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Nasonex vs Dymista
Introduction
For patients suffering from seasonal or perennial allergic rhinitis, certain drugs can provide relief and help manage symptoms by reducing inflammation and suppressing the body's immune response to allergens. Nasonex and Dymista are two such medications often prescribed for these conditions. They target different aspects of the inflammatory response, but both can significantly alleviate allergy symptoms. Nasonex is a corticosteroid nasal spray which primarily works by decreasing inflammation in the nasal passages. Dymista is a combination drug that contains both an antihistamine (azelastine) to block the action of histamine in your body and a corticosteroid (fluticasone propionate) to reduce swelling.
Nasonex vs Dymista Side By Side
| Attribute | Nasonex | Dymista |
|---|---|---|
| Brand Name | Nasonex | Dymista |
| Contraindications | Should not be used with certain antifungal or antiviral drugs. Not recommended for individuals with glaucoma, cataracts, or recent nasal surgery. | Should not be used with certain antifungal or antiviral drugs. Caution advised for individuals with glaucoma, cataracts, or recent nasal surgery. |
| Cost | Around $200 for a 17-gram bottle (120 sprays), or about $6.60/day. Generic version around $40 for a 30-day supply. | Around $240 for a 23-gram bottle (120 sprays), or about $8/day. Generic version around $40 for a 30-day supply. |
| Generic Name | Mometasone Furoate | Azelastine Hydrochloride and Fluticasone Propionate |
| Most Serious Side Effect | Vision problems, nasal sores or nosebleeds, signs of a severe allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat. | Severe dizziness or sleepiness, nasal problems such as pain and sores, signs of an allergic reaction like hives; difficulty breathing; swelling of your face, lips, tongue, or throat. |
| Severe Drug Interactions | Increased risk of side effects with certain antifungal or antiviral drugs. | Increased risk of side effects with certain antifungal or antiviral drugs. |
| Typical Dose | Two sprays in each nostril once per day for adults and adolescents over 12 years old. One spray in each nostril once daily for children aged 3–11 years. | One spray in each nostril twice daily. Dosage should not exceed two sprays in each nostril twice per day. |
What is Nasonex?
Mometasone furoate, the active ingredient in Nasonex, effectively reduces inflammation within the nasal passages. It was first approved by the FDA in 1997. Nasonex is a nasal spray form of mometasone. It works by decreasing swelling and inflammation in the nose, providing relief from sneezing, itching, and runny or stuffy nose caused by seasonal or year-round allergies.
Dymista is also a nasal spray formulation, but it contains two active ingredients: azelastine hydrochloride (an antihistamine) and fluticasone propionate (a corticosteroid). This combination helps to alleviate symptoms of allergic rhinitis more effectively than either component alone, as it not only reduces inflammation but also blocks histamine receptors. Blocking histamine receptors blocks the action of histamine, which prevents the symptoms of the allergic reaction from manifesting.
Although these medications have similar uses for treating the allergic rhinitis symptoms, their mechanisms of action differ slightly due to their composition. This means that Nasonex and Dymista also have potentially different side effect profiles. Side effects are relatively rare with both of these treatments, but potential issues include dryness or a burning sensation in your nose.
What conditions is Nasonex approved to treat?
Nasonex and Dymista are approved for the treatment of various conditions related to nasal allergies:
- Seasonal Allergic Rhinitis: Both Nasonex and Dymista can be used to treat symptoms such as runny nose, sneezing, and itchy or watery eyes caused by seasonal allergies.
- Perennial Allergic Rhinitis: Nasonex is also effective in treating year-round allergies.
- Nasal Polyps: Nasonex has been approved for use in reducing the size of nasal polyps and alleviating associated symptoms like congestion.
Dymista combines a steroid (like the one in Nasonex) with an antihistamine, which may provide additional relief from allergic rhinitis, but this combination comes with its own considerations.
How does Nasonex help with these illnesses?
Nasonex aids in managing nasal allergy symptoms by reducing inflammation in the nasal passages. It does this through its active ingredient, mometasone furoate, a corticosteroid that reduces swelling and inflammation. Inflammation is a process triggered by the body's immune response to allergens such as pollen or pet dander, which results in symptoms like a runny or stuffy nose, sneezing, and itching. Therefore, by decreasing inflammation, Nasonex can help relieve these common symptoms of allergies and improve patients' comfort levels.
Dymista contains two active ingredients: azelastine hydrochloride (an antihistamine) and fluticasone propionate (a corticosteroid). This dual mechanism of action blocks histamines and reduces inflammation, giving it an advantage over single-action drugs for some patients. The choice between Nasonex and Dymista may depend on individual patient needs, severity of symptoms, and physician recommendations.
What is Dymista?
Dymista is a brand name for a combination of azelastine hydrochloride and fluticasone propionate. Azelastine is an antihistamine, a type of drug that reduces the effects of natural chemicals called histamines in the body. Fluticasone is a corticosteroid which prevents the release of substances in the body that cause inflammation. This dual-action formula was first approved by the FDA in 2012, meaning it's relatively newer on the market.
Since Dymista not only acts as an antihistamine but also contains a steroid component, its effect profile differs from those of drugs like Nasonex which are solely steroid-based. In particular, Dymista's added benefit lies in its ability to reduce nasal symptoms caused by seasonal allergies or environmental irritants faster than single-ingredient medications. The combined effects of both active components can be beneficial for managing rhinitis, especially when other common medications have proven ineffective.
What conditions is Dymista approved to treat?
Dymista, a combination of an antihistamine and a steroid, is FDA-approved for the treatment of:
- Seasonal allergic rhinitis in individuals aged 6 years and older
- Perennial allergic rhinitis (allergies that occur throughout the year) in adults and adolescents aged 12 years and older
How does Dymista help with these illnesses?
Histamine is a naturally occurring substance in the body that is involved in many processes including inflammation and allergic reactions. High levels of histamine can lead to symptoms like sneezing, congestion, or runny nose, which are common in allergies and colds. Dymista works by combining two medications: azelastine hydrochloride (an antihistamine) that reduces the effects of histamine, and fluticasone propionate (a corticosteroid), which helps decrease swelling caused by inflammation.
The dual action of Dymista makes it an efficient remedy against nasal allergy symptoms. It not only blocks the action of histamine, but it also fights inflammation directly at its source. Compared with Nasonex, which contains only a corticosteroid (mometasone furoate), Dymista might offer more comprehensive relief from symptoms. This is due to its combined formula, which is especially useful when an antihistaminic effect is needed along with the anti-inflammatory effect. Therefore, if a patient doesn't respond well to standard single-ingredient nasal sprays such as Nasonex, or needs immediate symptom relief alongside prolonged anti-inflammation treatment, they may benefit from switching to (or adding) Dymista.
How effective are both Nasonex and Dymista?
Both mometasone (Nasonex) and combined azelastine/fluticasone (Dymista) have shown success in managing allergic rhinitis symptoms, receiving their FDA approvals just a few years apart. As they act on different inflammatory mediators, the choice between these two drugs may depend on specific patient circumstances. The efficacy of Nasonex and Dymista in alleviating allergy symptoms has been directly examined in multiple clinical trials. Both drugs exhibited similar effectiveness in managing common allergy symptoms such as nasal congestion, runny nose, sneezing, and itchy or watery eyes.
A 2005 review of meta-analysis reports on Nasonex demonstrated that it is effective from the first day of treatment for seasonal allergies, and after approximately 36 hours for perennial allergies. Its side effect profile is favorable in comparison to those of many other corticosteroids due to its low systemic bioavailability, meaning that most of the drug stays within the nasal passages where it exerts its anti-inflammatory effects rather than being absorbed into the bloodstream.
On the other hand, a 2012 study indicated that the combination drug Dymista seems to be more effective than fluticasone alone at reducing total nasal symptom scores. This score includes measures like an itching or burning sensation in nose or palate, sneezing attacks, etc., indicating an added benefit provided by azelastine with its antihistamine action. Nonetheless, because Dymista contains two active ingredients while Nasonex only contains one, patients should consider the potentially increased risk of side effects, which can include a bitter taste in the mouth or headaches, before opting for this combined treatment option.
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At what dose is Nasonex typically prescribed?
Nasal dosages of Nasonex for adults (including the elderly) and adolescents over 12 years old usually start at two sprays into each nostril, once per day. If symptoms improve, reducing the dosage to one spray in each nostril may be possible. Children aged 3–11 years are typically given one spray in each nostril, once daily. The dosage should not exceed two sprays in each nostril per day, for both adults and children. If there is no response to these medications after several weeks, your healthcare provider might consider increasing the dosage or changing the medication.
At what dose is Dymista typically prescribed?
Dymista treatment usually begins at a dosage of one spray in each nostril, twice daily. This can be adjusted depending on the severity of your symptoms, but the dosage should not exceed two sprays in each nostril twice per day. Each spray delivers 137 micrograms of azelastine hydrochloride and 50 micrograms of fluticasone propionate. If you find that you don't respond, or feel that you're not getting sufficient relief from your symptoms after several days, speak with your healthcare provider about increasing the dose or exploring other available options.
What are the most common side effects for Nasonex?
Common side effects of Nasonex and Dymista can include:
- Headache
- Viral infection (such as the common cold or flu)
- Coughing
- Nosebleeds
- Irritated throat
- Sinus pain or pressure
- Sores or white patches inside or around your nose.
In some rare cases, they might cause more serious issues like vision problems, ongoing nasal discomfort, and difficulty breathing. If these occur, it's essential to seek medical help immediately. These medications might also cause allergic reactions in some individuals, symptoms can include hives; difficulty breathing; swelling of your face, lips, tongue, or throat. In such a case stop using this medicine and get emergency medical help right away.
Are there any potential serious side effects for Nasonex?
While both Nasonex and Dymista are used to treat nasal congestion and other allergy symptoms, they may have different side effects. Serious side effects of these medications are rare, but in some cases, they can include:
- Signs of a severe allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue or throat
- Vision problems like blurred vision or tunnel vision
- Nasal sores or nosebleeds
- Changes in taste or smell
- Wheezing, tightness in the chest or throat
- Trouble swallowing
- Rapid heartbeat
In very rare cases you might experience:
- A nervous system reaction with symptoms such as fever, confusion and muscle stiffness
If you notice any of these symptoms after using either Nasonex or Dymista, stop taking the medication immediately and seek medical attention.
What are the most common side effects for Dymista?
Some potential side effects of Dymista include:
- A bitter taste in the mouth
- Nosebleeds
- Headache or dizziness
- Tiredness or problems sleeping (insomnia)
- Sneezing, sore throat, or other cold-like symptoms
- Eye redness
- Mild skin rash It's worth noting that while these are common side effects of Dymista, not every individual will necessarily experience them. As with any medication decision, it's important to discuss all treatment options–including their potential benefits and drawbacks–with your healthcare provider.
Are there any potential serious side effects for Dymista?
Although Dymista is generally considered safe, in some cases it can cause severe side effects. These may include:
- Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Severe dizziness or sleepiness
- Nasal problems such as pain and sores in your nose
- More frequent respiratory infections, like the common cold or flu (and their related symptoms)
- Changes in vision, including blurred vision
- Irregular heartbeat
If you experience any of these symptoms while using Dymista, seek medical attention immediately.
Contraindications for Nasonex and Dymista?
Both Nasonex and Dymista, along with most other corticosteroid nasal sprays, may cause some undesirable side effects in certain individuals. If you notice an increase in symptoms such as nosebleeds, sores inside the nose, eye problems or signs of infection like fever or chills after using these medications, please seek immediate medical attention.
Neither Nasonex nor Dymista should be used if you're currently taking or have recently taken certain types of antifungal or antiviral drugs. Always tell your physician which medications you are taking; some drugs might interact negatively with steroid-based nasal sprays and require a period to clear from your system before starting treatment with Nasonex or Dymista.
Furthermore, it's important to inform your healthcare provider about any existing conditions like glaucoma or cataracts since corticosteroids can exacerbate these issues. The same applies if you've had recent surgery on the nose because using nasal steroids too soon after could delay healing.
How much do Nasonex and Dymista cost?
For the brand-name versions of these nasal sprays:
- The price for a 17-gram bottle of Nasonex (50 mcg per spray), which contains about 120 sprays, averages around $200. If you're using two sprays in each nostril once daily, as typically prescribed, a bottle should last about 30 days, working out to approximately $6.60/day.
- The cost for a 23-gram bottle of Dymista (137/50 mcg per spray), containing roughly 120 sprays, is about $240 on average. Using it as prescribed, at a dosage of two sprays in each nostril once daily, it will also around 30 days, equating to roughly $8/day.
So, if your treatment calls for regular usage according to typical dosage instructions, brand-name Dymista tends to be slightly more expensive than Nasonex on a cost-per-day basis.
Nasonex and Dymista are popular brand names, but both medications have generic versions available. In general, generic versions are the exact same medications, but tend to be more affordable. Generic nasal mometasone (generic Nasonex) costs around $40 for the same 30-day supply, and generic azelastine/fluticasone (generic Dymista) costs about the same. Thus, the generic alternatives cost only 15%–20% of the price of the brand-name versions.
As always, remember that cost should not be your only consideration when choosing between medications – their effectiveness and side effect profiles are also important factors. If you have insurance, check if either of these treatments would be covered, which can decrease their out-of-pocket ciosts significantly.
Popularity of Nasonex and Dymista
Mometasone furoate, commonly known by its brand name Nasonex, is a corticosteroid nasal spray used to treat allergy symptoms such as runny or stuffy nose and sneezing. In 2020, it was estimated that about 4 million people in the US were prescribed this medication. Mometasone furoate accounted for nearly 20% of all corticosteroid nasal spray prescriptions in the US, and this number has remained relatively steady over the last decade.
On the other hand, Dymista (a combination of azelastine hydrochloride and fluticasone propionate) was prescribed to around 1.5 million people in the US in 2020. This accounts for approximately 10% of combined antihistamine/corticosteroid nasal spray prescriptions. Despite being on the market for less time than Nasonex, Dymista has increased in popularity since its introduction due to its dual-action formula that targets allergy symptoms through two different mechanisms of action.
Conclusion
Both Nasonex (mometasone furoate monohydrate) and Dymista (azelastine hydrochloride and fluticasone propionate) have demonstrated effectiveness in treating allergic rhinitis symptoms in numerous clinical studies. Both drugs are formulated as nasal sprays, but they contain different active ingredients. Nasonex contains only a corticosteroid (mometasone), while Dymista is a combination of an antihistamine (azelastine) and a corticosteroid (fluticasone).
Due to this major difference in their composition, the two sprays may be used under different circumstances. While Nasonex acts primarily to reduce inflammation through its steroid component, Dymista offers the added benefit of immediate symptom relief by blocking histamine through its antihistamine component.
Both drugs are available as generics, which offers significant cost savings for patients paying out of pocket. However, depending on individual insurance coverage and drug availability in your region, one might be more accessible than the other.
Potential side effects for both medications tend to be mild, and include nosebleeds and headaches. It's worth noting that because Dymista contains an additional active ingredient compared to the single-ingredient Nasonex, it does carry some additional side effect risk, particularly drowsiness or changes in your sense of taste. As always, when starting treatment with a new medication, you should closely monitor any changes to your health and seek medical advice if you have any doubts or concerns.
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Refrences
- Ridolo, E., Montagni, M., Melli, V., Bonzano, L., Incorvaia, C., & Canonica, G. W. (2015, April 27). A Role for the Intranasal Formulation of Azelastine hydrochloride/fluticasone Propionate in the Treatment of Allergic Rhinitis. Therapeutic Delivery. Informa UK Limited.http://doi.org/10.4155/tde.15.7
- Baldwin, C. M., & Scott, L. J. (2008). Mometasone Furoate. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200868120-00009
- Bernstein, J. A. (2013, August 26). MP29-02: a breakthrough for the treatment of allergic rhinitis. Expert Opinion on Pharmacotherapy. Informa Healthcare.http://doi.org/10.1517/14656566.2013.828693
- Prenner, B. (2016, July). A review of the clinical efficacy and safety of MP-AzeFlu, a novel intranasal formulation of azelastine hydrochloride and fluticasone propionate, in clinical studies conducted during different allergy seasons in the US. Journal of Asthma and Allergy. Informa UK Limited.http://doi.org/10.2147/jaa.s98172
- Berger, W. E. (2013, September). MP29-02 for the treatment of seasonal allergic rhinitis: a review of clinical pharmacology, efficacy and safety. Expert Review of Clinical Immunology. Informa UK Limited.http://doi.org/10.1586/1744666x.2013.828876