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Flonase vs Nasonex
Introduction
For individuals who suffer from allergies or inflammation in the nasal passages, certain medications can help control and manage symptoms by reducing the body's immune response to allergens. Flonase and Nasonex are two such drugs that are frequently prescribed for these conditions. Both of them belong to a class of drugs known as corticosteroids, which reduce swelling and inflammation in the nose. They operate on similar principles but have some differences.
Flonase (fluticasone propionate) is an over-the-counter medication used to treat seasonal and perennial allergy symptoms like sneezing, itchy or runny nose, itchy eyes, throat irritation etc., while Nasonex (mometasone furoate monohydrate) requires a prescription from your doctor and is primarily used for treating symptoms associated with both allergic rhinitis (hay fever) as well as non-allergic rhinitis.
Despite their shared effects on inflammatory responses, they differ slightly in terms of potency - with Nasonex being somewhat stronger than Flonase. However, individual patient experiences may vary depending on numerous factors including condition severity, length of treatment time among others.
Flonase vs Nasonex Side By Side
| Attribute | Flonase | Nasonex |
|---|---|---|
| Brand Name | Flonase | Nasonex |
| Contraindications | Should not be used if there has been recent nasal surgery or injury until healing has occurred. Caution in individuals with weakened immune systems. | Should not be used if there has been recent nasal surgery or injury until healing has occurred. Caution in individuals with weakened immune systems. |
| Cost | The price for a 16g bottle averages around $24 for brand name, and generic fluticasone propionate costs between $10 and $20. | The average price for a 17g bottle is about $200 for brand name, and generic mometasone furoate monohydrate may still be considerably more expensive than generic Flonase. |
| Generic Name | Fluticasone Propionate | Mometasone Furoate Monohydrate |
| Most Serious Side Effect | Signs of an allergic reaction, nasal problems like constant nosebleeds, eye conditions such as blurred vision, symptoms associated with adrenal insufficiency. | Signs of an allergic reaction, severe nosebleeds or nasal discomfort, symptoms suggestive of a hormonal disorder, vision problems, symptoms indicative of infections, changes in mood or behavior. |
| Severe Drug Interactions | Not specifically mentioned, but it's important to inform healthcare providers about all medications and supplements being taken. | Not specifically mentioned, but it's important to inform healthcare providers about all medications and supplements being taken. |
| Typical Dose | For adults and adolescents over 12 years old, start at two sprays in each nostril per day, which can be reduced to one spray in each nostril per day once symptoms are under control. | Typically initiated with a dosage of 50 mcg in each nostril once daily (total daily dose: 100 mcg). If symptoms are not adequately controlled, the dose may be increased to a total daily dose of 200 mcg. |
What is Flonase?
Fluticasone (the generic name for Flonase) and Mometasone (the generic name for Nasonex) are both types of corticosteroid nasal sprays, which represent a significant advancement over earlier classes of allergy medications. Both were approved by the FDA in the mid-1990s. They work by reducing inflammation in the nasal passages, thereby relieving symptoms like congestion, sneezing, itchy or runny nose caused by allergies or other conditions. Flonase primarily influences glucocorticoid receptors with minimal impact on mineralocorticoid receptors hence resulting in fewer water retention side effects than other steroids that have stronger impacts on these latter type receptors.
What conditions is Flonase approved to treat?
Flonase and Nasonex are approved for the treatment of various nasal conditions:
- Allergic and non-allergic rhinitis, commonly known as hay fever
- Nasal polyps (Nasonex only)
- Congestion, sneezing, itching, and runny nose Both medications can also be used to prevent recurrence of nasal polyps after surgical removal (Nasonex).
How does Flonase help with these illnesses?
Flonase helps to manage allergic symptoms by decreasing the amount of inflammation in the nasal passages. It does this by binding to glucocorticoid receptors, which inhibits various cells and mediators involved in inflammatory responses, thereby reducing swelling and irritation. Inflammation is a biological response that plays an important role in immune surveillance and tissue repair but can cause discomfort when it becomes chronic or uncontrolled. People with allergies have an amplified inflammatory response to triggers such as pollen or animal dander. Therefore, by decreasing inflammation, Flonase can limit the negative effects of allergies and help patients manage their condition and stabilize their comfort levels.
What is Nasonex?
Nasonex is a brand name for mometasone furoate, which is a corticosteroid that works by reducing the inflammation and swelling in the nasal passages. It's primarily prescribed for treating symptoms of seasonal allergies such as hay fever, or perennial allergies that occur all year round. Mometasone was first approved by the FDA in 1997. As it's not an antihistamine like some other allergy medications, it doesn't work to block histamines directly but instead reduces your body’s immune response to allergens overall. This function lends Nasonex a different side-effect profile compared to antihistamine drugs - while it may cause nasal dryness or irritation, unlike many antihistamines, it does not typically cause drowsiness or impaired cognition. The effects of mometasone can be highly beneficial for individuals struggling with persistent allergic reactions who do not respond well to "typical" over-the-counter antihistamine treatments.
What conditions is Nasonex approved to treat?
Nasonex, a prescription nasal spray, is approved for the treatment of:
- Seasonal allergic rhinitis in patients 2 years of age and older
- Perennial allergic rhinitis in patients 2 years of age and older
- Nasal congestion associated with seasonal allergic rhinitis in adults and pediatric patients 2 years and older
- Prophylaxis of seasonal allergenic rhinitis symptoms in adult and adolescent patients (12 years old or more)
- Nasal polyps’ symptomatic treatment for adults (18 years old or above)
How does Nasonex help with these illnesses?
Mometasone, the active ingredient in Nasonex, is a corticosteroid that works by reducing inflammation in the nasal passages. This can help to alleviate symptoms such as congestion, sneezing and runny nose which are common in conditions like allergic rhinitis. Like Flonase's fluticasone propionate, it reduces swelling and inflammation but has been shown to have fewer side effects due to its lower bioavailability. Its action on cytokines and cell adhesion molecules may also play roles in the effectiveness of Nasonex as an anti-inflammatory nasal spray. Since it does not significantly affect other systems within the body when used correctly, it is sometimes prescribed when a patient does not respond well or has adverse reactions to other corticosteroid sprays (such as Flonase), or may be combined with them for more effective treatment.
How effective are both Flonase and Nasonex?
Both fluticasone propionate (Flonase) and mometasone furoate (Nasonex) are corticosteroid nasal sprays used to treat symptoms of both seasonal and perennial allergic rhinitis, such as nasal congestion, sneezing, runny nose, or itchy eyes. They were approved by the FDA just a few years apart in the mid-1990s. As they act on similar mechanisms — reducing inflammation within the nasal passages — their indications for use are quite similar.
A comparative clinical trial conducted in 2005 demonstrated that Flonase and Nasonex had comparable efficacy in managing symptoms of allergic rhinitis with no significant differences observed between patients receiving either drug. A notable advantage of Nasonex over Flonase is its indication for use as a preventive treatment of seasonal allergies if initiated two to four weeks before pollen season.
In terms of safety profile, both drugs demonstrate minimal systemic absorption ensuring most action remains localized to where it's needed — within your nose! This results in fewer potential side effects compared to oral steroids. However, reports suggest that Flonase may have slightly higher instances of minor side effects like nosebleeds or throat irritation when compared to Nasonex.
Despite these slight variances, both medications remain excellent choices for treating allergic rhinitis with substantial evidence supporting their effectiveness from numerous clinical trials conducted over decades since their approval by the FDA.
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At what dose is Flonase typically prescribed?
Dosages of Flonase for adults and adolescents over 12 years old usually start at two sprays in each nostril per day, which can be reduced to one spray in each nostril per day once symptoms are under control. For children between the ages of 4-11, it is recommended to start with one spray in each nostril per day. If there is no response or insufficient symptom relief within a few weeks, consult your healthcare provider before increasing the dose. The maximum dosage that should not be exceeded for adults is two sprays in each nostril per day and for children (4-11 years) is one spray in each nostril per day.
At what dose is Nasonex typically prescribed?
Nasonex treatment is typically initiated with a dosage of 50 mcg in each nostril once daily (total daily dose: 100 mcg). If symptoms are not adequately controlled, the dose may be increased to a total daily dose of 200 mcg (two sprays in each nostril, once daily), then decreased back to 100 mcg per day once control is achieved. It's important not to exceed a maximum dosage of four sprays into each nostril per day (400mcg/day). If there isn't any significant improvement after several weeks on this regimen, your doctor might need to reassess your condition and treatment plan.
What are the most common side effects for Flonase?
Common side effects of Flonase, when compared to Nasonex, may include:
- Headache
- Nasal irritation or burning
- Nosebleed
- Sneezing
- Cough
- Altered sense of taste and smell
- Dizziness or lightheadedness (rare)
- Upset stomach or nausea (rare)
- Insomnia (uncommonly)
Nasonex shares many similar side effects with Flonase. Some individuals may experience these symptoms differently depending on their individual reaction to each medication. Always consult your healthcare provider if you experience any unusual symptoms while taking either drug.
Are there any potential serious side effects for Flonase?
While both Flonase and Nasonex are considered safe for the majority of users, some may experience adverse reactions. Pay attention to any unusual symptoms such as:
- Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Nasal problems like constant nosebleeds (several in a day), sores inside the nose that won't heal, whistling sounds when you breathe
- Eye conditions such as blurred vision or other changes in sight
- Symptoms associated with adrenal insufficiency including extreme tiredness or weakness, mental/mood changes (such as depression), unexplained weight loss
- Unusual/extreme tiredness or weakness
- Flu-like symptoms (fever, chills)
If you encounter any severe side effects while using either Flonase or Nasonex nasal spray stop use immediately and consult your doctor.
What are the most common side effects for Nasonex?
While Nasonex and Flonase are both nasal sprays used to relieve allergy symptoms, they do have different side effects. For those using Nasonex, it's essential to be aware of the potential reactions such as:
- Headache
- Viral infection (such as the common cold)
- Coughing
- Nosebleeds or sore throat
- Muscle or joint pain
- Sinusitis or bronchitis Nausea may also occur in some instances. Although these side effects aren't necessarily severe, if you experience persistent problems while using Nasonex, seek advice from your healthcare provider.
Are there any potential serious side effects for Nasonex?
When using Nasonex, there are certain side effects that can be serious and may need immediate medical attention. These include:
- Signs of an allergic reaction such as hives; difficulty breathing or swallowing; swelling of your face, lips, tongue, or throat.
- Severe nosebleeds or nasal discomfort
- Symptoms suggestive of a hormonal disorder including unintended weight gain in the face and shoulders, slow wound healing, skin discoloration (especially bruising), thinning skin with easy bruising and bleeding
- Vision problems like blurred vision, tunnel vision, eye pain or redness
- Symptoms indicative of infections - fever; sore throat; chills; sores in your nose/mouth/anal-genital areas that won't heal
- Changes in mood or behavior - sleep disturbances
If you experience any similar symptoms while on Nasonex treatment stop the medication immediately and consult your healthcare provider for further advice.
Contraindications for Flonase and Nasonex?
Both Flonase and Nasonex, along with most other corticosteroid nasal sprays, may cause a variety of side effects in some people. If you notice an increase in nosebleeds, vision problems or signs of infection such as persistent sore throat, fever/cough, seek immediate medical attention.
Neither Flonase nor Nasonex should be used if you have had recent nasal surgery or injury until healing has occurred due to the potential for slower wound healing. Always inform your healthcare provider about all medications and supplements you are taking; certain drugs may interact negatively with these nasal sprays.
It's crucial to mention that both Flonase and Nasonex can weaken your immune system making it easier for you to get an infection or worsening an existing one. Hence caution should be taken particularly among individuals who already have a weakened immune system either from disease (such as HIV/AIDS) or treatment (such as cancer medicine).
How much do Flonase and Nasonex cost?
For the brand name versions of these drugs:
- The price for a 16g bottle of Flonase (50 mcg/spray) averages around $24, which works out to approximately $0.80/day if you are using two sprays in each nostril daily.
- Nasonex's average price for a 17g bottle (50 mcg/spray) is about $200, working out to roughly $6.70/day when used as directed (two sprays per nostril daily).
Thus, if you are adhering to common dosages, then brand-name Flonase is less expensive on a per-day treatment basis than Nasonex. Please note that cost should not be your primary consideration in determining which nasal spray is right for you.
In terms of generic equivalents:
- Generic fluticasone propionate (the active ingredient in Flonase) costs between $10 and $20 for an equivalent 16g bottle, or from about $.30 to $.60 per day with typical use.
- Mometasone furoate monohydrate - the generic version of Nasonex - may be available but could still be considerably more expensive than generic Flonase.
Prices can depend on factors like where you live and whether or not you have health insurance coverage.
Popularity of Flonase and Nasonex
Fluticasone propionate, in generic form as well as brand names such as Flonase, was estimated to have been prescribed to about 8.1 million people in the US in 2020. Fluticasone accounted for a significant share of nasal steroid prescriptions in the US and has become increasingly popular since becoming available over-the-counter.
Mometasone furoate monohydrate, including brand versions such as Nasonex, was prescribed to around 3.5 million people in the USA during the same year. In terms of overall nasal steroid prescriptions within this period, mometasone held a lower percentage compared to fluticasone propionate. However, it remains a commonly used prescription treatment for seasonal allergies with a steady prevalence over recent years.
Both drugs are classified under intranasal corticosteroids and serve similar therapeutic purposes; they alleviate symptoms associated with seasonal or perennial allergic rhinitis like sneezing, runny nose and congestion among others.
Conclusion
Both Flonase (fluticasone) and Nasonex (mometasone) are widely recognized for their efficacy in managing nasal symptoms associated with allergies. They have been shown to be more effective than placebo treatments through numerous clinical studies. Both drugs work by reducing inflammation in the nasal passages, although they do this through slightly different mechanisms.
Flonase is often a first-line treatment option due to its proven effectiveness and accessibility, as it's available over-the-counter. On the other hand, Nasonex is typically used when patients don't respond well to initial treatments or need additional relief from allergy symptoms.
Both medications are also available in generic form which can lead to significant cost savings especially for individuals paying out of pocket. An adjustment period may be necessary for both Flonase and Nasonex before noticeable effects can be observed.
The side effect profile is similar between these two medicines; both are generally well-tolerated but may cause minor side effects such as headaches, nosebleeds, or sore throat. Patients must closely monitor their responses to these medications especially when starting treatment and should seek medical help immediately if they experience severe or persistent side effects.
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Refrences
- van Drunen, C., Meltzer, E. O., Bachert, C., Bousquet, J., & Fokkens, W. J. (2005, June 11). Nasal allergies and beyond: a clinical review of the pharmacology, efficacy, and safety of mometasone furoate. Allergy. Wiley.http://doi.org/10.1111/j.1398-9995.2005.00917.x
- Baldwin, C. M., & Scott, L. J. (2008). Mometasone Furoate. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200868120-00009
- Schenkel, E. (2003, September). Features of mometasone furoate nasal spray and its utility in the management of allergic rhinitis. Expert Opinion on Pharmacotherapy. Informa Healthcare.http://doi.org/10.1517/14656566.4.9.1579
- Aneeza, W. H., Husain, S., Rahman, R. A., Van Dort, D., Abdullah, A., & Gendeh, B. S. (2013, January). Efficacy of Mometasone Furoate and Fluticasone Furoate on Persistent Allergic Rhinoconjunctivitis. Allergy & Rhinology. SAGE Publications.http://doi.org/10.2500/ar.2013.4.0065
- Bronsky, E. A., Aaronson, D. W., Berkowitz, R. B., Chervinsky, P., Graft, D., Kaiser, H. B., … Nolop, K. B. (1997, July). Dose Ranging Study of Mometasone Furoate (Nasonex) in Seasonal Allergic Rhinitis. Annals of Allergy, Asthma & Immunology. Elsevier BV.http://doi.org/10.1016/s1081-1206(10)63084-0