Nasacort vs. Clarinex

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

Andre Stone | MD

Medically reviewed by Andre Stone | MD, University of Pittsburgh School of Medicine on September 7th, 2026.

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 is not approved specifically to treat eye or skin symptoms, although nasal corticosteroid sprays may improve some allergy-related eye 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

Common Symptoms and Related Diseases You Can Explore

Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.

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