Using Flonase or Nasacort AQ for Cold Symptoms

Corticosteroid nasal sprays such as Nasacort AQ (triamcinolone) and Flonase (fluticasone) are very popular over-the-counter medications used to treat itchy and runny noses due to allergies. Though those symptoms can also occur when you have a cold, research shows that these nasal sprays just aren't effective for cold symptoms.

The reason? What causes a runny nose when you have a cold is different from what causes this symptom when you have allergies.

Using nasal spray
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How Corticosteroid Nasal Sprays Work

Corticosteroid nasal sprays like Flonase and Nasacort AQ block the inflammatory agents that your body produces as a response to an allergen.

More specifically, they reduce the formation of inflammatory mediators produced by nasal epithelial cells and various allergic cells such as eosinophils and mast cells.

These cells are what cause the itching, watery eyes, runny nose, and sneezing you typically experience with an allergy.

What Happens When You Get a Cold

When you have a runny nose caused by a cold, excess mucus builds up in your sinuses due to swelling and your body's attempt to eliminate the invading germs.

Viral infections cause inflammation—just not allergic inflammation. Nasal corticosteroids may help reduce this inflammation but are not specifically indicated for this reason.

Several medical studies have investigated the use of corticosteroids to treat cold symptoms. Research results do not support the use of these medications for symptomatic relief, but study authors suggest that more study is needed.

Taking oral antihistamines for cold symptoms doesn't help for the same reasons, unless it's a sedating version such as Benadryl (diphenhydramine).

These drugs don't treat runny nose or watery eyes caused by colds, the flu, or other viral illnesses. But they are often included in multi-symptom cold medications because they have anticholinergic side effects, meaning they dry up secretions. Their ability to fight histamine is irrelevant, as that effect has no impact on these infections.

What You Can Do

If you start to feel symptoms such as a runny nose or stuffy head, try to determine whether your symptoms are caused by a cold or allergies.

Though they can seem similar, there are a few characteristics that can distinguish one from the other:

Likely a Cold
  • Productive cough

  • Yellow or green nasal discharge

  • Itchy eyes/nose/throat

Likely Allergies
  • Dry cough

  • Clear nasal discharge

  • Fever

If You Have a Cold

Try other over-the-counter medications to treat the symptoms you have. You can also use a humidifier, try rinsing your sinuses, or taking a steamy shower to treat your cold at home. 

Studies have found that physical interventions such as handwashing are likely beneficial when you have a cold. Additionally, zinc supplements may be helpful. However, other treatments including ginseng, echinacea and vitamin C supplementation are not likely to provide a benefit.

If You Have Allergies

Antihistamines or corticosteroid nasal sprays typically work very well for allergies. If you have been using over-the-counter products but are still having symptoms, contact your healthcare provider or allergist for further treatment options.  

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Article Sources
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  1. Hayward G, Thompson MJ, Perera R, Del Mar CB, Glasziou PP, Heneghan CJ. Corticosteroids for the common cold. Cochrane Database Syst Rev. 2015;(10):CD008116. doi:10.1002/14651858.CD008116.pub3

  2. Cleveland Clinic. Allergies: Questions and Answers. Updated March 25, 2016.

  3. Allan GM, Arroll B. Prevention and treatment of the common cold: making sense of the evidenceCMAJ. 2014;186(3):190–9. doi:10.1503/cmaj.121442

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