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Azelastine vs. Flonase

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Azelastine and Fluticasone are both nasal sprays used to treat allergy symptoms like a runny or stuffy nose. However, they belong to different medication classes. Azelastine is an antihistamine, while Fluticasone is a corticosteroid. Azelastine is available in prescription form as a generic nasal spray in two strengths (0.1% and 0.15%), while Fluticasone is available both over-the-counter and by prescription in various formulations. Azelastine is typically used twice a day, whereas Fluticasone is usually taken once a day. Azelastine can cause side effects like a bitter taste and sleepiness, while Fluticasone may lead to bitter taste, nosebleeds and, with long-term use, can slow growth in children. Azelastine may interact with alcohol and other sedatives, increasing drowsiness, while Fluticasone can raise the risk of infections and eye problems with prolonged use.

azelastine nasal spray

 

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fluticasone nasal spray

 

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Summary for Azelastine

Prescription only

Azelastine nasal spray is an antihistamine that treats allergies and nasal symptoms, such as runny or stuffy nose. The 0.1% and 0.15% strengths of the azelastine nasal spray are available with a prescription for adults and children. It's sprayed into the nostrils typically twice a day. Prescription azelastine nasal spray is a lower-cost generic. Possible side effects include a bitter taste in the mouth and nasal discomfort.

Note: Azelastine 0.15% nasal spray is also available over the counter under the brand name Astepro Allergy.

Indications for Azelastine

  • Seasonal allergy symptoms related to the nose
  • Year-round allergy symptoms related to the nose - azelastine 0.15% spray only
  • Runny or stuffy nose that isn't caused by allergies - azelastine 0.1% spray only

Pros and Cons for Azelastine

Pros

  • Works well to relieve nasal symptoms during allergy season
  • Might work faster than steroid nasal sprays and some oral antihistamines
  • Sprayed directly into the nose
  • Available in two different strengths (0.1% and 0.15%)

Cons

  • Doesn't have a counter to keep track of the number of sprays you have left in the bottle
  • Can leave a bitter taste in your mouth (but it goes away)
  • Can cause sleepiness in some people
  • Might need to use twice a day

Common Side Effects for Azelastine

Azelastine 0.1% nasal spray:

  • Bitter taste in the mouth (20%)
  • Headache (15%)
  • Sleepiness (12%)
  • Nasal burning (4%)

Azelastine 0.15% nasal spray:

  • Bitter taste in the mouth (4%)
  • Nasal discomfort (4%)

Warnings for Azelastine

  • Possible sleepiness and difficulty concentrating

Summary for Flonase

Prescription or over-the-counter

Fluticasone nasal spray is used to treat allergy symptoms, like runny nose and sneezing. Fluticasone nasal spray comes in brand and generic forms, and is available by a prescription or over-the-counter (OTC). Fluticasone nasal spray must be used daily in order for you to experience the maximum benefits. But if you're using OTC versions of this medication, don't use it for more than 6 months at a time (or 2 months at a time, for children) without first speaking to your provider.

Indications for Flonase

Nasal symptoms from allergies, such as:

  • Congestion
  • Runny nose
  • Sneezing
  • Itchy nose
  • Itchy, watery eyes

Pros and Cons for Flonase

Pros

  • Only has to be used once a day and can last up to 24 hours
  • Available OTC
  • Some formulations have generic versions
  • Can be used safely in children as young as 4 years old
  • Flonase Sensimist is a gentler version that can be used in children as young as 2 years old

Cons

  • Not a good option if you have an injured nose or had recent nasal surgery
  • Can raise the risk of bleeding and fungal infections in the nose
  • Can slow down growth rate in children if used for longer than 2 months per year
  • Can raise the risk for certain eye problems

Common Side Effects for Flonase

  • Headache (7-16%)
  • Sore throat (6-8%)
  • Nosebleeds (6-7%)
  • Asthma symptoms (3-7%)

Warnings for Flonase

  • Nasal problems
  • Slowed growth rate in children
  • Eye problems
  • Higher risk of infections
  • Stress hormone problems (adrenal gland problems)
  • Serious allergic reactions

Prices with our coupons for Azelastine vs. Flonase

Price Card Drug Icon
Azelastine1 nasal spray / 30ml of 137mcg/spray
$19.97$33.36
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Price Card Drug Icon
Fluticasone Propionate1 nasal spray / 16g of 50mcg
$14.67$47.00
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