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Compare Flonase vs. Azelastine

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

Key takeaways

Fluticasone nasal spray (Flonase, Flonase Sensimist) and azelastine nasal spray (Astepro) are both used to treat nasal symptoms from allergies, such as a runny or stuffy nose. However, they belong to different medication classes. Fluticasone is a corticosteroid that reduces inflammation in the nose, while azelastine is an antihistamine that blocks histamine to relieve symptoms. Fluticasone is available both over-the-counter and by prescription, whereas azelastine is primarily available by prescription, with an over-the-counter option for the 0.15% strength. Fluticasone is typically used once a day, while azelastine is usually taken twice a day. Common side effects of fluticasone include headaches and nosebleeds, while azelastine may cause a bitter taste and sleepiness. Fluticasone can slow growth in children and may increase the risk of eye problems, while azelastine can cause drowsiness, so you should avoid alcohol and be cautious when driving.

  • Fluticasone nasal spray
    Azelastine nasal spray
  • Fluticasone nasal spray
    Azelastine nasal spray

  • Summary of Flonase vs. Azelastine

    Summary for Corticosteroid

    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.

    Summary for Antihistamine
    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. <br/> Note: Azelastine 0.15% nasal spray is also available over the counter under the brand name Astepro Allergy.

  • Indications of Flonase vs. Azelastine

    Indications for

    Nasal symptoms from allergies, such as:

    •Congestion
    •Runny nose
    •Sneezing
    •Itchy nose
    •Itchy, watery eyes
    Indications for
    •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 of Flonase vs. Azelastine

    Pros and Const for Corticosteroid
    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
    Pros and Const for Antihistamine
    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 of Flonase vs. Azelastine

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

    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 of Flonase vs. Azelastine

    Common Side Effects for
    •Nasal problems
    •Slowed growth rate in children
    •Eye problems
    •Higher risk of infections
    •Stress hormone problems (adrenal gland problems)
    •Serious allergic reactions
    Common Side Effects for
    •Possible sleepiness and difficulty concentrating

  • Prices with our coupons for Flonase vs. Azelastine

    Learn more about Fluticasone nasal spray
    Learn more about Azelastine nasal spray

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