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
Clarinex
Astelin vs. Clarinex Dosage
Astelin
Clarinex
| 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 |
| 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
| 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
| 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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