Flonase vs. Nasacort


What is Flonase? What is Nasacort?

Flonase is a Brand name for a nasal spray medicine containing fluticasone as an active ingredient. Fluticasone is corticosteroid drug that prevents the release of body substances that causes inflammation.


Nasacort is a Brand name for a nasal spray medicine containing triamcinolone as an active ingredient.  Triamcinolone is a corticosteroid. This drug prevents the release body substances that can cause inflammation.

Flonase fluticasone




Are Flonase and Nasacort same thing?

They are both intranasal corticosteroids and have similar effects and same indications, but they are not the same thing, and have differences.

The major difference is that Flonase nasal spray is indicated for relieving both nose and eye related allergy symptoms such as itchy and watery eyes, while Nasacort can be used only for nose allergy symptoms.

Also, Fluticasone, the active substance of Flonase is second generation intranasal corticosteroid while Triamcinolone, the active substance of Nasacort is the first generation intranasal corticosteroid.

These products have equal efficacy, although the second generation intranasal corticosteroids such as Fluticasone have the total bioavailability lower than first-generation agents, which results in a lower risk of causing systemic side effects.

Studies have shown that smaller doses and reduced systemic availability of intranasal corticosteroid agents significantly reduces the risk of hypothalamic-pituitary-adrenal axis suppression.

Several studies of the second- and third-generation intranasal corticosteroids have shown minimal effects on the hypothalamic-pituitary-adrenal axis in both pediatric and adult patients when they are used at recommended doses.

How do Flonase and Nasacort work?

They act by binding to the glucocorticoid receptors. Unbound corticosteroids molecules can cross the cells membranes of mastocytes and eosinophils binding with high affinity to glucocorticoid receptors.

The results of drug-receptor interaction are 3 processes: transcription, alteration and protein synthesis, reduced release of enzyme called leukocytic acid hydrolases, reduction of collagen deposition, leukocyte adhesion to the capillary wall interference, reduction of the proliferation of fibroblasts, prevention of macrophage accumulation into the sites of  inflammation, reduction of capillary membrane permeability and edema, decrease of complement components, inhibition of proinflammatory substances such as  kinin and histamine release, and interference with scar tissue formation.

Flonase and Nasacort Uses

Flonase nasal spray indications are: nasal congestion, runny nose, sneezing, watery or itchy eyes caused by seasonal or year-round allergies.

Nasacort indications are nasal allergy symptoms such as: itching, sneezing and runny nose that is caused by hay fever or seasonal allergies.

Flonase and Nasacort available dosages and forms

Flonase is available as 0.05% nasal spray.

Nasacort is available in the form of nasal inhaler, spray and aerosol in the dose of 55 ug/1.

Flonase side effects

Nasacort side effects

  • Headache (17%)
  • Upper respiratory infections (15%)
  • Nasal congestion (8%)
  • Pharyngitis (6-8%)
  • Dysphonia (4%)
  • Fever (1-5%)
  • Cough (3-4%)
  • Aches and pains (1-3%)
  • Nasal discharge (1-3%)
  • Flu-like syndrome (1-3%)
  • Diarrhea (1-3%)
  • Bronchitis (1-3%)
  • Abdominal pain (1-3%)
  • Nasal ulcer (1%)
  • Loss of taste – not defined frequency
  • Nasal burning irritation, and nasal soreness, nasal dryness, nasal septal perforation – postmarketing report
  • Flu syndrome (9%)
  • Pharyngitis (5-8%)
  • Headache (6%)
  • Bronchitis (3%)
  • Dyspepsia (3-5%)
  • Tooth disorder in children (3%)
  • Epistaxis (3-5%)
  • Excoriation in children (3%)
  • Increased cough (2- 8%)
  • Upper abdominal pain (5%)
  • Diarrhea (3%)
  • Rash (3%)
  • Asthma (3%)
  • Rhinorrhea (2%)
  • Postmarketing reports: Nasal discomfort, Sneezing, Alterations of taste and smell, Nausea, Insomnia, Dizzinessm, Fatigue, Dyspnea, Decreased blood cortisol, Cataract,, Glaucoma, Pruritus, Rash, Hypersensitivity

Can you buy Flonase and Nasacort over the counter?

Flonase and Nasacort are available without prescription. Patients can buy these products over the counter.

Flonase and Nasacort price

  • Flonase nasal spray average price for 9.9 milimeter(s) is about $17.83
  • Nasacort nasal spray average price for 16.9 milimeter(s) and 120 sprays is about $18.99

Who should use Flonase and Nasacort ?

  • Flonase should not be used in a child under 4 years old. Corticosteroids can affect growth in children.
  • Patients who have tuberculosis or any other infection herpes simplex virus of the eyes, sores and ulcers inside their nose, glaucoma or cataracts, liver disease, or patients who have recent surgery or nose injury should talk with their doctor first before using Flonase.
  • Nasacort should not be used in a child under 2 years old without doctor advice. Corticosteroids can affect growth in children.
  • Patients allergic to triamcinolone should not use Nasacort.
  • Patients who have tuberculosis, chicken pox or measles, asthma, infection, history of glaucoma or cataracts, and patients who have recent surgery or nose injury should talk with their doctor first before using Nasacort.
  • Flonase and Nasacort FDA pregnancy category are C. It is not known whether Nasacort or Flonase will harm an unborn baby. Women should tell their doctor if they are pregnant or plan to become pregnant while using these products,
  • It is not known whether triamcinolone or fluticasone passes into breast milk. Mothers who are breast-feeding a baby should not use these products without their doctor permission.
  • Patients with diabetes should tell their doctors if they are using these drugs, corticosteroids can increase sugar levels in blood.

How should Flonase and Nasacort be used?

To use Flonase or Nasacort nasal spray properly, patients should follow next steps:

  • Remove the cap from the bottle and shake the bottle gently.
  • If you are using the pump for the first time you must prime the pump. Press and release the nozzle to release 5 sprays into the air away from the face. If you have not used it for 2 weeks or longer, press and release 1 spray into the air away from the face.
  • Gently blow your nose until your nostrils are clear. A small child may need help to gently blow his or her nose.
  • Remove the bottle cap and gently shake the bottle.
  • Hold the pump with the applicator between your forefinger and middle finger and the bottom resting on your thumb.
  • Press one finger on the other hand against the side of one of your nostrils to hold it closed.
  • Put the spray tip into your other nostril. Aim the tip toward the back of your nose, but do not push the tip deep into your nose. Do not point the tip toward your nasal septum (divider between your nostrils).
  • Sniff gently. While you are sniffing, use your forefinger and middle finger to press firmly down on the applicator and release a spray.
  • If you are using 2 sprays, repeat steps 6 to 8.
  • Repeat steps 6 to 8 in the other nostril.
  • Do not blow your nose for 15 minutes after using the spray.
  • Wipe the applicator with a clean tissue and cover it with the cap.

How many times and how often can patients take Flonase and Nasacort?

Flonase and Nasacort should be used exactly as prescribed by their doctor or as directed on the label.

The usual dose of Flonase is 1 to 2 sprays into each nostril once per day. Dose may be changed after if symptoms improve.

The usual dose of Flonase is 1 spray into each nostril once per day. Adults can use higher doses if their doctors prescribe.

How long does it take for Flonase and Nasacort to be effective?

Patients should know that Flonase and Nasacort can control their symptoms of allergies and hay fever but do not cure these conditions. Patient’s symptoms may improve on the day they start using spray, but usually it may take up to 1 week of daily use before patients begin to feel the full benefit of these drugs. If symptoms do not improve after 1 week, patients should call their doctor.

What if I overdose Flonase or Nasacort?

Flonase or Nasacort overdose is not expected to cause life threatening side effects. However, if those steroids are used for a long term period, they can cause symptoms such as easy bruising, thinning skin, changes in location of body fat especially in face, back, neck, and waist, menstrual problems, increased acne or facial hair, impotence, or decreased libido.

If someone swallows Flonase or Nasacort nasal spray, local poison control center at 1-800-222-1222 should be called. If the victim has collapsed or is not breathing, local emergency services at 911 should be called.

What if I missed the dose of Flonase or Nasacort?

Patients should take the missed dose as soon as they remember it. However, if it is almost time for the next dose, patients should skip the missed dose and continue with their regular dosing schedule. Patients should never use double dose to make up for a missed one.

How long both Flonase and Nasacort should be used?

Patients should not use Flonase or Nasacort for more than 1 week, unless their doctor prescribed them otherwise.

How long do Flonase and Nasacort stay in your system?

  • Half-life time of fluticasone after intravenous administration is 7.8 hours. After intranasal administration it is expected that half-life should be much lower.
  • Half-life time after Nasacort intranasal administration is 88 minutes.

Can I take Flonase and Nasacort with Zyrtec?

Since there are no significant and dangerous interaction between Zyrtec and Flonase or Nasacort, patients can use them together for a treatment of seasonal allergies, but they always need to consult their doctor or pharmacist first.

These drugs work pretty well together in treating symptoms associated with allergic rhinitis. Zyrtec is second generation antihistamine and has fewer side effects such as sedation and drowsiness compared to older antihistamines. However, patients need to see an allergist first for more definitive treatment options.

Can I take Flonase and Nasacort with Benadryl?

Since there is no direct interaction, intranasal corticosteroids can be taken in combination with Benadryl. Intranasal corticosteroids such as Flonase and Benadryl are the first line treatment for allergic rhinitis, but sometimes patients need more than a spray for better relieving of their symptoms, so adding an antihistamine drug such Benadryl is acceptable and quite common.

These drugs do not interact and both work to help patient’s allergy symptoms. Patients should use the smallest effective dose when needed for a short time period.

Can I drink alcohol while taking Flonase or Nasacort?

Alcohol should never be used in combination with any drug, as it can alter side effects. Although there are no major interactions between alcohol and nasal corticosteroids, if they are used for a short time period.

However if intranasal steroid are used for a more than week, alcohol can potentiate their side effect. Also, many patients who use intranasal steroids also use antihistamines for their allergy symptoms relief. Combination of alcohol and antihistamines can alter antihistamine sedative effects.

Can I use Flonase or Nasacort if I have a bloody nose?

Patients should never use these products if they have bloody nose. Active substance can be absorbed from broken blood vessel into systemic circulation and may cause systemic side effects.

Patients should stop using these products if their nose becomes to bleed, and they should call their doctor immediately. Nose bleeding is most common limiting side effect of nasal steroid spray.

When you cannot absolutely use Flonase and Nasacort?

Patients who have tuberculosis or any other infection, herpes simplex virus of the eyes, sores and ulcers inside their nose, frequently nose bleedings, glaucoma or cataracts, liver disease, or patients who have recent surgery or nose injury, children younger than 2 years should not use these products.

What are the alternatives for Flonase and Nasacort?

  • Alternative for Flonase on the market that contains fluticasone as an active ingredient is Veramyst nasal spray.
  • Alternatives for Nasacort on the market that contain triamcinonole as an active ingredient are Allergy Nasal, Equate and Nasal Allergy spray.

Are Flonase and Nasacort addictive?

Intranasal corticosteroids are not addictive substances. True addiction is a compulsive physiological need for and use of a habit-forming substance known to be physically, psychologically or socially harmful. OTC nasal sprays don’t cause the physiological desires that mark an addiction.

However, after a few days of administrating nasal sprays, in some patients, nose may become less responsive to the effects of nasal sprays. However, this is more common in patients using nasal decongestant, and it is generally not usual for corticosteroids.

As a result, patients may need to use more and more to control congestion. Congestion may also worsen if patient stop using these products. This is called a rebound effect, not addiction. That’s why patients should not use these products for more than a week, and always as directed by doctor or pharmacist.

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