Nasacort vs. Astelin
See how Nasacort and Astelin compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Nasacort is an over-the-counter corticosteroid spray taken once daily, while Astelin is a prescription antihistamine spray taken twice daily.
Astelin tends to work within minutes, but Nasacort's steroid action treats nasal inflammation more broadly over time.
Astelin also covers vasomotor rhinitis, a nonallergic condition, while Nasacort is approved only for seasonal and perennial allergic rhinitis.
Nasacort vs. Astelin Drug Summary
Nasacort
Nasacort is an over-the-counter nasal corticosteroid that treats the nasal symptoms of seasonal and perennial allergic rhinitis. It is sprayed into each nostril once a day and works by reducing inflammation in the nasal passages.
Astelin
Astelin is a prescription nasal antihistamine that treats seasonal allergic rhinitis and vasomotor rhinitis. It is sprayed into each nostril twice a day and works by blocking histamine receptors to quickly ease symptoms.
Nasacort vs. Astelin Side Effects
Nasacort
Astelin
Nasacort vs. Astelin Dosage
Nasacort
Astelin
| 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 |
| STAGE | DOSE | WHEN |
| Starting dose | 1 spray/nostril BID | At the start |
| Maximum dose | 2 sprays/nostril BID | If needed |
| Dose changes | 1 increase | As tolerated |
Nasacort
| 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 |
Astelin
| STAGE | DOSE | WHEN |
| Starting dose | 1 spray/nostril BID | At the start |
| Maximum dose | 2 sprays/nostril BID | If needed |
| Dose changes | 1 increase | As tolerated |
Nasacort vs. Astelin Indications
Nasacort
Nasacort treats the nasal symptoms of seasonal and perennial allergic rhinitis, including congestion, sneezing, and runny nose. It reduces inflammation in the nasal passages rather than blocking histamine directly. It is approved for adults and children as young as 2 years old.
Nasal symptoms of seasonal allergic rhinitis
Nasal symptoms of perennial allergic rhinitis
Approved for children as young as 2
Available over-the-counter, no prescription needed
Astelin
Astelin treats seasonal allergic rhinitis in adults and children 5 and older, and it also covers vasomotor rhinitis, a nonallergic nasal condition, in adults and teens 12 and older. It works by blocking histamine at H1 receptors rather than reducing inflammation broadly. It remains available only by prescription.
Seasonal allergic rhinitis in adults and kids 5+
Vasomotor (nonallergic) rhinitis in adults and teens 12+
Prescription-only nasal antihistamine
FDA approved since 1996
Nasacort vs. Astelin Pros and Cons
Nasacort
Nasacort is available without a prescription and only needs to be used once a day, making it simple to fit into a routine. As a corticosteroid, it treats inflammation broadly but takes several days of regular use to reach full effect. It also costs less out of pocket than many prescription nasal sprays.
Pros
Available over-the-counter, no prescription needed
Once-daily dosing only
Roughly $13 to $24 per month, cheaper than Astelin
Approved for children as young as 2
Cons
Takes several days of regular use for full effect
Not approved for vasomotor (nonallergic) rhinitis
Steroid warnings: septal irritation, growth effects in kids, glaucoma/cataract risk
Original prescription version discontinued in the US
Astelin
Astelin is a nasal antihistamine that can ease symptoms within minutes, and it is also approved for vasomotor rhinitis, a use Nasacort does not cover. It requires a prescription and twice-daily dosing, and some people notice a bitter taste or drowsiness after each dose. It typically costs more out of pocket than over-the-counter options like Nasacort.
Pros
Can relieve symptoms within minutes
Also approved for vasomotor (nonallergic) rhinitis
No corticosteroid-related risks like septal perforation
Long track record since 1996 with no boxed warning
Cons
Requires twice-daily dosing
Common bitter taste after spraying
Can cause drowsiness; avoid driving or alcohol until effects known
Roughly $21.60 to $70.38 per month, pricier than Nasacort
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