Highlights
- Over 81 million people suffer from seasonal allergies in the U.S.
- Drugs like Flonase and Astelin can improve sufferers’ quality of life significantly.
- Flonase vs. Astelin: Which is more effective with fewer side effects?
- eDrugstore offers you low prices on these drugs and a complimentary consultation with a U.S.-licensed doctor.
Michael DiLeo, MD, has over 30 years of experience in clinical and academic medicine. Through medical school, residency, and private practice, he has functioned as both a specialist and a primary care practitioner. He has twice served as chief of staff of a large regional hospital. He is a published author on women's health for McGraw-Hill. Learn More
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“Nature is a wonderful thing. Nature does not love me, though.” – Jennie Koeper
In 2021, 81 million people struggled with seasonal allergic rhinitis in the U.S. That means 26 percent of adults and 19 percent of children suffer from stuffy noses and other allergic symptoms. Seasonal allergies are severe quality-of-life destroyers for many.
But solutions exist, including accessible, over-the-counter medications like Flonase and Astelin. Flonase is a corticosteroid while Astelin is an antihistamine. Which one is better? Let’s settle the Flonase vs. Astelin debate for good!
Flonase vs. Astelin: The Basics
Over-the-counter or prescription allergy sprays like Astelin and Flonase are your most straightforward options for seasonal allergy treatment. How do they work, and how effective are they for seasonal allergies?
Flonase
Flonase is an over-the-counter nasal spray for the treatment of seasonal allergy symptoms. The active substance in Flonase is a corticosteroid called fluticasone propionate, better known to most as simply fluticasone. Flonase is recommended for adult patients and children over four.
Fluticasone modulates the constriction and widening of blood vessels and reduces inflammation. It blocks cells that create inflammation in the nose, like eosinophils, monocytes, and macrophages, and boosts the action of anti-inflammatory substances. The drug can reduce stuffiness by constricting blood vessels in the lining of the nose.
Astelin
Astelin is a nasal spray that uses azelastine hydrochloride as its active substance. It works by blocking histamine receptors in the lining of the nasal passage. Histamine widens blood vessels, leading to nasal congestion. It also causes inflammation. Antihistamines cause the smooth muscles to constrict blood vessels, and inflammation fizzles out.
Here’s a quick head-to-head comparison of the basics.
| Flonase | Astelin | |
|---|---|---|
| Active Ingredient | Fluticasone propionate (steroid) | Azelastine hydrochloride (antihistamine) |
| How it Works | Reduces inflammation in the nasal passages and constricts blood vessels. | Blocks histamine receptors, reducing allergy symptoms. |
| Overview | Prescription or over-the-counter steroid nasal spray for allergic rhinitis and non-allergic rhinitis. May take a few days to show full effect. | Prescription or OTC nasal spray for allergic rhinitis. Works quickly, within minutes, to relieve symptoms. |
Effectiveness for Seasonal Allergies
The most relevant part of the Astelin vs. Flonase battle is the efficacy-wise comparison of the two drugs.
Their effectiveness for seasonal allergy symptoms is comparable, but some differences may tip the scale one way or the other, depending on the unique needs of patients.
Researchers agree that the two solutions work equally well, but azelastine works faster than fluticasone.
A 2012 study found that around 50 percent of fluticasone and azelastine test subjects achieved a 50 percent reduction in their allergic rhinitis nasal symptoms. After 14 days of treatment, however, 53 percent of azelastine patients had experienced 50 percent reductions in their symptoms, compared to just 39 percent of fluticasone patients over the same period.
Azelastine “kicks in” within 15 minutes of administration. Fluticasone’s first therapeutic effects appear in two to four hours, but it can take up to 12 hours to act.
Conclusions:
- Astelin and Flonase work equally well for allergic rhinitis.
- Astelin works faster.
- Astelin has a better safety profile.
- Doctors can prescribe or recommend Astelin to more patients than Flonase.
- Astelin may be a safer solution for children and patients suffering from glaucoma and cataracts.
Some patients may not have to choose between Astelin and Flonase for allergies. The best nasal spray for allergies may be a combination of the two. A combination of azelastine and fluticasone can be a more effective allergy treatment than either agent used alone.
Flonase vs. Astelin Side Effects Comparison
We can’t assess the effectiveness of a medication without considering its side effects. A drug’s unwanted and undesirable effects can negate its benefits, rendering patients unable to take it. Both Flonase and Astelin produce side effects, ranging from mildly unpleasant to disruptive. Side effects differ from one patient to another.
Flonase vs. Astelin Side Effects Comparison
We can’t assess the effectiveness of a medication without considering its side effects. A drug’s unwanted and undesirable effects can negate its benefits, rendering patients unable to take it. Both Flonase and Astelin produce side effects, ranging from mildly unpleasant to disruptive. Side effects differ from one patient to another.
| Side Effect | Flonase (Fluticasone) | Astelin (Azelastine) |
|---|---|---|
| Common | Headache, nasal burning/irritation, sneezing, dry mouth, throat irritation, unpleasant taste | Bitter taste in mouth, drowsiness, tiredness, nasal burning/irritation, sneezing, runny/stuffy nose, headache, red eyes |
| Rare | Nosebleeds, burning/crusting in the nose, slowed wound healing, vision problems, increased risk of infection with long-term use | Nosebleeds, severe fatigue, allergic reaction (hives, swelling, wheezing) |
Astelin’s bitter taste may be a dosage-related problem. If it results from an incorrect dosage, it’s easy to minimize.
Using the two medications together may increase the frequency and intensity of side effects.
Flonase vs. Astelin Drug Interactions
Both medications can interact with foods, beverages, vitamins, supplements, and other drugs. Talk to your doctor about your medications, supplements, and vitamins before using Flonase or Astelin for seasonal allergies.
The two drugs can produce potentially dangerous interactions with:
- Alcohol (increases drowsiness)
- Other medications that cause sleepiness
- Central nervous system depressants, like opioids
- Anxiety medications
- Seizure drugs
- Muscle relaxants
- Sleeping pills
- Antifungal medications
- HIV protease inhibitors
If you take both Flonase and Astelin, you increase the spectrum of potential drug interactions.
This list of drug interactions is not complete. Both drugs may interact with many other medications. Visit the Drugs.com Interaction Checker for potential interactions with other medications you may be taking.
Cost and Availability
Your doctor may prescribe Flonase or Astelin for seasonal allergies, but both drugs and their generic equivalents are available over the counter.
Prescription Flonase is the same as OTC Flonase.
The FDA approved azelastine hydrochloride for OTC use in 2021.
According to Drugs.com:
- A 16 gram Flonase spray costs from $91.62 to $107. You can buy generic fluticasone nasal sprays from $11.97 for 9.9 milliliters.
- A 30 milliliter Astelin nasal spray costs $70.38. Generic azelastine sprays are available from $36.96 per 30 milliliters.
Prices can vary depending on your insurance, patient assistance programs, coupons, and rebates you may get.
User Experiences and Preferences
Flonase/fluticasone
Flonase users left 68 reviews at Drugs.com. Thirty-eight percent of users report positive experiences with the drug, while 51 percent share negative experiences.
Those with positive experiences point to fewer allergy-related headaches, less nasal congestion, and clearer sinuses.
Complaints include back pain, panic attacks, out-of-control anxiety, headaches, and disrupted sleep.
Astelin/azelastine
Astelin users left 19 reviews, of which 84 percent are positive and 5 percent are negative.
Some users hail Astelin as a “miracle cure.” Others say they only see mild or no side effects from the drug.
On the downside, one person complained of a burned nose and throat, while another found the bitter aftertaste of the drug unbearable.
Many Users Prefer Astelin
The available user reviews on Flonase and Astelin favor the latter. Astelin has less feedback, however, as it is a drug that only became available for OTC use recently.
Flonase vs. Astelin: Which is Right for You?
Flonase and Astelin appear to be equally effective at relieving allergy symptoms. However, the efficacy of the medications may differ from person to person.
Flonase casts a wider net in its fight against allergic rhinitis symptoms, blocking more potential symptom-causing factors.
Astelin is gentler, with a more attractive safety profile. Research shows it may be safer for children and people suffering from glaucoma and cataracts. Astelin may also provide quicker relief than Flonase.
The side effect profiles of the two medications are slightly different, but remember that not all individuals will experience the same side effects. If you find the side effects of one medication overwhelming, try the other.
Final Thoughts
When choosing between Flonase and Astelin, consider the following factors:
- Efficacy
- Safety profile
- Side effect frequency and intensity
- Onset speed
- User preferences and feedback
- Drugs you use and any underlying health conditions
Always consult with a qualified healthcare provider for a personalized treatment plan.
eDrugstore Can Help
We carry both fluticasone (Flonase) and azelastine (Astelin) at better prices than those mentioned above.
When you become an eDrugstore client, you can take advantage of a complimentary consultation with a U.S.-licensed physician. Our doctors can help you choose the right medication for you and write your prescription for the allergy relief medication of your choice.
Create an account and place your order now. When you shop with eDrugstore, shipping is always free.
Disclaimer: This article provides general information about health and related topics but is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
James West is a seasoned health and wellness writer with a focus on topics related to physiology, sleep, and men’s health. He has contributed articles on a range of subjects, from erectile dysfunction treatments and sleep aids to hair loss, providing well-researched insights to help readers make informed health decisions.