In Part 1, I discussed oral antihistamines. In this post, I will review OTC allergy nasal sprays. The main OTC options are Nasacort (triamcinolone), Flonase (fluticasone propionate), Rhinocort (budesonide), and Flonase Sensimist (fluticasone furoate). These allergy nasal sprays are far more effective compared to oral antihistamines when it comes to treating classic allergy symptoms. So, if you have tried oral antihistamines but still suffer from allergy symptoms, you should try an allergy nasal spray. Further, they are effective for nasal stuffiness, whereas oral antihistamines are not. All of the 4 products above are topical steroid sprays. They work best if used on a daily basis. They are not as effective if used intermittently. Further, they usually become more effective after 3-4 days of use. Even though they are steroids, they are safe and most are FDA approved down to the age of 2 (Rhinocort is approved down to the age of 6).
In general, I usually recommend Nasacort as I feel it offers the best combination of effectiveness and tolerability. Nasacort is odorless and gentle on the mucous membranes. Flonase is effective but not as well tolerated as Nasacort. It has an odor (artificial flowers) and seems to cause more irritation compared to Nasacort. Rhinocort is effective, has a mild odor, and is fairly well tolerated. Flonase Sensimist is the best tolerated of the four, as it is odorless and has the smallest volume compared to the rest. However, that small volume comes with a price – less medication. Flonase Sensimist only contains 27.5 mcg of medication per spray compared to 50 mcg for Flonase and 55mcg for Nasacort.
So, if your allergy pill is not doing the job, give an allergy nasal spray a try.
Michael Park, MD