Allegra vs. Flonase

See how Allegra and Flonase compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Allegra is an oral antihistamine for allergy symptoms and chronic hives, while Flonase is a nasal spray that also treats nasal congestion and inflammation.

  • Flonase works directly in the nasal passages and covers nonallergic rhinitis, a use Allegra does not have.

  • Flonase's main side effects are local, like nosebleeds and nasal irritation, while Allegra's are systemic, like headache and dizziness.

Allegra vs. Flonase Drug Summary

Allegra

Allegra (fexofenadine) is a second-generation oral antihistamine used to relieve seasonal allergy symptoms and chronic hives. It comes as a tablet, an orally disintegrating tablet, or a liquid, and is taken once or twice daily depending on age and dose.

Flonase

Flonase (fluticasone propionate) is a corticosteroid nasal spray used to treat seasonal and year-round allergic and nonallergic rhinitis. It is sprayed into each nostril daily, working directly on nasal tissue to reduce inflammation and congestion.

Allegra vs. Flonase Side Effects

Allegra

Most common
Headache (up to 2%)
Back pain (up to 2%)
Dizziness (up to 2%)
Stomach discomfort (up to 2%)

Flonase

Most common
Headache (up to 16.1%)
Pharyngitis (up to 7.8%)
Epistaxis (up to 6.9%)
Cough (up to 3.8%)

Allegra vs. Flonase Dosage

Allegra

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 30 mg twice daily At the start
Maximum dose 60 mg once daily If needed
Dose changes 3 increases As tolerated

Flonase

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 200 mcg once daily At the start
Maximum dose 100 mcg once daily If needed
Dose changes 1 increase As tolerated

Allegra vs. Flonase Indications

Allegra

Allegra treats seasonal allergy symptoms like sneezing, runny nose, and itchy or watery eyes. It's also approved for chronic idiopathic urticaria, a form of hives lasting six weeks or longer. Its oral forms suit people who prefer not to use a nasal spray.

  • Seasonal allergic rhinitis (sneezing, itchy, watery eyes)

  • Chronic idiopathic urticaria (hives)

  • Available as tablet, ODT, or oral liquid

  • Approved for ages 6 and older

Flonase

Flonase treats seasonal and year-round allergic rhinitis by reducing inflammation directly in the nasal passages. It's also approved for nonallergic rhinitis, a use oral antihistamines don't cover. It's approved for both adults and children as young as 4.

  • Seasonal allergic rhinitis in ages 4 and older

  • Perennial (year-round) allergic rhinitis

  • Nonallergic (perennial) rhinitis

  • Available as prescription or OTC nasal spray

Allegra vs. Flonase Pros and Cons

Allegra

Allegra is a widely available oral antihistamine with a long safety record and minimal drowsiness. It's approved for both seasonal allergies and chronic hives, giving it broader systemic use than nasal-only treatments. It's also available over the counter at low cost.

Pros

  • Available as tablet, ODT, or liquid form

  • Non-sedating with minimal drowsiness risk

  • Also treats chronic hives, not just allergies

  • Minimal liver metabolism, fewer drug interactions

Cons

  • Doesn't reduce nasal inflammation directly

  • Less effective for severe nasal congestion

  • Requires twice-daily dosing at lower strengths

  • No approved use for nonallergic rhinitis

Flonase

Flonase is a corticosteroid nasal spray that treats allergy symptoms right where they start, in the nasal passages. It's approved for both allergic and nonallergic rhinitis, covering a broader range of nasal conditions than oral antihistamines. It's sold both by prescription and over the counter, though it typically costs more per month.

Pros

  • Treats inflammation directly in nasal tissue

  • Also approved for nonallergic rhinitis

  • Once-daily dosing for maintenance

  • Available both OTC and by prescription

Cons

  • Can cause nosebleeds or nasal irritation

  • Risk of Candida infection in nose or throat

  • Possible growth effects with long-term pediatric use

  • Roughly $20 to $95 per month, costs more than Allegra

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