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Drug vs. Drug

Flonase vs. Nasacort: Differences, similarities, and which is better for you

Flonase and Nasacort are steroid nasal sprays for allergies. Learn about differences such as side effects, dosage, and interactions.
Karen Berger medical writer and reviewer headshot
By | Updated on Dec. 30, 2024 Medically reviewed by Anne Jacobson, MD, MPH
Bottles of nasal spray Flonase and Nasacort comparisons

Key takeaways

  • Flonase and Nasacort are both nasal steroid sprays that treat allergy symptoms like congestion and runny nose.

  • Flonase and Nasacort are equally effective in studies, but individuals may find that one works better for them.

  • Most people use Flonase or Nasacort without significant side effects.

  • There are a few differences between the two nasal sprays regarding medication interactions, age guidelines, and price.

In this article:

If you suffer from seasonal or year-round allergies, you are not sneezing alone. More than 50 million Americans suffer from allergies each year. 

Flonase (fluticasone propionate, or fluticasone) and Nasacort (triamcinolone acetonide, or triamcinolone) are two popular medications used for allergy relief. They are in a class of medications called corticosteroids, more commonly known as steroids. Nasal steroids work by decreasing swelling and congestion in your nose. Although Flonase and Nasacort work in the same way, they do have some notable differences. 

What are the main differences between Flonase and Nasacort?

Flonase (fluticasone) and Nasacort (triamcinolone) treat nasal allergy symptoms like congestion and runny nose. In the past, both drugs were only available with a prescription, but now can be purchased over-the-counter (OTC). Flonase and Nasacort come in adult and children’s formulations. 

Flonase is still available as a prescription drug, as its generic, fluticasone. Flonase is also available in a “Sensimist,” which delivers a more gentle mist. Both drugs can be used in children and adults, but Nasacort can be used in children 2 years and older, while Flonase can be used in children 4 years and older. 

Main differences between Flonase and Nasacort
Flonase Nasacort
Drug class Nasal corticosteroid Nasal corticosteroid
Brand/generic status OTC: Brand (Flonase Allergy Relief) and generic

Rx: generic

 OTC only: Brand (Nasacort Allergy 24 hour) and generic
What is the generic name? Fluticasone propionate Triamcinolone acetonide
What form(s) does the drug come in? Nasal spray

Children’s nasal spray

Gentle mist spray 

Children’s gentle mist spray

 Nasal spray

Children’s nasal spray
What is the standard dosage? Adults and children 12 and older: 1-2 sprays (50 mcg per spray) in each nostril once daily 

Children 4 – 11 years old: 1 spray in each nostril daily 

 Adults and children 6 and older: 1-2 sprays (55 mcg per spray) in each nostril once daily. 

Children age 2 to 5: 1 spray in each nostril daily
How long is the typical treatment? Short-term or long-term, depending on symptoms and doctor’s instruction

*consult with doctor if your child needs to use for more than 2 months a year 

 Short-term or long-term, depending on symptoms and doctor’s instruction

*consult with doctor if your child needs to use for more than 2 months a year 
Who typically uses the medication? Adults, adolescents, children age 4 and older  Adults, adolescents, children age 2 and older 

Conditions treated by Flonase and Nasacort

Flonase and Nasacort are used to treat nasal congestion, sneezing, and runny nose caused by seasonal or year-round allergies. Flonase and Nasacort can also be used off-label to treat conditions like nasal polyps and sinusitis. 

Is Flonase or Nasacort more effective?

A 2019 study found that after 28 days of treatment,Flonase and Nasacort were similarly effective in treating nasal allergy symptoms. Other studies have shown the same results. In general, Flonase and Nasacort are equally safe, effective, and well-tolerated. 

You and your doctor can determine the nasal steroid that will work best for you.

Coverage and cost comparison of Flonase vs. Nasacort

Most commercial insurance and Medicare Part D plans cover the prescription form of generic Flonase, fluticasone. However, the amount of coverage and copay may vary. The OTC version of Flonase is not usually covered. Flonase usually costs around $20 but generic fluticasone nasal spray can be purchased for as little as $7 with a SingleCare pharmacy coupon.

Nasacort is only available OTC and is generally not covered by insurance (some state Medicaid plans may pay for generic ) or Medicare Part D. The retail price for Nasacort commonly costs over $30, but you can get generic triamcinolone nasal spray at a participating pharmacy for as low as $13.50 with a SingleCare coupon.

Common side effects of Flonase vs. Nasacort

In general, Flonase and Nasacort don’t have many side effects.

For Flonase, the most common side effects include: 

  • Headache
  • Sore throat
  • Nosebleed
  • Nasal irritation
  • Nausea or vomiting
  • Asthma symptoms
  • Cough

Common side effects of Nasacort include:

  • Sore throat
  • Nosebleed
  • Cough

Children under 12 using Nasacort may also experience:

  • Flu-like symptoms
  • Bronchitis
  • Upset stomach
  • Tooth problems

Talk to your healthcare provider about any side effects you may be experiencing from either Flonase or Nasacort.

Drug interactions of Flonase vs. Nasacort

Flonase is processed by an enzyme called cytochrome-P 450 3A4, otherwise known as CYP3A4. Certain drugs inhibit this enzyme and slow it down from processing Flonase. That can lead to increased steroid side effects. Drugs that should not be taken with Flonase include:

  • Antiviral drugs: ritonavir, atazanavir, indinavir, nelfinavir, saquinavir, lopinavir
  • Antidiuretic hormone inhibitor: conivaptan
  • Antifungals: itraconazole, ketoconazole, voriconazole
  • Antibiotics: clarithromycin, telithromycin
  • Antidepressant: nefazodone

Talk with your healthcare provider if you have concerns about drug interactions.

Nasacort does not have significant interactions with other medications.

Warnings of Flonase and Nasacort

  • Less common but more serious side effects that may occur include nosebleeds, nasal ulceration, local Candida (yeast) infection, nasal septal perforation, and impaired wound healing.
  • Steroids may cause glaucoma or cataracts with long-term use. You should be closely monitored if you have any changes in vision or if you have a history of increased intraocular pressure, glaucoma, and/or cataracts. If you use Flonase or Nasacort long-term or have any eye symptoms, follow up regularly with an ophthalmologist.
  • If a hypersensitivity reaction occurs (skin symptoms, trouble breathing, facial swelling), stop taking Flonase or Nasacort and seek emergency medical attention. 
  • Because steroids suppress the immune system, you may be more prone to infections while using a steroid nasal spray. 
  • Children may experience slower growth. Growth should be closely monitored. The lowest possible dose, for the shortest duration of time, should be used. 
  • Rarely, adrenal suppression may occur, and the nasal steroid should be slowly tapered to discontinuation (not stopped abruptly). 
  • Because there is not enough data about nasal steroids in pregnancy, consult with your doctor before taking Flonase or Nasacort if you are pregnant. If you are already taking Flonase or Nasacort and find out that you are pregnant, contact your healthcare provider for guidance. 

Frequently asked questions about Flonase vs. Nasacort

What is Flonase?

Flonase is a nasal steroid that can help relieve allergy symptoms. The active ingredient is fluticasone propionate. It is available OTC in brand-name and generic versions, and by prescription in its generic form. It can be used in adults and children ages 4 and older.

What is Nasacort?

Nasacort is a nasal steroid used to help relieve symptoms of allergy. The active ingredient in Nasacort is triamcinolone. It is available OTC in both brand-name and generic versions. Nasacort can be used in adults as well as children ages 2 and older. 

Are Flonase and Nasacort the same?

Flonase and Nasacort are very similar and have many of the same uses and warnings. However, they have some differences, such as in the active ingredient, drug interactions, and price. Other medications in the nasal steroid category include Rhinocort (budesonide), QNasl (beclometasone), and Nasonex (mometasone). Fluticasone is also available as a combination drug in the form of brand-name Dymista, which contains azelastine along with fluticasone. 

Is Flonase or Nasacort better?

Both drugs have been found in studies to be well-tolerated, and effective in improving symptoms. 

Can I use Flonase or Nasacort while pregnant?

There is not enough data, so it is best to discuss your allergy symptoms with your doctor. 

Can I use Flonase or Nasacort with alcohol?

Flonase or Nasacort are considered safe to use with alcohol. However, if you are taking other medications for your allergy symptoms, check with your doctor or pharmacist to see if those medications are compatible with alcohol.

Which nasal allergy spray is most effective?

There are a variety of nasal allergy sprays and some work in different ways. While drugs like Flonase and Nasacort are steroids, some nasal allergy sprays contain other ingredients such as azelastine, which is an antihistamine and works differently than a steroid. Many people like Afrin nasal spray; however, you have to be careful to use this medication for only 3 days or less, otherwise it can cause rebound congestion. The most effective allergy spray is the one that works best for you. 

Is Nasacort good for sinus infection?

While Nasacort may help relieve some of the nasal symptoms caused by a sinus infection, it will not treat the infection itself. If you have a bacterial sinus infection, you will need to take antibiotics prescribed by your doctor.

Does Flonase help sinus pressure?

Flonase can be helpful in managing sinus symptoms. However, if the sinus pressure is caused by a bacterial infection, Flonase may help the symptoms but will not clear the infection. If you have a bacterial infection, you will need to take prescription antibiotics.