Flonase vs. Nasacort

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

Key Takeaways

  • Both Flonase and Nasacort are once-daily corticosteroid nasal sprays sold over-the-counter, but Flonase is also approved for nonallergic rhinitis while Nasacort is not.

  • Flonase is approved for children 4 and older, while Nasacort is approved down to age 2, making it an option for younger kids with allergies.

  • Flonase typically costs more per month than Nasacort, though both are generally affordable without insurance.

Flonase vs. Nasacort Drug Summary

Flonase

Flonase (fluticasone propionate) is a corticosteroid nasal spray used to treat seasonal and perennial allergic rhinitis, as well as nonallergic rhinitis, in adults and children 4 and older. It starts at a higher daily dose that can be reduced once symptoms are under control.

Nasacort

Nasacort (triamcinolone acetonide) is a corticosteroid nasal spray used to relieve nasal symptoms of seasonal and perennial allergic rhinitis in adults and children 2 and older. It uses a fixed once-daily dose, with a higher dose available if more relief is needed.

Flonase vs. Nasacort Side Effects

Flonase

Most common
headache (up to 16.1%)
pharyngitis (up to 7.8%)
epistaxis (up to 6.9%)
cough (up to 3.8%)

Nasacort

Most common
headache (1% to 10%)
pharyngitis (1% to 10%)
epistaxis (1% to 10%)
flu syndrome (1% to 10%)

Flonase vs. Nasacort Dosage

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

Nasacort

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 110 mcg once daily At the start
Maximum dose 220 mcg once daily If needed
Dose changes 1 increase As tolerated

Flonase vs. Nasacort Indications

Flonase

Flonase treats seasonal and perennial allergic rhinitis in adults and children 4 and older. It is also FDA-approved for nonallergic (perennial) rhinitis, a use most nasal steroids do not cover.

  • Seasonal allergic rhinitis, ages 4 and up

  • Perennial (year-round) allergic rhinitis, ages 4 and up

  • Nonallergic perennial rhinitis, ages 4 and up

  • Available by prescription or over-the-counter

Nasacort

Nasacort treats nasal symptoms of seasonal and perennial allergic rhinitis in adults and children 2 and older. It is sold only over-the-counter, since its prescription version was discontinued in the US.

  • Nasal symptoms of seasonal allergic rhinitis, ages 2 and up

  • Nasal symptoms of perennial allergic rhinitis, ages 2 and up

  • Sold over-the-counter, no prescription needed

  • Not approved for asthma or children under 2

Flonase vs. Nasacort Pros and Cons

Flonase

Flonase is a corticosteroid nasal spray available both by prescription and over-the-counter, with approval covering allergic and nonallergic rhinitis in children as young as 4. It offers a step-down maintenance dose once symptoms are controlled, but it tends to cost more per month than Nasacort.

Pros

  • Approved for nonallergic rhinitis, a use Nasacort lacks

  • Long track record, approved by the FDA since 1994

  • Maintenance dose can be reduced once symptoms improve

  • Available both by prescription and over-the-counter

Cons

  • Not approved for children under 4

  • Typically costs more than Nasacort, roughly $20 to $95 per month versus $13 to $24

  • Requires a step-down to a lower dose, adding an extra step for patients

Nasacort

Nasacort is an over-the-counter corticosteroid nasal spray approved for allergic rhinitis in children as young as 2, one of the lowest age approvals among nasal steroids. It uses a flat once-daily dose with no titration step, and it typically costs less per month than Flonase.

Pros

  • Approved for children as young as 2, younger than Flonase's minimum age

  • First nasal corticosteroid approved for OTC sale in the US

  • Simple once-daily dosing with no step-down required

  • Typically costs less than Flonase, roughly $13 to $24 per month versus $20 to $95

Cons

  • Not approved for nonallergic rhinitis, only allergic rhinitis

  • No longer available as a prescription formulation in the US

  • Not approved for use in patients with asthma

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