Nasonex vs. Allegra for Allergic Rhinitis: Important Differences and Potential Risks.

Key takeaways

Nasonex (mometasone) and Allegra (fexofenadine) are both used to treat allergy symptoms, but they work in different ways and belong to different medication classes. Nasonex is a corticosteroid nasal spray that reduces inflammation and swelling in the nose, while Allegra is an oral antihistamine that blocks histamine to relieve symptoms like itchiness and runny nose. Nasonex is available both over-the-counter and by prescription, whereas Allegra is only available over-the-counter. Nasonex can take 1 to 2 weeks to show full effects, but Allegra starts working in about 2 hours. Nasonex is used for both short-term and long-term treatment, including nasal polyps, while Allegra is used for short-term relief of allergy symptoms and hives. Common side effects of Nasonex include headache and nosebleeds, whereas Allegra can cause headache and dry mouth.

mometasone nasal spray

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Fexofenadine

(Allegra)

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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%)

Warnings for Nasonex

Nose injury and slowed wound healing
Fungal infection in the nose and throat
Vision changes
Risk of infection
Hormone changes
Poor growth in children

Summary for Allegra

Over-the-counter

Fexofenadine (Allegra) is an antihistamine. It's used to ease symptoms of allergy and hives in adults and children. Fexofenadine (Allegra) can be found over the counter as a tablet, fast-melting tablet, and liquid. This medication is taken once or twice per day, depending on the formulation. Fexofenadine (Allegra) starts to work in about 2 hours and its effects can last up to 24 hours. Fexofenadine (Allegra) doesn't make you as drowsy compared to some other antihistamines, such as diphenhydramine (Benadryl). Other possible side effects of fexofenadine (Allegra) include headache and dry mouth.

Indications for Allegra

Short-term relief of allergy symptoms (sneezing, runny nose, itchy or watery eyes, itchy nose or throat)
Treatment of hives

Pros and Cons for Allegra

Pros

First-choice option for relieving allergy symptoms
Some products can also be used to relieve itchiness from hives.
Available as 12-hour and 24-hour tablets, as well as a liquid and quick-dissolving tablets for those who have a hard time swallowing pills
All formulations available over the counter

Cons

Liquid form might not be the best choice for people on a low-salt diet because it contains sodium
Once-daily formulations not recommended for children younger than 12 years old
Might have a higher risk of side effects if you have liver or kidney problems
Can cause headache