Flonase vs. Nasacort

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

What are the differences between Flonase vs. Nasacort?

What are Flonase and Nasacort?

Flonase (fluticasone) is a man-made corticosteroid. The exact mechanism of action of Flonase is not known; however, it stimulates glucocorticoid receptors in humans that produces a potent anti-inflammatory response. Flonase also works on multiple cells and mediators that are responsible for the inflammatory symptoms of allergic rhinitis (sneezing, runny nose, etc.).

Nasacort (triamcinolone acetonide) is a man-made corticosteroid. It is administered as a nasal spray for relieving symptoms of rhinitis. Corticosteroids are naturally occurring hormones produced by the adrenal glands that prevent or suppress inflammation and immune responses. Nasacort provides relief from allergy-induced runny or stuffy nose, postnasal drip, sneezing, and itching of the back of the throat which are symptoms associated with allergy. A beneficial response usually is noted within a few days but can take as long as 4 weeks.

What are the side effects for Flonase vs. Nasacort?

Flonase

Side effects of fluticasone include:

Some children may experience growth suppression from use of inhaled steroids.

Nasacort

The most common side effects following nasal inhalation of triamcinolone acetonide are:

  • nasal irritation and itching,
  • increased cough,
  • nausea or vomiting,
  • sore throat,
  • nasal congestion,
  • sneezing,
  • nasal burning,
  • bloody nasal discharge, and
  • nasal dryness.

Other adverse effects reported with intranasal triamcinolone acetonide include:

All of these are either mild or uncommon.

Nasal septal perforation, oral or nasal fungal infections, growth suppression in children, glaucoma, cataracts, and decreased production of cortisol by the adrenal glands also may occur.

What is the dosage for Flonase vs. Nasacort?

Flonase

  • Adults: The recommended dosing is 2 sprays per nostril daily. The maximum dose is 200 mcg/day (4 sprays). Maintenance therapy is 1 spray in each nostril daily.
  • Adolescents and children 4 years of age and older: the recommended dosing is 1 spray per nostril daily (total dose 100 mcg.) Patients that do not respond adequately may increase to two sprays in each nostril once a day. The maximum dose is 200 mcg/day.

Nasacort

The recommended dose is one or two sprays in each nostril once daily. Before use of the nasal spray, the nose should be blown gently, and the inhaler or spray should be shaken. The head should be tilted backwards, with the nozzle inserted into one nostril, the opening of the nozzle toward the swollen area. The other nostril should be closed. and the spray or inhaler activated while breathing in through the nose and out through the mouth. The inhaler or spray should be cleaned daily. The canister should be removed from the inhaler, rinsing the cap, nosepiece, and the inhaler with warm water and then drying them thoroughly.

What drugs interact with Flonase and Nasacort?

Flonase

Ritonavir (Norvir) and ketoconazole (Nizoral, Extina, Xolegel, Kuric) increase fluticasone levels in the body by delaying its metabolism (elimination). It is not clear how important this effect is.

Nasacort

No drug interactions have been described with nasal triamcinolone.

Are Flonase and Nasacort safe to use while pregnant or breastfeeding?

Flonase

There are no adequate studies of fluticasone to determine its safety and effectiveness in pregnant women.

It is not known whether fluticasone enters breast milk; therefore, it is best to be cautious before using it in nursing mothers.

Nasacort

Serious complications (including cleft palate and still births) have been reported when oral corticosteroids were administered during pregnancy. It is not known if the small amounts of corticosteroids that appear in the blood following intranasal use carry the same risk. Triamcinolone acetonide use during pregnancy should be avoided unless the physician feels that the potential therapeutic benefit justifies the potential risk to the fetus.

It is unknown whether triamcinolone acetonide accumulates in breast milk. However, it is known that other corticosteroids are excreted in breast milk. The effects on the child, if any, are unknown.

Summary

Flonase (fluticasone) and Nasacort (triamcinolone acetonide) are synthetic steroids for the control sneezing, itching, and runny nose caused by seasonal allergies or hay fever. The nasal inhalers are both available over the counter. Learn dosage, side effects, and pregnancy safety information.

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Medically Reviewed on 10/30/2017
References
FDA Prescribing Information
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