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Nasal Steroid Sprays for Allergies

Flonase, Nasonex, Veramyst, Omnaris, Rhinocort and Nasacort for Allergies

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Updated April 11, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

What Are Nasal Steroids?

Nasal steroids are a commonly used medication to treat the symptoms of allergic rhinitis (also called hay fever). These medications work by decreasing the allergic inflammation within the nasal passages, and treat symptoms such as sneezing, itchy nose, runny nose, congestion and post-nasal drip. Since steroids generally take many hours before they begin to work, nasal steroids do not work well on an "as-needed" basis, and therefore need to be used routinely for best effect.

Most studies show that nasal steroids are the single most effective medicine available for the treatment of nasal allergies. In fact, many studies show that nasal steroids are better at treating allergy symptoms than oral antihistamines, nasal antihistamine sprays or Singulair. Nasal steroids are also particularly good at treating symptoms of eye allergies.

Which Nasal Steroid Is Best to Use?

There are a number of nasal steroids available, all by prescription only. There are two generic versions, called fluticasone propionate (formerly marketed under the brand name Flonase) and flunisolide (formerly marketed under the brand name Nasarel). There are also a number of brand name nasal steroids, including Nasonex (mometasone), Veramyst (fluticasone furoate), Nasacort AQ (triamcinolone), Omnaris (ciclesonide) and Rhinocort (budesonide).

Studies comparing the efficacy of the different nasal steroids show no particular differences from one to another, although there are certain subtleties between the nasal steroids that may result in a person choosing one over another. It is certainly possible that a person finds that one of these nasal steroids works better or causes fewer side effects than another.

Flonase (also available as generic fluticasone propionate)

Advantages: Available in generic form (lower cost), also approved by the Food and Drug Administration (FDA) to treat non-allergic rhinitis.

Disadvantages: Flowery smell bothers some people, contains an alcohol preservative that may cause irritation in some people.

Nasarel (also available as generic flunisolide)

Advantages: Available in generic form (lower cost).

Disadvantages: Needs to be used 2 to 3 times a day for best effect.

Nasonex

Advantages: FDA approved for children as young as 2 years of age, FDA approved for the treatment of nasal polyps, generally the lowest cost brand name nasal steroid.

Disadvantages: None to my knowledge.

Veramyst

Advantages: FDA approved for children as young as 2 years of age, multiple studies show consistent benefit for the treatment of eye allergies (although not currently FDA approved for this reason).

Disadvantages: High cost.

Nasacort AQ

Advantages: FDA approved for children as young as 2 years of age.

Disadvantages: High cost, generally poor medical insurance coverage.

Omnaris

Advantages: Fewer steroid side effects since medication is a pro-drug, less nasal irritation given the lack of benzalkonium chloride as a preservative (present in all other nasal steroids).

Disadvantages: High cost, generally poor medical insurance coverage.

Rhinocort Aqua

Advantages: Preferred nasal steroid during pregnancy (pregnancy category 'B' risk).

Disadvantages: High cost, generally poor medical insurance coverage.

Learn more about the use of nasal sprays for the treatment of allergies.

Sources:

Wallace D, Dykewicz M, editors. The Diagnosis and Management of Rhinitis: An Updated Practice Parameter. J Allergy Clin Immunol 2008;122:S1-84.

Flonase package insert. GSK Corporation. Website accessed January 30, 2011.

Nasonex package insert. Merck Corporation. Website accessed January 30, 2011.

Nasacort package insert. Sanofi Aventis Corporation. Website accessed January 30, 2011.

Veramyst package insert. GSK Corporation. Website accessed January 30, 2011.

Omnaris package insert. Sepracor Corporation. Website accessed January 30, 2011.

Rhinocort AQ package insert. Astra Zeneca Corporation. Website accessed January 30, 2011.

DISCLAIMER: The information contained in this site is for educational purposes only, and should not be used as a substitute for personal care by a licensed physician. Please see your physician for diagnosis and treatment of any concerning symptoms or medical condition.

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