8 Things to Know About Rhinocort vs. Flonase for Allergies

If you get all stuffy and sneezy when your allergies act up, then you know how allergic rhinitis (hay fever) feels. Allergy symptoms can be annoying, uncomfortable, and disruptive to your day-to-day life. In fact, allergies are the most common medical reason adults miss work. And for kids, symptoms can interfere with their sleep and school participation.

Steroid nasal sprays are first-choice medications for nasal allergy symptoms, such as a runny or stuffy nose.

Here, we’ll compare two that are available both over the counter (OTC) and with a prescription: Rhinocort (budesonide) and Flonase (fluticasone propionate). If you’ve never used a steroid nasal spray before, it’s a good idea to talk to your healthcare provider or pharmacist first. They can help make sure it’s right for you.

1. Rhinocort and Flonase are both first-choice medications for allergies

Rhinocort and Flonase are considered first-choice medications for allergic rhinitis. They both contain a type of medication called a corticosteroid, or “steroid” for short. They work by lowering your body’s inflammatory response to allergens like pollen or mold. This helps relieve the runny nose and swelling caused by allergies.

You may be more familiar with oral antihistamines for allergies, such as Xyzal (levocetirizine) or Allegra (fexofenadine). These medications work by blocking histamine — a chemical in the body that causes allergy symptoms. But steroid nasal sprays are generally preferred over taking antihistamines alone. Studies show they’re more effective at treating nasal symptoms.

2. Flonase comes in more forms than Rhinocort

Flonase and Rhinocort are each available both OTC and with a prescription. But their strengths and recommended dosages are different. Make sure to follow the instructions on the product you’re using, or the ones given to you by your healthcare provider.

Flonase also has another option: Flonase Sensimist (fluticasone furoate). It has the same steroid as Flonase — fluticasone — but in a different chemical form. The main advantage of Flonase Sensimist is that it’s a gentler spray that may be easier to use than regular Flonase. And both versions of Flonase come in an additional child-friendly size with a smaller spray nozzle for little noses.

3. Flonase is approved for more age groups than Rhinocort

Flonase is approved for adults and children as young as 4 years of age. Flonase Sensimist can be used in even younger children, 2 years of age and older.

Rhinocort is approved to treat allergy symptoms in adults and children ages 6 years and older. It’s also the preferred steroid nasal spray during pregnancy, but Flonase is also considered safe to use.

4. Flonase may be more effective than Rhinocort

There’s some evidence that Flonase might work better than Rhinocort for nasal allergy symptoms. A study published in 2021 compared Flonase and Rhinocort head-to-head. A group of 62 people ages 12 years and older were randomly divided into 2 groups. One group was treated with Flonase, the other with Rhinocort.

After 8 weeks of treatment, both groups noticed relief in allergy symptoms. But the group using Flonase saw a greater improvement, and results were seen faster than with Rhinocort. But this was a small study and isn’t enough evidence for experts to recommend one nasal spray over the other.

Good to know: Steroid nasal sprays typically don’t offer immediate symptom relief. It can take a few weeks of regular use to feel the full benefit. So, starting Flonase or Rhinocort a few weeks before the start of allergy season may be a good idea if you suffer from seasonal allergies.

5. Flonase and Rhinocort have similar side effects

Flonase and Rhinocort generally have few side effects. They aren’t well-absorbed into the bloodstream, so their effects are mainly isolated to the nose.

Common side effects

Common side effects of both Rhinicort and Flonase include a sore throat, cough, and nasal irritation or dryness. Flonase may also cause a headache or stomach upset.

Nosebleeds can also happen in about 4% to 8% of people using steroid nasal sprays. They’re more likely with long-term use (over 1 year) and can often be prevented with proper spray technique. Be sure to follow the instructions closely and point the spray nozzle towards the outer side of each nostril. If you do experience nosebleeds, let your healthcare provider know. They can review your technique and recommend a different product if needed.

Good to know: In children with nasal allergies, steroid nasal sprays may actually help prevent nosebleeds by lessening the urge to rub or pick an itchy nose.

Rare side effects

Steroid nasal sprays have been linked to small growth delays in children. But the research is mixed, and this doesn’t seem to be a common issue for most children. To be safe, it’s best to limit your child’s use of steroid nasal spray to no more than 2 months per year without your healthcare provider’s OK.

Other rare side effects of Rhinocort and Flonase include nose infections or a perforated septum (hole through the middle of your nose). But these aren’t common. If you notice nose soreness that isn’t going away while using a steroid nasal spray, stop using it and have it checked by your healthcare provider.

6. Flonase and Rhinocort interact with the same medications

Flonase and Rhinocort don’t reach the bloodstream in large amounts. So, it’s not likely that they’ll have any serious interactions with other medications.

But if you combine Flonase or Rhinocort with another steroid medication, the risk for steroid-related side effects goes up. These include a greater risk of infection, osteoporosis, and more.

Talk with your healthcare provider before starting Flonase or Rhinocort if you’re taking another steroid medication. They can tell you whether it’s safe for you to take them together.

You also shouldn’t combine more than one steroid nasal spray. Doing so will only raise your risk of side effects and isn’t recommended.

There are certain medications, such as Norvir (ritonavir) and ketoconazole, that may raise Flonase and Rhinocort levels in your body. So before starting a steroid nasal spray, it's best to ask your pharmacist or healthcare provider to review your medication list and check for any interactions.

7. You can use Flonase and Rhinocort with other nasal sprays

If your allergy symptoms aren’t completely managed by Flonase or Rhinocort, there are other steroid-free nasal sprays that are safe to use along with them. These include:

• Astepro (azelastine), an antihistamine nasal spray

• Afrin (oxymetazoline), a decongestant nasal spray

• NasalCrom (cromolyn sodium), a mast cell stabilizer

It’s recommended to wait at least 15 minutes between each type of nasal spray. And make sure to follow the dosing directions closely. For example, you shouldn’t use decongestant nasal sprays for more than 3 days in a row. Ask your pharmacist if you’re unsure about anything.

8. There are several ways to save on Rhinocort and Flonase

The prescription versions of Rhinocort and Flonase are both available as lower-cost generics. GoodRx can help you save over 60% off the average retail price of the generic versions. Generic Rhinocort’s price at certain pharmacies is less than $10.16 with a free GoodRx discount. Generic Flonase’s price at certain pharmacies is less than $14.00 with a free GoodRx discount.

GoodRx can also help you save on OTC Rhinocort and Flonase. All you need is a prescription for the OTC version from your healthcare provider. OTC Rhinocort’s price at certain pharmacies is as low as $ with a free GoodRx discount. And OTC generic Flonase’s price at certain pharmacies is as low as $18.87.

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Written by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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