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Flonase vs Beconase Aq
Introduction
For patients suffering from allergic rhinitis or other types of nasal allergies, certain medications that reduce the inflammation and swelling in the nasal passage can help alleviate symptoms. Flonase and Beconase AQ are two such drugs often prescribed for these conditions. They each work by suppressing inflammatory responses in the body, but both have different characteristics to consider.
Flonase (fluticasone propionate) is a synthetic corticosteroid known for its potent anti-inflammatory action. It works by reducing cellular infiltration and edema during an inflammatory reaction while also inhibiting mast cells, which trigger allergic reactions.
On the other hand, Beconase AQ (beclomethasone dipropionate), although also a corticosteroid nose spray like Flonase, has fewer indications for use compared to Flonase due to its lower potency towards broad-spectrum allergy relief.
Flonase vs Beconase Aq Side By Side
| Attribute | Flonase | Beconase aq |
|---|---|---|
| Brand Name | Flonase | Beconase Aq |
| Contraindications | Should not be used if there is an untreated infection in the nasal passages or sinuses. Caution advised if taking ritonavir. | Should not be used if there is an untreated infection in the nasal passages or sinuses. |
| Cost | For the brand name, around $30 for a 16gm bottle (50mcg/spray). Generic versions cost between $10 and $20 for one 16 gm bottle. | For the brand name, about $220 for a 25ml bottle. Generic versions generally cost around $70-$100 per bottle. |
| Generic Name | fluticasone propionate | beclomethasone dipropionate |
| Most Serious Side Effect | Severe allergic reactions, vision problems, rapid heartbeat or palpitations, fatigue and weakness associated with adrenal suppression, symptoms of low potassium levels. | Signs of an allergic reaction, changes in vision, severe nasal irritation leading to nosebleeds, unusual mood changes, trouble sleeping, rapid weight gain. |
| Severe Drug Interactions | Ritonavir (a medication for HIV/AIDS) due to a possible increase in steroid levels within the body. | Not specifically mentioned, but as with all corticosteroids, caution should be exercised when taking other medications that could potentially increase systemic steroid levels. |
| Typical Dose | For adults and children over 12 years, two sprays (50 mcg/spray) in each nostril once daily, totaling 200 mcg/day. Dosage can be adjusted based on response but should not exceed 400 mcg/day. | Begins with 1 to 2 sprays into each nostril twice daily. The dose can be adjusted based on the patient's response and tolerance, but should not exceed 336 mcg per day. |
What is Flonase?
Fluticasone propionate (the generic name for Flonase) was the first drug of its class, corticosteroids, which marked a major development upon other classes of meds used to treat nasal symptoms. It was first approved by the FDA in 1994. Flonase works by reducing inflammation and swelling in the nose, effectively "calming" it for longer than usual. It is prescribed for treating different forms of allergic rhinitis including hay fever and year-round allergies. Flonase has a selective influence on glucocorticoid receptors with only minor influence on mineralocorticoid receptors, which results in it having fewer side effects than other corticosteroids that have stronger effects on these two receptor types.
On the other hand, Beclomethasone dipropionate (Beconase AQ) belongs to the same class as Flonase but differs slightly in terms of mechanism and potential side effects. Like Flonase, Beconase AQ also provides relief from nasal allergy symptoms but may cause more local side-effects like nosebleeds or burning sensations inside your nose compared to fluticasone propionate-based products.
What conditions is Flonase approved to treat?
Flonase is approved for the treatment of different types of allergic reactions:
- Seasonal and perennial rhinitis, often triggered by pollen, dust mites, or pet dander
- Nonallergic (vasomotor) rhinitis, a chronic condition with symptoms like chronic sneezing or having a congested, drippy nose without an identified allergy
- Adjunctive therapy to manage sinusitis and to relieve associated eye symptoms in patients 12 years of age and older.
How does Flonase help with these illnesses?
Flonase manages nasal allergy symptoms by reducing inflammation in the nasal passages. It works by inhibiting various types of cells and chemical mediators involved in inflammatory responses, including mast cells, eosinophils, neutrophils, macrophages, lymphocytes, cytokines among others. This results in a decrease in rhinitis symptoms caused due to an allergic reaction.
Histamine is one substance that plays a significant role during the allergic response causing itching and increasing mucus production. By suppressing histamine release along with other chemicals involved in inflammation Flonase can alleviate the negative effects of allergens on individuals susceptible to them.
Beclomethasone dipropionate (Beconase AQ) has similar action as it also belongs to corticosteroids group but it's generally considered less potent than fluticasone propionate (Flonase). Both medications help control and prevent nasal allergy symptoms such as sneezing and runny nose but your healthcare provider may recommend one over the other based on specific patient characteristics or disease severity.
What is Beconase Aq?
Beconase AQ, also known as beclomethasone dipropionate, is a corticosteroid used to prevent and treat symptoms of allergic rhinitis. It functions by reducing inflammation in the nasal passages thereby relieving congestion, sneezing, itching or runny nose caused by allergies. Beconase AQ was first approved by the FDA in 1981.
Unlike drugs that work directly on histamine receptors (like antihistamines), Beconase AQ doesn't have a direct action on these receptors but instead reduces the inflammatory response which is part of allergic reactions. This means its side-effect profile differs from antihistamines; it's less likely to cause drowsiness or dry mouth for example.
While both Flonase and Beconase AQ are effective treatments for allergy symptoms, some patients may find one works better than the other due to individual differences in response. Given this subjective variable, it could be advantageous for patients who don't respond well to Flonase as an allergy medication alternative.
What conditions is Beconase Aq approved to treat?
Beconase Aq is a nasal allergy spray that's been approved for the treatment of conditions such as:
- Seasonal and perennial allergic rhinitis, which includes symptoms like sneezing, runny or itchy nose caused by dust mites, pet allergies and hay fever.
- Nasal polyps; these are small growths in the nasal passages which can lead to discomfort or difficulty breathing.
How does Beconase Aq help with these illnesses?
Beclomethasone dipropionate, the active ingredient in Beconase Aq, is a corticosteroid which also functions as an anti-inflammatory agent. It plays a crucial role in reducing swelling and inflammation in the nasal passages, providing relief from symptoms like congestion, runny nose or sneezing associated with allergies. This action can be likened to norepinephrine's effect on stress response by preparing the body for action under discomfort. Beconase AQ operates by decreasing levels of certain immune responses that lead to allergic reactions instead of directly increasing any neurotransmitter levels like Wellbutrin does with norepinephrine. Its unique mechanism of action makes it suitable for patients who do not find adequate relief from other typical allergy medications such as Flonase or may be combined with these treatments for more effective control of symptoms.
How effective are both Flonase and Beconase Aq?
Both Flonase (fluticasone) and Beconase AQ (beclomethasone) have established histories of effectiveness in the treatment of nasal symptoms related to allergies, such as sneezing, stuffy or runny nose. They were both approved by the FDA in the 1990s with only a few years apart. Since they are categorized under different classes of corticosteroids, they might be prescribed under varying patient conditions.
The efficacy of fluticasone and beclomethasone was directly studied in clinical trials; both drugs exhibited similar efficacy in managing allergic rhinitis symptoms while delivering favorable safety profiles. None of the parameters used to measure their efficiency differed significantly between patients receiving fluticasone or those using beclomethasone.
Meta-analysis studies on fluticasone show that it is effective from first use at mitigating nasal symptoms associated with allergies, has a side effect profile comparable or better than many other steroid sprays, and is well-tolerated even among children and elderly populations. It's also reported that fluticasone has become one of the most commonly prescribed corticosteroid nasal sprays worldwide due to its proven effectiveness.
A review conducted in 2017 indicated that beclomethasone seems to exhibit more potency than placebo for treating allergic rhinitis but similarly effective compared to other common intranasal steroids like budesonide or mometasone furoate. However, it's typically considered after alternatives such as antihistamines fail to provide relief because it tends not work immediately but requires consistent usage over days before significant improvement can occur.
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At what dose is Flonase typically prescribed?
Dosages of Flonase for adults and children over 12 years typically start at two sprays (50 mcg/spray) in each nostril once daily, totaling 200 mcg/day. The same dosage is also sufficient for treating allergic rhinitis in most individuals. For some patients, a dose of one spray in each nostril (100 mcg/day) is enough. Children between the ages 4 to 11 may be started on one spray in each nostril per day. Dosage can be increased after a few weeks if there is no response, but should not exceed two sprays in each nostril per day (400 mcg/day).
At what dose is Beconase Aq typically prescribed?
Beconase Aq treatment typically begins with 1 to 2 sprays into each nostril twice daily. The dose can then be adjusted based on the patient's response and tolerance, but should not exceed a maximum of 336 mcg per day (4 sprays in each nostril twice daily). If symptoms do not improve after a week, or worsen while using Beconase Aq, patients should consult their healthcare provider. Similarly, if there is no response to treatment at the usual dose for several weeks, other forms of therapy may need to be considered.
What are the most common side effects for Flonase?
Common side effects of Flonase and Beconase AQ may include:
- Nosebleed or nose dryness
- Nausea or vomiting
- Headache
- Sore throat, cough, or hoarseness
- Stinging or burning in the nose
- Upset stomach
- Unpleasant taste/smell
- Dizziness
While both medications can relieve nasal symptoms caused by allergies, they might also cause some temporary discomfort. It's important to remember that not everyone experiences these side effects and if you do, it is typically at a very manageable level. However, if these persist or worsen over time, seeking medical advice would be beneficial.
Are there any potential serious side effects for Flonase?
In rare cases, Flonase can cause potentially serious side effects, which include:
- Severe allergic reactions: hives, difficulty breathing or swallowing, swelling of the face and throat
- Vision problems such as blurred vision, tunnel vision or seeing halos around lights due to possible rise in intraocular pressure
- Rapid heartbeat or palpitations
- Fatigue and weakness that might be associated with adrenal suppression
- Symptoms indicative of low levels of potassium in the body - muscle cramps or spasms, irregular heartbeats
On very rare occasions it may also lead to a severe nervous system reaction causing symptoms like restlessness, trembling or shaking.
Similarly, Beconase AQ can cause similar side effects but additionally there might be instances of nasal irritation or discomfort. Nosebleeds are more common with Beconase AQ use.
Should you experience any these symptoms while using either medication stop taking them immediately and seek medical attention.
What are the most common side effects for Beconase Aq?
Beconase Aq, like many nasal sprays, can cause a variety of side effects such as:
- Stinging or burning in the nose
- Sneezing after application
- Sore throat or cough
- Nausea
- Headache or dizziness
- Unpleasant taste or smell
These symptoms are generally mild and temporary. However, if they persist with regular use of Beconase Aq, it is advisable to consult your healthcare provider. It's also worth noting that although these side effects can occur with most nasal steroids, some people may experience fewer issues with Beconase Aq compared to other options like Flonase.
Are there any potential serious side effects for Beconase Aq?
While Beconase Aq is generally well-tolerated, there can be serious side effects in some cases. These include:
- Signs of an allergic reaction such as hives, itching, swelling in your face or throat; difficulty breathing; severe skin reaction with symptoms like fever, sore throat, burning eyes and a red or purple skin rash that spreads (especially in the face or upper body) causing blistering and peeling.
- Changes in vision including blurred vision or seeing halos around lights
- Severe nasal irritation leading to nosebleeds
- Unusual mood changes such as feeling overly excited or restless
- Trouble sleeping
- Rapid weight gain, especially in your face and midsection
If you experience these symptoms after using Beconase AQ, immediately stop its use and seek medical attention.
Contraindications for Flonase and Beconase Aq?
Both Flonase and Beconase AQ, like most other corticosteroid nasal sprays, can cause side effects such as nosebleeds or irritation in the nose. If you experience persistent discomfort or frequent bleeding while using these medications, please seek immediate medical attention.
Flonase and Beconase AQ should not be used if you have an untreated infection in your nasal passages or sinuses. Always inform your physician about any current conditions; these infections need proper treatment to prevent potentially serious complications from the use of Flonase or Beconase AQ.
It's also crucial to disclose all medications you're currently taking before starting either of these drugs – some medicines may interact adversely with corticosteroids. For instance, individuals on ritonavir (a medication for HIV/AIDS) are typically advised against using Flonase due to a possible increase in steroid levels within the body.
How much do Flonase and Beconase Aq cost?
For the brand name versions of these drugs:
- The price of 1 nasal spray bottle (16gm) of Flonase (50mcg/spray) averages around $30, which works out to $0.15–$1/day, depending on how many sprays you use per day.
- The price for a nasal spray bottle (25ml) of Beconase AQ is about $220, working out to approximately $2.20/day.
Thus, if you are using several sprays daily from your Flonase treatment then brand-name Beconase AQ could potentially be more expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.
For the generic versions:
- Generic fluticasone propionate (the active ingredient in Flonase) typically costs between $10 and $20 for one 16 gm bottle with an average dose being between two and four sprays per nostril once daily i.e., approximate costs can range from as low as $.010 to up to $.40 per day.
- Similarly, generic beclomethasone dipropionate (active ingredient in Beconase AQ), while still more expensive than its counterpart fluticasone propionate generally costing around $70-$100/bottle - this will work out at approx $.70 - 1$/day again depending upon usage frequency.
Popularity of Flonase and Beconase Aq
Fluticasone, available in brands like Flonase, was prescribed to an estimated 8.2 million people in the US in 2020. Its use has been increasing over the past few years due to its effectiveness and safety profile for both adults and children aged four years and above. It accounted for about 15% of all intranasal corticosteroid prescriptions dispensed.
Beclomethasone dipropionate, sold under names such as Beconase AQ, was prescribed to approximately 1.5 million people in the USA during the same time period accounting for around 3% of all intranasal corticosteroid prescriptions. Both medications are used primarily for relief from seasonal or perennial nasal allergies but they differ slightly in their pharmacokinetics - fluticasone is more potent than beclomethasone dipropionate which means that lower doses can achieve similar efficacy with potentially fewer side effects. The prevalence of Beconase AQ usage has remained steady over the last decade while Flonase continues to increase, possibly owing to its wider market availability including a nonprescription status since mid-2010s.
Conclusion
Both Flonase (fluticasone propionate) and Beconase Aq (beclomethasone dipropionate) are widely recognized as effective treatments for seasonal and perennial nasal allergies such as rhinitis. They work by decreasing inflammation in the nasal passages, thereby reducing symptoms like sneezing, itching, and congestion. While both drugs share a similar mechanism of action, they can have varying effects depending on individual patient responses.
Flonase is often the first choice because it has a wider scope of indications including non-allergic rhinitis whereas Beconase Aq is typically used specifically for allergic rhinitis. However, both medications are available over-the-counter offering easy access to patients.
In terms of side effects, both Flonase and Beconase Aq may cause mild nosebleeds or nasal irritation but these are usually temporary. Patients should monitor their symptoms closely when starting treatment with either drug and seek medical help if symptoms persist or worsen.
Both products also offer generic alternatives which can be beneficial from an economic standpoint especially for those who need long-term management of allergy symptoms.
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Refrences
- RUDOLPH, R., KUNKEL, G., STAUD, R.-D., & KOENNECKE, R. (1976, October). The nasal application of beclomethasone diproprionate (Beconase) in allergic rhinitis. Clinical Otolaryngology. Wiley.http://doi.org/10.1111/j.1365-2273.1976.tb00652.x
- Jones, N. S., & Kenyon, G. S. (1988, December). Topical nasal steroids in non-atopic perennial rhinitis; subjective symptom scores and objective measurement of nasal resistance by active anterior rhinomanometry. The Journal of Laryngology & Otology. Cambridge University Press (CUP).http://doi.org/10.1017/s002221510010742x
- Ratner, P. H., Paull, B. R., Findlay, S. R., Hampel, F., Jr, Martin, B., Kral, K. M., & Rogenes, P. R. (1992, September). Fluticasone propionate given once daily is as effective for seasonal allergic rhinitis as beclomethasone dipropionate given twice daily. Journal of Allergy and Clinical Immunology. Elsevier BV.http://doi.org/10.1016/s0091-6749(05)80005-3
- VANAS, A., BRONSKY, E., DOCKHORN, R., GROSSMAN, J., LUMRY, W., MELTZER, E., … ROGENES, P. (1993, June). Once daily fluticasone propionate is as effective for perennial allergic rhinitis as twice daily beclomethasone diproprionate. Journal of Allergy and Clinical Immunology. Elsevier BV.http://doi.org/10.1016/0091-6749(93)90317-9
- VANAS, A., BRONSKY, E., DOCKHORN, R., GROSSMAN, J., LUMRY, W., MELTZER, E., … ROGENES, P. (1993, June). Once daily fluticasone propionate is as effective for perennial allergic rhinitis as twice daily beclomethasone diproprionate. Journal of Allergy and Clinical Immunology. Elsevier BV.http://doi.org/10.1016/0091-6749(93)90317-9