Nasacort vs. Clarinex

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

Key Takeaways

  • Nasacort treats nasal allergy symptoms only, while Clarinex also relieves non-nasal symptoms like itchy eyes and hives.

  • Nasacort is available over the counter for about $13 to $24 a month, while Clarinex is prescription-only and typically costs $270 to $300 a month.

  • Nasacort works locally in the nose to reduce inflammation, while Clarinex works throughout the body to block histamine.

Nasacort vs. Clarinex Drug Summary

Nasacort

Nasacort is a nasal corticosteroid spray used for the nasal symptoms of seasonal and perennial allergic rhinitis. It is sprayed into each nostril once a day and has been sold over the counter since 2013.

Clarinex

Clarinex is a second-generation antihistamine that blocks the H1 histamine receptor throughout the body. It relieves nasal and non-nasal allergy symptoms and chronic hives, taken once daily as a tablet, dissolving tablet, or liquid.

Nasacort vs. Clarinex Side Effects

Nasacort

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

Clarinex

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

Nasacort vs. Clarinex Dosage

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

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

Nasacort vs. Clarinex Indications

Nasacort

Nasacort is FDA-approved for the nasal symptoms of seasonal and perennial allergic rhinitis in people age 2 and older. It works directly in the nasal passages to reduce inflammation that causes congestion, sneezing, and runny nose. It is not approved for asthma or for children under 2.

  • Seasonal allergic rhinitis (nasal symptoms)

  • Perennial allergic rhinitis (nasal symptoms)

  • Approved for ages 2 and up

  • Not approved for asthma treatment

Clarinex

Clarinex is FDA-approved to relieve both nasal and non-nasal symptoms of seasonal and perennial allergic rhinitis. It is also approved to relieve itching and hives from chronic idiopathic urticaria. Approval extends down to 6 months of age depending on the specific indication.

  • Seasonal allergic rhinitis (nasal and non-nasal)

  • Perennial allergic rhinitis (nasal and non-nasal)

  • Chronic idiopathic urticaria (itching, hives)

  • Approved for ages 6 months and up (by indication)

Nasacort vs. Clarinex Pros and Cons

Nasacort

Nasacort works directly in the nasal passages to reduce inflammation, making it a strong option for congestion and nasal symptoms specifically. It is sold over the counter at a low price, but it can take several days of regular use to reach full effect and does not treat eye or skin symptoms.

Pros

  • Available without a prescription

  • Roughly $13 to $24 per month without insurance

  • Specifically targets nasal congestion and inflammation

  • Simple two-dose maintenance schedule

Cons

  • Doesn't relieve itchy eyes, hives, or skin symptoms

  • Takes several days of regular use for full effect

  • Carries risk of nasal irritation or septal perforation with long-term use

  • Not approved for children under 2

Clarinex

Clarinex works systemically to block histamine, so it covers nasal, eye, and skin symptoms including chronic hives. It requires a prescription and costs significantly more out of pocket, but it is non-sedating at the recommended dose and starts working faster than a nasal steroid.

Pros

  • Treats non-nasal symptoms like itchy, watery eyes

  • Also approved for chronic hives (urticaria)

  • Non-sedating at the recommended dose

  • Available in tablet, dissolving tablet, and liquid forms

Cons

  • Prescription required

  • Roughly $270 to $300 per month without insurance

  • Doesn't directly reduce nasal inflammation the way a steroid spray does

  • Multiple formulations can add dosing confusion in children

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