Flonase vs. Nasonex – Which is Better?

Flonase vs. Nasonex – which is the best over the counter nose spray?

Nasonex vs Flonase: What is better?
It’s time you learn the best OTC nasal steroid!
Dr. Webber,
I hope this isn’t too silly of a question, but I’ve heard a lot of commercials about different nose sprays.  I’m wondering if there is any difference and what nose spray I should pick.

– Melanie


The Current Market of Nasal Steroids

Over the past year, it seems every other commercial is for an allergy medication and recently it’s been about nose sprays (PS – thanks, Netflix and Hulu, you’re the real MVPs for saving me from these commercials one binge-watch at a time).

In early 2015 Flonase (fluticasone) went over the counter and the most recent (and last) to join the over the counter nasal steroid market is Nasonex (mometasone).  Today,  I’m going to review these two titans and give you an answer of what nasal steroid I recommend.

Note:  there are other noses-spray allergy medications, but I’m specifically talking about nasal steroids.

Nasal steroids are best medication to treat allergies
Nasal steroids are the BEST treatment for allergy symptoms!

General Benefits of Nasal Steroids

I’ve mentioned this in prior articles but in general, a nasal steroid is probably the single BEST medication for treating seasonal allergies, year-round allergies and irritant allergies (if you’re not sure what you have, take this 5 minute quiz and get your answer!)

The general benefits of nasal steroids are:

  • Best symptom control
  • Once a day dosing (you can split it to two times a day based on comfort, but the benefits truly lasts > 24 hours)
  • Flexibility for adults and children


Nasal steroids are the best “fix it and forget it” type of medicine:  if you take it once a day, every day, the majority of people won’t have to worry about allergies at all!  The class is that good!

Not sure if you actually have allergies?  Take this 5 minute quiz and find out!

You’re probably thinking “But with so many choices, there must be SOME differences.”  There are!  So let the battle between Flonase (fluticasone) vs Nasonex (mometasone) begin!  (It’s hard to make nose sprays exciting… but I’m trying!)



Flonase (Fluticasone)

Flonase benefits vs Nasonex
First to go over the counter: Flonase!

Benefits of Flonase (fluticasone) vs Nasonex (mometasone):

  • Flonase (fluticasone) has an age indication down to age 4
  • Flonase (fluticasone) is usually the most cost effective!

Problems of Flonase (fluticasone) vs Nasonex (mometasone):

  • Flonase (fluticasone) has a floral/flowery taste and smell
  • Flonase (fluticasone) is alcohol based (which can dry the nose a little more)



Nasonex (mometasone)

Nasonex benefits vs flonase
The most recent to become OTC: Nasonex

Benefits of Nasonex (mometasone) vs Flonase (fluticasone)

  • Nasonex (mometasone) is safe to age 2
  • Nasonex (mometasone) is a water based formula (which means less drying of the nose)

Problems of Nasonex (mometasone) vs Flonase (fluticasone)

  • Nasonex (mometasone) has a chemical taste/smell to it
  • Nasonex (mometasone) currently costs more



When do I choose Flonase (fluticasone) vs Nasonex (mometasone)?

As a general rule, I think of these two medications this way:

  1. If you are treating your child ages 2-4, Nasonex (mometasone) has the FDA approval for this age range.
    • There is nothing unique about the medication in how it works for kids and this is more a function of the initial FDA approval studies.
    • But I try to stay in FDA guidelines as much as possible.
    1. If you treating your child age >4 or treating yourself, I usually recommend starting with Flonase (fluticasone).
Flonase (fluticasone) cheapest at costco
Costco remains the CHEAPEST and best option for fluticasone
    • This is based on the cost. If both medications work the same, cheaper = better.
    • Right now, Costco has the cheapest price with their Kirkland Fluticasone sprays (5 bottles for $30, I believe). THE BEST DEAL PERIOD!
    • And if you don’t already know this from my prior posts, you DO NOT need a membership to buy medications at Costco.
  1. If you have a problem with the smell or taste of Flonase (fluticasone), then I’d consider changing to Nasonex (mometasone)
  1. If you have frequent nose bleeds with Flonase (fluticasone), then I would consider changing to Nasonex (mometasone) as well (the water-based formula tends to help reduce nose bleeds).


Still not sure?

If you are still not sure, or have another question with these medications then I would recommend you do one of the following:

  1. Take this quiz to find out what type of allergies you have and then email me your specific questions.
  2. Just ask me!  It takes 5 minutes and you’ll get personalized answers to YOUR questions and concerns!


What about the other nasal steroids?

There are two other nasal steroids out there:  Nasacort (triamcinolone) and Rhinocort (budesonide).  These are also great options for treating allergies.  I’m working on a HUGE post comparing them all (you can request it sooner by clicking here) but overall these tend to be overpriced or with more adverse effects than those listed above.

If you don’t have a preference or haven’t gotten a nasal steroid yet, I’d recommend following my guide above.  But if you are using one of the above nasal steroids and it is working, then please continue it.  ANY nasal steroid will give you the best allergy control!

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  • Braden Bills says:

    I’ve been having a lot of issues with allergies lately. I didn’t know that Flonase was so cost effective! It seems like a good way to get rid of these annoying allergies.

  • Nancy Mitchell says:

    Dear Dr. Webber: In the above article, you state that “the most recent (and last) to join the over the counter nasal steroid market is Nasonex (mometasone).” Also, “The most recent to become OTC: Nasonex.” Both my physician and pharmacy disagree. Both Nasonex and its generic, Mometasone Furoate Monohydrateone, require a prescription at this time.

  • Not sure where you got your info. Nasonex is not available otc

    • You’re right. They decided to make it generic prescription only instead. I’m updating my article now.

      Thank you for being so proactive in your care that you know the medicines and also thank you for helping all our readers. I appreciate you and the time you took to help.

  • Gina Atoigue says:

    Not sure if cat dander is breaking my son out .. and his lip is swollen.. I vacuumed the bed and rug.. what can I buy over the counter..

    • Gina,

      Your best bet is to buy an over the counter antihistamine like Zyrtec (cetirizine) and use it once to twice a day. Cetirizine is an OTC antihistamine that does a great job on itchiness and hives and comes in many different forms good for kids. Make sure you read the directions for dosing and ask your provider if you have any questions.

      Also, if the swelling worsens or is not controlled with cetirizine, consider seeing an allergy specialist. I know we have A LOT we can do for cat allergy.

      If you have more questions, feel free to Email me and I will happily provide more help.

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