By Beth Coopman, Pharm. D.
In this three-month series of articles, we’ve been tackling the topic of seasonal allergies, giving you some tips and tricks to stay ahead of your allergy symptoms and keep you as healthy as possible.
You can revisit April’s article about allergen prevention and oral antihistamines by clicking here. This month we focus on nasal spray options for helping with allergy symptoms.
Flonase, Rhinocort, Nasonex and Nasacort are examples of steroid nasal sprays and a great starting point for addressing and minimizing uncomfortable allergy symptoms like sinus congestion, sneezing, itchy or runny nose and itchy/watery eyes.
In fact, for persistent allergy symptoms, nasal steroids are the most effective option. They all work similarly, have generic options and, excepting Nasonex, are available over-the-counter (OTC). Generic nasal steroids are comparable to brand name products and save you money.
For those with extra nasal sensitivities, Flonase Sensimist, Nasacort and Rhinocort are all scent- and alcohol-free. Flonase Sensimist and Rhinocort also have less liquid per spray, resulting in less nasal drip.
To limit nosebleeds and irritation, nasal sprays should be pointed slightly away from your septum (the middle hard part of your nose). The alternate-hand method of administration, spraying your left nostril with your right hand and your right nostril with your left hand, naturally tilts the nasal spray away from your septum to promote proper technique.
There are notable differences between using oral antihistamine allergy medications versus nasal steroids.
Nasalcrom and Afrin are other popular allergy nasal sprays.
Afrin works quickly and is effective for congestion. However, Afrin should only be used for up to three days, as directed on the label. If used longer, recurrent and worsening nasal congestion may occur. Oral decongestants may be a better option due to the challenges with Afrin’s dosing guidelines.
Nasalcrom prevents sneezing, allergic sinus congestion and runny or itchy nose and should be started one to two weeks before allergen exposure. Nasalcrom is most useful for those with inadequate congestion relief with other treatments or if parents have safety concerns using other allergy medications.
Nasal saline solutions can be used to for nasal allergy symptoms to clear the nose of mucus, relieve nasal irritation and dryness. All ages can use nasal saline and because it has few side effects, it is a good first choice in pregnancy, breastfeeding and children with allergy-related sinus congestion.
Brand Name |
Generic Name |
Age Allowed |
Onset of Effect |
Peak |
Duration |
Common Side Effects |
Cost/Bottle |
Flonase ClariSpray |
Fluticasone Propionate |
≥ 4 yrs |
12 hrs |
2 weeks |
24 hrs |
Headache Nose irritation Bloody nose |
$14 |
Flonase Sensimist |
Fluticasone Fumarate |
≥ 2 yrs |
12 hrs |
2 weeks |
24 hrs |
Headache Bloody nose |
$23 (no generic) |
Nasonex Rx only |
Mometasone Rx only |
≥ 2 yrs |
12 hrs
|
2 weeks |
24 hrs |
Headache Bloody nose |
$50 |
Nasacort |
Triamcinolone |
≥ 6 yrs |
12 hrs
|
2 weeks |
24 hrs |
Bloody nose Sore throat |
$13 |
Rhinocort |
Budesonide |
≥ 2 yrs |
12 hrs |
2 weeks |
24 hrs |
Bloody nose Sore throat |
$14 |
Afrin |
Oxymetazoline |
≥ 6 yrs |
rapid |
15 min |
12 hrs |
Nasal burning or stinging |
$4 |
Nasalcrom |
Cromolyn |
≥ 2 yrs |
1 wk |
2-4 weeks |
6-8 hrs |
Nasal stinging sneezing |
$18 |
Ocean Saline |
Sodium Chloride 0.65% |
All |
rapid |
rapid |
4-6 hrs |
Nasal discharge Nasal burning |
$4 |
*Reference: Micromedex® and pricing estimates from Walmart.com and Goodrx.com
** Cost listed is for generic product and cost decreases per dose as package size increases.
Be an informed health care consumer. Know how your prescription choices impact your plan’s costs. Ask your doctor or pharmacist about cost alternatives for your prescriptions or OTC selections. If you have any questions pertaining to this article, email the pharmacy team at pharmacists@networkhealth.com.