Astepro vs. Flonase

In this article:

• Key differences
• Conditions treated
• Side effects
• Insurance coverage and cost
• Using Flonase and Astepro together
• Which is better?
• FAQs

In this article

• Key differences
• Conditions treated
• Side effects
• Insurance coverage and cost
• Using Flonase and Astepro together
• Which is better?
• FAQs

Seasonal allergies can be a massive hassle, causing an itchy nose, nasal congestion, and other symptoms. Many people turn to one (or more) nasal sprays to help them cope. One popular option is Flonase, a corticosteroid spray that works best with consistent daily use to manage ongoing allergy symptoms. Another is Astepro, an antihistamine spray that can provide quick relief from symptoms.

Both types of nasal sprays are available over-the-counter (OTC). However, before you decide which one to buy, it’s important to understand which one you need for your symptoms and the potential side effects.

Compare Astepro vs. Flonase key differences
Differences	Astepro	Flonase
Active ingredient	Azelastine (antihistamine)	Fluticasone propionate (corticosteroid)
How it works	Blocks the effects of histamine, a chemical released by the body in response to an allergen	Reduces inflammation in the nasal passages
Onset of relief	Can start feeling relief within about 30 minutes of using	Some relief within 12 hours; full effect after several days of daily use
Best for	Quick relief	Ongoing, year-round or seasonal allergy control
OTC availability	Yes	Yes
Age approval (OTC)	6 years and older	4 years and older

Conditions treated

As you consider what nasal spray to choose for your seasonal allergies, take a closer look at each one first.

Astepro is the brand name for azelastine, an antihistamine. Astepro works by blocking the action of a chemical called histamine that’s released by the body when it detects an allergen. Using Astepro can reduce itching and swelling from seasonal allergies. It also works quickly to bring you relief and help you breathe easier. According to the manufacturer, Astepro starts working in 30 minutes and can create relief from those pesky nasal symptoms for as long as 24 hours.

“For short term or unpredictable symptoms, Astepro tends to be the better bet,” says Joe Higgins, Pharm.D., ICU clinical pharmacist for OSF Healthcare Little Company of Mary Medical Center.

Meanwhile, Flonase is the brand name for the corticosteroid known as fluticasone propionate. Like Astepro, Flonase also blocks the action of histamine. But it also works against some other natural substances that the body produces during an allergic reaction, including prostaglandins, cytokines, tryptases, chemokines, and leukotrienes.

Unlike Astepro, Flonase is not considered a quick-acting treatment for allergies. According to Heather Swanson, MD, regional medical officer for CareMore Health in Memphis, Tennessee, it takes anywhere from two to 12 hours to experience the first effect of fluticasone, and it takes about two weeks of consistent daily use to experience the maximum benefit.

“Fluticasone is designed for continuous seasonal use, daily throughout the allergy season,” she says.

Your healthcare provider can help you figure out which nasal spray is best to treat your symptoms.

Side effects

To minimize side effects, it’s important to use the lowest recommended dose that’s appropriate for you.

The most common side effects from fluticasone nasal spray include symptoms such as a bloody nose, cough, headache, fever, and irritation in the nose or throat. Gastrointestinal side effects such as nausea or vomiting are also possible, and some people may also experience a change in their sense of taste or smell. Let your healthcare provider know if you begin to experience any signs of an allergic reaction, such as a skin rash, hives, or swelling of the face, throat, mouth, or tongue, or any other more serious side effects.

The most common side effects of azelastine nasal spray include drowsiness or sleepiness and a bitter taste in the mouth. Nosebleeds may occur, too.

Compare Astepro vs. Flonase side effects
Side effect	Astepro	Flonase
Drowsiness	Possible in a small percentage of users	Not typically
Bitter taste	Common if sprayed incorrectly	Uncommon
Nosebleeds	Possible	Possible, more common with regular use
Nasal irritation/dryness	Possible	Possible
Headache	Possible	Possible

Before you use a nasal spray like Flonase or Astepro, you may need to prime the spray first. Experts also recommend blowing your nose to clear your nostrils, too.

The proper technique for a nasal spray starts with inserting the spray tip into one nostril and closing the other by placing your finger against the side of the nose. Dr. Higgins recommends tilting your head slightly forward and spraying to the outer wall of the nostril. It can help to use your opposite hand for each nostril. Don’t feel the need to sniff hard right afterward, either, as a light inhale will do the job. Hold your breath for a few seconds, then gently exhale through your mouth.

“The mistake that some people make is spraying straight across and hitting the septum, and then they wind up with nosebleeds or irritation,” Dr. Higgins says. Steroid nasal sprays can cause nosebleeds because they tend to dry out the nasal passages, and using the right spray technique can reduce the nosebleed risk from Flonase. Using the right technique can also reduce the strong bitter taste from the Astepro.

If you do experience frequent or heavy nosebleeds while using Flonase or any other nasal steroid spray, talk to your healthcare provider. Also let your provider know if you’re experiencing drowsiness or other side effects that interfere with your normal daily activities like driving.

Insurance coverage and cost

The good news about these nasal sprays is that the cost is generally not prohibitive. “Cost is rarely a major differentiator,” Dr. Higgins says. “Both are available over-the-counter and are reasonably priced.”

You could also save some money by purchasing a generic version of Flonase or Astepro. However, generic Astepro is only available with a prescription. As Dr. Higgins notes, “The store-brand versions work exactly the same as the name brand, so [you can] grab whichever is cheaper.”

Sometimes, a provider will still write a prescription for one of these sprays, so you can use a SingleCare coupon to reduce the cost even more than the typical OTC shelf price.

Compare Astepro vs. Flonase insurance coverage and cost
Coverage and cost	Astepro (azelastine)	Flonase (fluticasone propionate)
Typically covered by insurance?	Usually not (OTC)	Usually not (OTC)
Generic available?	Yes (generic azelastine, with a prescription)	Yes (generic fluticasone propionate)
Retail price without insurance	$135 for 30, 30 ml bottle of 0.1% generic azelastine	$91 for 1, 16gm bottle of 50 mcg/act generic fluticasone
Lowest SingleCare price	$9 for 30, 30 ml bottle of 0.1% generic azelastine at Walmart	$5 for 1, 16gm bottle of 50 mcg/act generic fluticasone at Walmart

Using Flonase and Astepro together

You could also consider using both Flonase and Astepro together. In fact, you may be able to achieve more complete symptom relief by using both, as Astepro blocks histamine while Flonase reduces inflammation, according to Dr. Higgins.

“Using azelastine and fluticasone together is safe and is, in fact, an established evidence-based combination,” Dr. Swanson says. “The two are so commonly and effectively combined that they are co-formulated in an FDA-approved product branded Dymista.”

Indeed, Dymista contains both azelastine and fluticasone in a single spray, and Dymista could be a good option for some people. “The upside is convenience, where you have one spray instead of two,” Dr. Higgins says. “The downside is it’s prescription-only and costs more than just buying both OTC.”

Dr. Swanson agrees that patients may want to consider the cost-benefit ratio, saying, “While it is convenient to have the medications delivered in one actuation, the cost is significantly less with the two OTC products versus the branded product.” Just be sure to consult with a healthcare provider or pharmacist before combining two nasal sprays, especially if you have other health conditions.

Which is better: Astepro or Flonase?

There’s not a universal right answer to the question. When deciding which nasal spray is the right choice, it’s necessary to consider several factors, including your symptoms and how quickly you need relief.

For example, do you need fast relief from sneezing and itching? In that case, you might choose Astepro. Some people also choose Astepro if they don’t want to use a steroid nasal spray.

Meanwhile, if you’re on the hunt for a nasal spray that can help you maintain control of congestion and inflammation during allergy season, you might reach for Flonase instead.

However, if you’re struggling to find one product that works well for you, Dr. Swanson has a suggestion. “Add, instead of switching, if you aren’t getting relief,” she says. “If a single medication doesn’t control your symptoms, adding the other class is more effective than swapping. The combination outperforms either alone.”

When in doubt, consult a pharmacist or a healthcare provider. A number of nasal sprays are available on the market, and they can help you narrow down your choices if you’re uncertain.

Frequently asked questions

Can you use Astepro and Flonase together?

Yes, you can use Astepro and Flonase together. You can also talk to your provider about Dymista, which is a nasal spray that essentially combines the two.

Is Astepro or Flonase better for congestion?

Both medications can help you in different ways. The choice really depends on if you need a quick-acting treatment or something for long-term management.

Is there a generic version of Astepro?

Yes. Look for allergy nasal spray packages that list “azelastine hydrochloride” on the label.