Afrin vs. Flonase for Nasal Congestion: 6 Differences to Consider
Key takeaways:
Afrin (oxymetazoline) and Flonase (fluticasone) are both over-the-counter nasal sprays used to help relieve nasal congestion. But they work in different ways.
Afrin works within minutes. Flonase takes longer to provide relief but also treats a wider range of allergy symptoms, including itchy eyes and sneezing.
To prevent rebound congestion, Afrin should only be used for up to 3 days in a row. Flonase can be used daily for up to 6 months to treat allergy symptoms in people ages 12 and older. Children under 12 years old shouldn’t use it for more than 2 months per year. After that, ask your healthcare team if you or your child should keep using Flonase.
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Table of contents
A stuffy nose can make it difficult to breathe, sleep, and go about daily activities. It happens when nasal passages become swollen and inflamed, often due to allergies, a cold, or a sinus infection.
Two common over-the-counter (OTC) medications for nasal congestion are Afrin (oxymetazoline) and Flonase (fluticasone). While both come as nasal sprays, they work differently and have distinct benefits and limitations.
If you’re deciding between Afrin and Flonase, here are six differences you should know about.
1. Afrin and Flonase work differently for nasal congestion
Afrin and Flonase both help clear a stuffy nose, but they do this in different ways. And because they work differently, what’s causing your nasal congestion can make one a better option than the other.
Afrin is a nasal decongestant that belongs to a class of medications called alpha-1 receptor agonists. It works by shrinking swollen blood vessels in the nasal passages, quickly relieving congestion and sinus pressure. Because of how it works, Afrin can help provide temporary relief from congestion due to various causes, including allergies and the common cold.
Flonase is a steroid nasal spray that reduces inflammation in the nasal passages. It works by blocking the release of several inflammation-causing substances that trigger allergy symptoms. Because of how it works, Flonase can help prevent and treat nasal congestion and other symptoms caused by allergies. It can also relieve congestion from sinus infections.
Know your options. There are many nasal sprays that can help treat and prevent allergy symptoms. Review your options to see which nasal spray may be right for you.
Feeling stuffed up? Here’s how to relieve sinus pain and congestion at home.
Afrin (oxymetazoline) vs. Sudafed (pseudoephedrine): Afrin and Sudafed are both decongestants. Learn about the key ways they differ for nasal congestion.
2. Afrin works faster than Flonase
Another difference between Afrin and Flonase is how fast they work. If you’re looking for immediate congestion relief, Afrin is the faster option.
Afrin starts working in 5 to 10 minutes, making it ideal for short-term, rapid relief. Flonase takes 2 to 4 hours to start working, and up to 2 weeks to deliver the full benefits.
But one advantage of Flonase is that it can help prevent nasal congestion and other allergy symptoms from happening in the first place. This isn’t the case for Afrin; you should only use it if you already have a stuffy nose.
For Flonase to work best, it’s recommended to use it daily throughout allergy season, starting a few weeks before the season begins.
3. Afrin primarily relieves congestion, while Flonase can treat more symptoms
Whether you choose Afrin or Flonase can depend on your symptoms and their underlying cause. Both medications can help relieve nasal congestion, but Flonase can help treat other symptoms, too.
The main action of Afrin is unclogging the nose. As discussed above, Afrin shrinks blood vessels in your nose to help you breathe more easily. You can use it to relieve a stuffy nose due to the common cold, hay fever, or allergies.
Flonase is FDA approved to relieve various symptoms caused by hay fever and allergies, including:
Nasal congestion
Runny nose
Itchy nose
Itchy, watery eyes
Sneezing
If you’re having multiple symptoms related to allergies, Flonase could be a better choice.
4. Flonase has more formulation options than Afrin
When browsing the pharmacy shelves, you may notice that Afrin and Flonase come in multiple formulations. These formulations can differ in device size, ingredients, and the age groups they’re approved for.
Afrin comes in two concentrations that are approved for different age groups:
Afrin Original (0.05%): the original product for adults and children ages 6 and older
Afrin Children’s (0.025%): a lower-concentration product for children as young as 2 years old
There are several Flonase formulations available that differ slightly in their ingredients, the age groups they’re approved for, and their device size:
Flonase Allergy Relief: This original product contains 50 mcg of fluticasone propionate per spray. It’s approved for adults and children ages 4 and older. All versions of Flonase Allergy Relief contain phenylethyl alcohol, which can also give them a floral smell.
Children’s Flonase Allergy Relief: This formulation is the same as Flonase Allergy Relief, but the nasal spray device is usually smaller in size for children.
Flonase Sensimist: This is a newer formulation for people ages 2 and older that doesn’t contain alcohol and is gentler than the original Flonase. Each spray contains 27.5 mcg of fluticasone furoate, which is equivalent to 50 mg fluticasone propionate.
Children’s Flonase Sensimist Allergy Relief: This formulation is the same as Flonase Sensimist, but the nasal spray device is smaller in size.
Before giving your child OTC medications for allergy or cold symptoms, it’s always best to check with their pediatrician.
5. Afrin is limited to short-term use, while Flonase can be used for a longer period of time
One of the most significant differences between Afrin and Flonase is how long you can safely use them. Afrin should only be used for a few days, while Flonase can be used for a longer period of time.
Afrin can cause rebound congestion if you use it too long. This is when congestion becomes worse as the medication’s effects start to wear off. To prevent rebound congestion, don’t use Afrin for more than 3 days in a row. Contact your healthcare team for guidance if you’re still experiencing symptoms after 3 days.
Flonase isn’t known to cause rebound congestion. It’s generally safe for people ages 12 and older to use the medication every day for up to 6 months. After that, talk to your healthcare team about whether you should keep using it. You should also let them know if your symptoms don’t improve within 7 days of starting Flonase treatment.
It’s not recommended for children ages 2 to 11 to use Flonase for more than 2 months a year. This is because steroids like Flonase can slow down growth in children when used daily for a long period of time. If your child needs to use Flonase for longer than 2 months, speak to their pediatrician about treatment options.
6. Afrin and Flonase can cause different side effects
Both Afrin and Flonase are generally well tolerated. But some people may experience side effects with the medications. These side effects are usually mild and get better once you stop treatment.
The chart below includes a summary of common side effects for Afrin and Flonase.
| Common Afrin side effects | Common Flonase side effects |
|---|---|
|
|
More serious side effects from Afrin and Flonase are rare. Afrin can cause a faster heartbeat or higher blood pressure in some people. And in rare cases, Flonase can cause oral thrush (a type of fungal infection). It also carries warnings about eye problems and slowed growth in children.
Contact your or your child’s healthcare professional if you notice any bothersome side effects from either medication.
Can you use Afrin and Flonase together?
Yes, you can use Afrin and Flonase together. Because they work differently, using them together might offer more benefits. But keep in mind that it’s not recommended to use Afrin for more than 3 days in a row because of the risk of rebound congestion. Using more than one nasal spray can also raise your risk for nasal irritation and other side effects.
If you’re using more than one nasal spray, it’s best to wait 15 minutes between administering the products. This will allow the medication from the first nasal spray to get absorbed before you use the next one.
The bottom line
Afrin (oxymetazoline) and Flonase (fluticasone) are both over-the-counter nasal sprays that can relieve a stuffy nose, but they work differently. Afrin is an alpha-1 receptor agonist that treats nasal congestion due to the common cold, hay fever, or allergies. Flonase is a steroid nasal spray that treats a variety of allergy symptoms, including nasal congestion.
Another big difference is how long you can use each medication. To avoid rebound congestion, don’t use Afrin for more than 3 days in a row. People ages 12 and older can use Flonase daily for up to 6 months. Children under 12 shouldn’t use it for more than 2 months per year. If you need a long-term treatment to relieve your symptoms, consult your primary care provider.
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References
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