Flonase vs. Nasacort: what are the differences?

Seasonal allergies can make people miserable with a stuffy nose, itchy eyes, etc. Luckily, several over-the-counter and prescription medications may help relieve these symptoms, including two steroid nasal sprays: Flonase and Nasacort.

Read on to learn how to compare Flonase vs. Nasacort so you can decide if this treatment is right for you.

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Here’s a basic breakdown of how allergies work: if you’re sensitive to a particular trigger in the environment (called an allergen), your immune system may see that substance as a threat and try to fight it. Your immune system goes into overdrive and releases several chemicals, including histamine, causing allergy symptoms. Some people are allergic to certain foods or medications, while others are sensitive to dust mites, pet dander, or other everyday substances. 

People with seasonal allergies or hay fever might only experience allergy symptoms like sneezing, runny nose, coughing, and nasal congestion at certain times of the year. You might only feel your allergies pop up when the allergens you're sensitive to are more abundant in the environment. Some people also experience "seasonal" allergy symptoms year-round; these are called perennial allergies (Akhouri, 2021). 

Many of the signs and symptoms of a common cold can resemble allergies, especially things like a stuffy nose, sneezing, sinus congestions, postnasal drip, etc. However, studies show that intranasal steroids do not help you get over your cold faster (Hayward, 2015).

Flonase and Nasacort are both inhaled corticosteroid medications FDA-approved to treat allergic rhinitis. By delivering the drug directly into the nostril, these nasal sprays provide allergy relief without all of the side effects that steroid pills can cause. 

Both Flonase and Nasacort effectively treat nasal allergy symptoms—more than some of the other allergy treatments. Clinical trials suggest that steroid nasal sprays are better at improving allergy symptoms than oral antihistamines, like cetirizine (brand name Zyrtec), fexofenadine (brand name Allegra), and loratadine (brand name Claritin) (Akhouri, 2021). 

Corticosteroids, like Flonase and Nasacort, improve allergy symptoms because they are anti-inflammatory drugs. They tone down the inflammatory response produced by your immune system. Scientists don’t know the precise mechanisms involved, but steroids decrease the inflammatory cells, reduce tissue swelling, and constrict blood vessels (vasoconstriction). The combination of these anti-inflammatory effects is an overall improvement in your allergy symptoms (Remien, 2021).

Flonase (generic name fluticasone propionate) is an allergy nasal spray that helps improve nasal allergy symptoms like nasal congestion, sneezing, and an itchy or runny nose. It can also help with other allergy symptoms like itchy or watery eyes (UpToDate, n.d.-a). 

Fluticasone propionate comes both as an over-the-counter (OTC) steroid nasal spray (brand name Flonase 24-hour Allergy Relief) and as a prescription nasal steroid (brand name Flonase or Xhance). Xhance has a different dose of fluticasone propionate and is mainly used for nasal polyps (UpToDate, n.d.-a).

Flonase can safely be used for up to six months at a time—maybe longer if approved by your healthcare provider. It is FDA-approved for use in children over two years of age, and the typical dose is one or two sprays in each nostril 1–2 times daily (UpToDate, n.d.-a).

Nasacort (generic name triamcinolone acetonide) is another intranasal steroid to treat allergic rhinitis symptoms like congestion, runny nose, sneezing, and more. The over-the-counter form of triamcinolone acetonide comes as the brand name Nasacort Allergy 24HR Nasal Spray or generic formulations. 

Nasacort should be used for a shorter time than Flonase. Most people experience the full effect of Nasacort within one week of starting the medication. If you don’t feel adequate relief from Nasacort within three weeks of treatment, you should stop using it and talk to your healthcare provider (UpToDate, n.d.-b).

Nasacort is FDA-approved for use in children over two years of age, and the typical dose is two sprays per nostril twice daily (UpToDate, n.d.-b).

As intranasal steroids, Flonase and Nasacort share several adverse effects like nasal irritation and nosebleeds. The best way to prevent nosebleeds is to make sure to point the tip of the applicator towards the outer corner of your eye rather than at the nasal septum (the wall that divides your two nostrils).

While they have many similarities, Nasacort and Flonase have their differences as well. 

Flonase side effects

The most common side effects of Flonase are (FDA, 2019):

• Headache

• Pharyngitis (sore throat)

• Epistaxis (nosebleeds)

• Nasal burning/irritation

• Nausea/vomiting

• Asthma symptoms

• Cough 

Nasacort side effects

The most common side effects of Nasacort are (FDA, 2013):

• Pharyngitis (sore throat)

• Epistaxis (nosebleeds)

• Flu-like symptoms

• Cough

• Bronchitis

• Tooth problems

• Headache

• Abdominal pain

• Diarrhea

Both Flonase and Nasacort may interact with other medications and cause other side effects, so it’s always important to talk with your healthcare provider about all the pros and cons of any medications or supplements you take.

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Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

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Current version

July 12, 2021

Written by

Michelle Konstantinovsky

Fact checked by

Chimene Richa, MD

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About the medical reviewer

Chimene Richa, MD

Dr. Richa is a board-certified Ophthalmologist and medical writer for Ro.