Nasal Spray for Allergies: What to Know and How to Choose (2024)

If you deal with seasonal allergies anddon’tuse a nasal spray, we’ve got just one question for you: What are you waiting for?


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“Nasal sprays really are the best medical therapy we have for managing allergic rhinitis, or hay fever,” says allergistMark Aronica, MD. He weighs in on what nasal sprays do, how to figure out which one is best for you and how to use them.

What are nasal allergy sprays?

Itchy eyes, stuffy nose, sneezing and wheezing … you’re already very familiar with the symptoms that accompanyallergy season. When the symptoms start to hit, it can be truly miserable to try to make it through the day.

But nasal sprays can help — alot.

“You generally use them just once a day in most instances, but they do take a little time to kick in and have benefits,” Dr. Aronica says. “I usually tell my patients that because of that time lag and efficacy, you want to start using your nose spray at least two to three weeks before allergy season starts.”

How to use a nasal spray

Before you spray, take a moment for proper positioning and best practices. Dr. Aronica shares some tips.

  • Spare your septum.You want to spray straight up and steer away from the midline of your nose, known as your septum; it’s the cartilage and bone that separates your nasal cavity. Directing your spray here can damage the tissue, causing irritation and a bloody nose.
  • Take agentlesniff.No giant snorts! “The biggest mistake people make is doing a big sniff when they spray,” Dr. Aronica says. “If you suck the medicine to the back of your throat and it’s swallowed, it’s not doing anything for the nose or sinus.” So, after you’ve sprayed, take just a light sniff.
  • You shouldn’t taste it.If you can taste the medicine down the back of your throat, it’s not staying where it belongs — in your nose. “You want as much of that medicine to stay in the nose and sinus as possible,” Dr. Aronica advises.

If you’re banking on a nasal spray to keep your allergy symptoms at bay, it’s important that you use it right so it can do its job. Follow all tips forusing nasal spray properlyto give it the best chance of working its medical magic.

Choosing an allergy nasal spray

There are two main classes of these medications: nasal steroid sprays and antihistamine nose sprays. But you might have to figure out which nasal spray works best for you — and your primary care doctor or allergist can guide you.

Dr. Aronica explains the differences between them, including how they work and where to get them.

Nasal steroid sprays

Nasal congestion happens when your nasal tissue become swollen and inflamed. Nasal steroid sprays, a popular over-the-counter (OTC) option, target inflammation to reduce swelling and help clear up stuffiness. They’re sold as:

  • Fluticasone (Flonase®).
  • Betamethasone (Nasacort®).

“Nasal steroid sprays are generally once-a-day medications, but the benefits take a little bit of time to kick in,” Dr. Aronica explains. “Because of that time lag, you should start using them two to three weeksbeforeallergy season starts.”

Antihistamine nose sprays

When your allergies make you feel itchy, you can blame it on histamine, a chemical that causes your blood vessels to be more permeable (leaky) and leads to overall stuffiness.


“Antihistamine sprays block some of the effects of histamine,” Dr. Aronica says, “and studies show that they have anti-inflammatory properties, as well.”

They do what their OTC counterparts do, but they’re only available by prescription, sold as azelastine (Astepro® and Astelin®) and olopatadine (Patanase®).

“Both are very effective, and they work a little bit quicker than nasal steroid sprays,” Dr. Aronica says. “But they usually have to be used twice a day for maximum benefit.”

Can you use pills and sprays together?

It depends. Some don’t mesh well, while others can go together as long as they’re used correctly and safely. Here are some rules of thumb; though, it’s always best to check with your doctor.

  • Take it easy on the antihistamines.“It’s technically not really a problem to take both an antihistamine spray and an oral antihistamine, as the spray is delivered locally and has little systemic effect,” Dr. Aronica says. But it also may not do much. Though some people find it helpful to take both, most studies show minimal benefit.
  • Do add an antihistamine pill if you need it.“I recommend nasal steroid sprays for regular use,” Dr. Aronica says, “but it’s OK to sometimes add an oral antihistamine on top of that.”Long-acting, non-sedating antihistaminesare generally safe for everyday use, though check with your doctor to be sure they’re OK for you. They include cetirizine (Zyrtec®), fexofenadine (Allegra®) and loratadine (Claritin®).
  • Don’t mix and match multiple nasal sprays.Unless your doctor has specifically instructed you otherwise, stick to one at a time. If an antihistamine spray isn’t working for you, you can wait until tomorrow and try a nasal steroid spray, and vice versa. But you may want to give them a chance, even if relief is slow to come.“I do tell patients that a 30-day trial of one spray, used daily and as directed, is generally a good indicator of whether it is going to be helpful or not,” Dr. Aronica says.

Are nasal allergy sprays safe?

Nasal sprays are generally considered safe for use, and the risk of side effects is pretty low. But if you overuse them, they can cause health issues, like:

  • Dryness or stinging in your nose.
  • Headaches
  • Nausea.
  • Sinus pains.
  • Sore throat.
  • Vomiting

Other sprays called decongestant sprays (oxymetazoline, sold as Afrin®) shouldn’t be used for more than three or four days, as they can be habit-forming (and they don’t cure allergies, they just treat your symptoms in a pinch). But nasal steroid sprays and antihistamine nose sprays aren’t habit-forming and should be used regularly for best effect.

Still, Dr. Aronica recommends taking the minimal effective dose.


“If you’re getting benefit from a nasal spray, try dropping your dose to find the lowest dose that keeps your allergy symptoms under control,” he suggests. “You may want to bring the dose back up during pollen season or if your symptoms increase.”

Are they safe for children?

Some nasal sprays are specifically formulated for kids, though different sprays have different minimum ages — usually 2 or 4 years old. As with all medications, be sure to follow the instructions closely, and talk to your pediatrician about any questions or concerns.

Are they safe while pregnant?

There are plenty of medications you shouldn’t take or should scale way back on while you’re pregnant, but you can probably keep taking your nasal spray as needed for allergies. As you’ll hear so often while pregnant, it’s best to check with your own doctor.

And don’t forget saline sprays!

Not to be confused with medicated nasal sprays, saline sprays and rinses are simple, over-the-counter options that help flush irritants out of your nasal lining.

“Clearing out your sinuses with a nasal lavage can provide a nonmedical treatment,” Dr. Aronica says. “When you rinse the sinuses with saline, you remove some of that pollen that accumulates during the day.”


Nasal Spray for Allergies: What to Know and How to Choose (2024)


Nasal Spray for Allergies: What to Know and How to Choose? ›

The bottom line

Which nasal spray is best for allergies? ›

Experts say that over-the-counter (OTC) anti-inflammatory nasal sprays—such as FLONASE nasal sprays or Nasacort® 24 Hour—are the most effective form of nasal allergy symptom relief.

What nasal sprays do doctors recommend? ›

They're often the first drug recommended for allergies, but it takes about a week before you'll notice your symptoms getting better. Examples of steroid nasal sprays available by prescription include beclomethasone (Beconase, Qnasl), ciclesonide (Zetonna), fluticasone furoate (Veramyst), and mometasone (Nasonex).

Is Flonase or Nasacort better? ›

Official answer. Nasacort and Flonase are equally effective, safe, and well tolerated for the treatment of allergic rhinitis. Therefore the choice of either Nasacort or Flonase comes down to personal preference, availability or price.

Which nasal spray has the least side effects? ›

Of the different types of allergy nasal sprays, saline nasal spray is known to cause the fewest side effects because it does not contain any medication.

What are the pros and cons of Flonase? ›

Advantages: Approved for the treatment of eye allergy symptoms in addition to nasal allergy symptoms. Disadvantages: Flowery smell bothers some people, contains an alcohol preservative that may cause irritation in some people.

Which is better Allegra or Flonase? ›

Flonase (fluticasone) is typically recommended for sinusitis as it works directly in your nose to reduce swelling and is better at treating sinusitis than Allegra (fexofenadine). While Allegra (fexofenadine) can help relieve itchy eyes, watery eyes, runny nose, sneezing, itchy throat, it cannot relieve inflammation.

Who should not use Nasacort? ›

You should not use Nasacort AQ until your nose has healed if you have a sore in your nose, if you have had surgery on your nose, or if your nose has been injured. Eye problems such as glaucoma and cataracts.

Why was Flonase discontinued? ›

Issues Voluntary Nationwide Recall of Fluticasone Propionate Nasal Spray USP 50 mcg Per Spray 120 Metered Sprays Due to Potential for Small Glass Particles.

Is it better to take Zyrtec or Flonase? ›

FLONASE, a nasal spray, tends to be more effective for nasal symptoms like congestion, while Zyrtec, an oral antihistamine, may be better for symptoms like itching and hives. Individual responses vary, so personal trial is beneficial. What Should You Know About Allergies?

Is there a nasal spray that is safe to use everyday? ›

Nasal steroids sprays (Flonase®, Nasocort®, Nasonex®, etc. ) are safe to use on a daily basis and are now largely over-the-counter. These sprays are non-addictive and typically do not cause any long term changes to the nasal passages.

What is the best nasal spray for seniors? ›

Steroid nasal sprays, such as Flonase (fluticasone propionate), are some of the best allergy medicines for older adults. Astepro (azelastine) nasal spray, and non-drowsy oral antihistamines, such as Allegra (fexofenadine) are also first-choice options. All of these allergy medications are safe for older adults.

Is FLONASE a steroid or antihistamine? ›

The active ingredient in Flonase Allergy Relief Spray is the nonprescription version of fluticasone, a corticosteroid that works by blocking the release of the substances that cause allergies. Many allergy pills on the shelves are single-ingredient antihistamines, meaning they only block the production of histamine.

What nasal spray is good for allergies and blocked nose? ›

Examples include Flonase, Rhinocort, and Nasonex. Decongestant nasal sprays: These sprays contain active ingredients like oxymetazoline and phenylephrine that constrict blood vessels in the nasal passages, which can reduce swelling and congestion. Examples include Afrin and Neo-synephrine.

Is Afrin or Flonase better for allergies? ›

One common misperception when choosing a nasal allergy spray is that all nasal sprays are created equal. However, this is not true. For example, nasal sprays such as Afrin® are only decongestants, while FLONASE allergy relief nasal sprays offer more complete* relief by treating additional nasal allergy symptoms.

What is the fastest working allergy nasal spray? ›

Astepro Allergy (azelastine) is the most common antihistamine nasal spray. It works quickly — within 15 minutes, and it can be used to both treat and prevent allergy symptoms.

Which allergy medicine is best for nasal congestion? ›

Antihistamine nasal sprays help relieve sneezing, itchy or runny nose, sinus congestion, and postnasal drip. Side effects of antihistamine nasal sprays might include a bitter taste, drowsiness or feeling tired. Prescription antihistamine nasal sprays include: Azelastine (Astelin, Astepro)


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