Overview of Nasal Steroid Sprays for Allergies

Nasal Steroid Spray
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Professional societies, like the American Academy of Allergy, Asthma and Immunology (AAAAI) and the  American College of Allergy, Asthma, and Immunology (ACAAI), recommend nasal steroid sprays as the single best therapy for people with persistent or moderate-to-severe symptoms of allergic rhinitis (also known as hay fever), including seasonal allergies.

To back this recommendation up, research shows that nasal steroids are better at treating allergy symptoms than oral antihistaminesnasal antihistamine sprays, and Singulair. Nasal steroids are also particularly good at treating symptoms of eye allergies

How Nasal Steroids Work

Nasal steroids work by decreasing the allergic inflammation within your nasal passages, treating symptoms such as sneezing, itchy nose, runny nose, congestion, and post-nasal drip. Since steroids generally take many hours before they begin to work, nasal steroids do not work well on an as-needed basis and need to be used routinely for best results. In addition, nasal steroid sprays can take a few days up to a week to obtain relief—so remain patient if this is the first time you are trying one out for allergies. 

Side Effects

The good news is that nasal steroid sprays are generally well-tolerated, although some are associated with a mild, unpleasant odor or taste.

In addition, nasal steroids can dry out the lining of the nose in some people and even cause some crusting or bleeding, especially during cold, winter months. Switching to a non-alcohol based spray, and/or applying a moisturizing nasal gel (for example, petroleum jelly or a saline nose spray) before using the steroid spray can be helpful.

Which Nasal Steroid Is Best?

There are a number of nasal steroids available, and studies comparing the benefit of the different nasal steroids show no particular difference from one to another.

Although, there are some subtleties between the nasal steroids that may result in a person choosing one over another. It is certainly possible that a person finds that one of these nasal steroid sprays works better or causes fewer side effects than another.

Here is a closer look at some of the pros and cons of each nasal steroid spray, and why switching to a different one (in addition to ensuring you are using it correctly) is a reasonable next step if you are not getting adequate relief with one.

Comparison of Brand Name Nasal Steriods

Flonase Allergy Relief (fluticasone propionate)Available in generic form (lower cost), also approved by the Food and Drug Administration (FDA) to treat non-allergic rhinitis, FDA approved for children as young as 4 years of age, and available OTCA flowery smell bothers some people and contains an alcohol preservative that may cause irritation in some people
Nasarel (flunisolide)Available in generic formNeeds to be used two to three times a day for best effect and only available by prescription
Nasonex (mometasone)Available in generic form, FDA approved for children as young as 2 years of age, FDA approved for the treatment of nasal polyps, and generally the lowest cost brand name nasal steroidOnly available by prescription
Flonase Sensimist fluticasone furoate)FDA approved for children as young as 2 years of age, multiple studies show consistent benefit for the treatment of eye allergies (although not currently FDA approved for this reason ), and available OTCHigh cost
Nasacort AQ (triamcinolone)Available in generic, FDA approved for children as young as 2 years of age, and available OTCHigh cost, generally poor medical insurance coverage
Omnaris (ciclesonide)Fewer steroid side effects since medication is a pro-drug. There is also less nasal irritation given the lack of benzalkonium chloride as a preservative (present in all other nasal steroids)High cost, generally poor medical insurance coverage, and only available by prescription
Rhinocort Allergy(budesonide)Available in generic form, preferred nasal steroid during pregnancy (pregnancy category 'B' risk), and available OTCHigh cost, generally poor medical insurance coverage

A Word From Verywell

If you are looking for a nasal steroid, work with your medical provider to determine which medication is best for you. Take note, as well, while nasal steroid sprays are generally considered safe to use for many years, it's important to follow up with your doctor as advised for periodic nasal exams—this way your doctor can check for any nasal irritation, infection, or rare side effects. 

Lastly, if your child is using a nasal steroid spray, be sure to talk to his pediatrician. There is a small worry that nasal steroids may slightly slow the growth rate in children, so limiting their use to no more than two months a year is often advised.


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