal steroid that helps reduce inflammation and nasal congestion.

Can you use Nasonex every day?

Nasonex should be used every day as needed for it to work at its best. For example, if you usually have allergy symptoms from April to June, you can start using Nasonex two weeks before you have general symptoms and continue using it every day until your allergy symptoms are gone.