Flonase vs. Nasonex for Nasal Congestion and Allergic Rhinitis: Important Differences and Potential Risks.

Key takeaways

Flonase (fluticasone) and Nasonex (mometasone) are both corticosteroid nasal sprays used to treat allergy symptoms, but they have several differences. Flonase is available both by prescription and over-the-counter (OTC) and come in two formulations: Flonase Allergy Relief (fluticasone propionate) and Flonase Sensimist (fluticasone furoate). Nasonex, on the other hand, is available as Nasonex 24HR Allergy OTC and as a prescription generic mometasone nasal spray. Flonase can be used in children as young as 2 years old for the Sensimist version, while Nasonex can be used in children as young as 2 years old for the OTC version. Flonase is typically used for up to 6 months at a time. Prescription Nasonex can be used long-term for treating nasal polyps. Both medications can cause side effects like headaches and nosebleeds, but Nasonex has a higher reported rate of headaches (26%) compared to Flonase (7-16%).

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

Summary for Nasonex

Prescription or over-the-counter

Mometasone nasal spray is used to prevent the nose symptoms of seasonal allergies, as well as to treat nose and sinus inflammation in adults with nasal polyps. Some side effects this medication can cause include headache and bloody nose. Mometasone nasal spray is available both with a prescription and over the counter (OTC).

Indications for Nasonex

Temporary relief of allergy symptoms (e.g., stuffy or runny nose, sneezing, itchy nose) (OTC only)
Prevention of seasonal allergies (prescription only)
Treatment of long-term nose and sinus inflammation with nasal polyps (prescription only)

Pros and Cons for Nasonex

Pros

Works well to prevent and treat allergy symptoms
Available OTC
Can be used to help control allergy symptoms in children 2 years or older (OTC only)
Available as a lower-cost generic with a prescription

Cons

Can take 1 to 2 weeks or longer to see the full effects
Doesn't have a counter on the spray bottle, so it can be hard to remember how many sprays are left
Can cause side effects like headache and nose bleeds in some people
Unknown if safe while pregnant or breastfeeding

Common Side Effects for Nasonex

Headache (26%)
Viral infection (14%)
Sore throat (12%)
Bloody nose or mucus (11%)
Coughing (7%)
Upper respiratory tract infection (i.e., common cold; 6%)
Period cramps (5%)
Muscle pain (5%)
Congestion, pressure near the nose or forehead, and other symptoms of sinus infection (5%)