Astelin vs. Clarinex

See how Astelin and Clarinex compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Astelin is a nasal antihistamine spray used twice daily, while Clarinex is an oral tablet or dissolving tablet taken once a day.

  • Astelin can cause drowsiness and a bitter taste, while Clarinex is designed to be non-sedating at its approved dose.

  • Astelin also treats non-allergic (vasomotor) rhinitis, while Clarinex additionally covers chronic hives, giving each drug a use the other lacks.

Astelin vs. Clarinex Drug Summary

Astelin

Astelin is an antihistamine nasal spray that treats seasonal allergic rhinitis and vasomotor (non-allergic) rhinitis. It works locally in the nose and is sprayed into each nostril twice a day.

Clarinex

Clarinex is a second-generation oral antihistamine that treats seasonal and perennial allergic rhinitis and chronic hives. It is taken once daily as a tablet, dissolving tablet, or liquid.

Astelin vs. Clarinex Side Effects

Astelin

Most common
bitter taste (≥2%)
headache (≥2%)
somnolence (≥2%)
nasal burning (≥2%)

Clarinex

Most common
pharyngitis (up to 4.1%)
dry mouth (up to 3.0%)
myalgia (up to 2.1%)
fatigue (up to 2.1%)

Astelin vs. Clarinex Dosage

Astelin

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 1 spray/nostril twice daily At the start
Maximum dose 2 sprays/nostril twice daily If needed
Dose changes 1 increase As tolerated

Clarinex

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 1 mg once daily At the start
Maximum dose 5 mg once daily If needed
Dose changes 3 increases As tolerated

Astelin vs. Clarinex Indications

Astelin

Astelin is FDA-approved for seasonal allergic rhinitis in people 5 and older and for vasomotor rhinitis, a non-allergic form of nasal irritation, in people 12 and older. It is not approved for seasonal allergic rhinitis in children under 5 or vasomotor rhinitis in children under 12.

  • Seasonal allergic rhinitis (ages 5+)

  • Vasomotor (non-allergic) rhinitis (ages 12+)

  • Delivered directly into the nose

  • Not approved for children under 5

Clarinex

Clarinex is FDA-approved for seasonal allergic rhinitis starting at age 2, perennial allergic rhinitis starting at 6 months, and chronic idiopathic urticaria (hives) starting at 6 months. It treats both nasal and non-nasal allergy symptoms system-wide.

  • Seasonal allergic rhinitis (ages 2+)

  • Perennial allergic rhinitis (ages 6 months+)

  • Chronic hives and itching (ages 6 months+)

  • Also sold combined with pseudoephedrine as Clarinex-D

Astelin vs. Clarinex Pros and Cons

Astelin

Astelin acts locally in the nose and works well for people whose main complaint is nasal congestion or irritation not tied to allergies. It requires twice-daily dosing and carries a real risk of drowsiness and taste disturbance that oral non-sedating antihistamines usually avoid.

Pros

  • Also approved for non-allergic (vasomotor) rhinitis

  • Acts directly at the site of symptoms in the nose

  • Lower typical monthly list price, roughly $22 to $70 without insurance

  • No boxed warning

Cons

  • Requires twice-daily nasal spraying, which some find inconvenient

  • Can cause drowsiness, so driving or machinery use needs caution

  • Common bitter taste after each spray

  • Not approved for children under 5

Clarinex

Clarinex offers once-daily oral dosing and is designed to be non-sedating at its approved dose, which suits people who need to stay alert. It covers a broader age range down to 6 months and also treats chronic hives, but its typical list price runs considerably higher than Astelin's.

Pros

  • Once-daily oral dosing instead of twice-daily spraying

  • Non-sedating at the recommended dose

  • Also approved for chronic hives (urticaria)

  • Approved down to 6 months old for perennial rhinitis

Cons

  • Much higher typical monthly list price, roughly $270 to $300 without insurance

  • Treats symptoms system-wide rather than acting locally in the nose

  • Not approved for vasomotor (non-allergic) rhinitis

  • Contraindicated in anyone allergic to loratadine as well as desloratadine

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