A Guide to Best Nasal Sprays for Allergies (2024)

The best nasal spray for allergies will depend on your symptoms. If you have a runny nose or congestion because of allergies, your healthcare provider may recommend you use an over-the-counter (OTC) or prescription nasal spray to ease your symptoms.

Allergies occur when the immune system mistakes a harmless substance for an invader and overreacts. The body produces immunoglobulin-E (IgE) antibodies, which then signal the release of chemicals like histamine that result in an allergic reaction. Nasal congestion, runny nose, and sneezing are a few common symptoms of allergies.

A nasal spray can help you feel better when used correctly, but it’s important to use the right type for your symptoms. Always check with your healthcare provider first, especially if you are pregnant or nursing.

There are six types of nasal sprays, some of which can be purchased at a drugstore and some that are only available by prescription. What works for one person may not work for another.

A Guide to Best Nasal Sprays for Allergies (1)

Antihistamine Sprays

As the name suggests, antihistamine sprays block histamine. This is especially helpful for those with a runny nose caused by allergies. Prescription antihistamine sprays include Patanase (olopatadine) and Astelin (azelastine), and there's also an OTC form of Astelin called Astepro.

Decongestant Sprays

The main purpose of decongestant nasal sprays, which are available OTC, is to give you temporary relief from nasal congestion. They do this by constricting the blood vessels in your nose, reducing swelling and thus congestion.

Brand names of these nasal sprays include:

  • Afrin
  • Zicam
  • Sinex
  • Dristan

These sprays are meant to help when you have a brief cold or allergy flare-up and should not be used for more than three consecutive days. If used for longer than that, they can cause rebound congestion, leading to your needing more of the nasal spray, causing a vicious cycle.

Steroid Nasal Sprays

Some steroid nasal sprays are only available with a prescription. However, many others can be bought OTC and are often the first treatment used to address allergies. They can reduce nasal inflammation and congestion as well as help with runny nose and sneezing.

To get the benefits of the medication, you'll need to use it once or twice a day for several weeks. Common steroid nasal sprays include:

  • Rhinocort (budesonide)
  • Flonase (fluticasone)
  • Nasonex (mometasone)
  • Nasacort (triamcinolone)
  • Veramyst (fluticasone furoate)

Saline Sprays

Saline sprays are different from the other sprays on this list because they aren't meant to relieve congestion or other allergy symptoms. Instead, their main function is to help keep your nasal passages moist, which in turn can help prevent nosebleeds due to dryness. Brands of these sprays include Simply Saline, Xlear, and Ayr.

Anticholinergic Sprays

Anticholinergic nasal sprays, such as Atrovent (ipratropium bromide HFA), help to treat a runny nose for those who have allergic rhinitis and nonallergic rhinitis. They work by blocking a neurotransmitter called acetylcholine that triggers nasal secretions. This type of nasal spray can only be obtained with a prescription.

Mast Cell Inhibitor Sprays

Mast cell inhibitor sprays, such as Nasalcrom (cromolyn sodium), work by stabilizing mast cells so they don't release substances that cause inflammation (swelling) in the air passages of the nose. This results in fewer allergy symptoms.

Mast cell inhibitor sprays are available without a prescription.

Nasal sprays are safe when used appropriately and as directed. If you have any medical conditions or are pregnant or nursing, talk with your healthcare provider before using nasal sprays—even OTC ones.

Side Effects of Nasal Sprays

Ask your healthcare provider about any possible side effects of the nasal spray you are using. Common side effects can include:

  • Bitter taste in the mouth
  • Dry mouth
  • Nasal burning
  • Rebound effect (with nasal decongestants), causing more congestion
  • Nosebleeds

Always follow the instructions from your provider or on the product label to determine how often you can use a particular nasal spray.

Are Nasal Sprays Addictive?

Nasal sprays don't produce cravings or highs and are not addictive based on the clinical definition. That said, it is possible to misuse them. Overuse of nasal sprays can lead to rebound congestion (which results in you needing more and more of the spray to get relief), nosebleeds, headaches, and reduced effectiveness of the medication.

In particular, the OTC nasal decongestant spray Benzedrex (propylhexedrine) has the potential to be dangerous if misused. Benzedrex abuse can cause heart problems, such as high blood pressure, and mental health problems, such as paranoia. Always take the nasal spray as directed. If you do not have any relief after using it as stated, talk with your healthcare provider.

Alternatives to Nasal Sprays

If you don’t want to use a nasal spray for your symptoms, sometimes nasal irrigation can be helpful. This involves using a mixture of sterile water and salt (and sometimes baking soda) and flushing it into the nose to rinse mucus out. This can be done with a bulb syringe or a neti pot. It’s important to only use sterile water, not tap water.

Other alternatives to treat your allergies include oral medications like antihistamines, decongestants, and corticosteroids.

Summary

Many different kinds of nasal sprays are available, both over the counter and by prescription only. Talk with your healthcare provider about your symptoms and which nasal spray might be best for you.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

A Guide to Best Nasal Sprays for Allergies (2)

By Jaime R. Herndon, MS, MPH
Herndon is a freelance health/medical writer with a graduate certificate in science writing from Johns Hopkins University.

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A Guide to Best Nasal Sprays for Allergies (2024)

FAQs

A Guide to Best Nasal Sprays for Allergies? ›

The best sinus spray for allergies may vary for each individual, but Fluticasone Propionate (Flonase) and Triamcinolone Acetonide (Nasacort) are widely recommended. These steroid nasal sprays are effective in reducing inflammation and relieving symptoms like nasal congestion, sneezing, and runny nose.

Which nasal allergy spray is most effective? ›

Experts say that over-the-counter (OTC) anti-inflammatory nasal sprays—such as FLONASE nasal sprays or Nasacort® 24 Hour—are the most effective form of nasal allergy symptom relief.

What is the best nasal spray for seniors? ›

Steroid nasal sprays, such as Flonase (fluticasone propionate), are some of the best allergy medicines for older adults. Astepro (azelastine) nasal spray, and non-drowsy oral antihistamines, such as Allegra (fexofenadine) are also first-choice options. All of these allergy medications are safe for older adults.

What nasal sprays do doctors prescribe? ›

Some examples: Nasal steroids are often a first-line treatment for allergies. Examples like triamcinolone acetonide (Nasacort) and fluticasone propionate (Flonase) are available over the counter. Doctors can also prescribe nasal sprays like beclomethasone (Beconase), ciclesonide (Zetonna), and mometasone (Nasonex).

What nasal spray is safe to use daily? ›

Nasal steroids sprays (Flonase®, Nasocort®, Nasonex®, etc. ) are safe to use on a daily basis and are now largely over-the-counter. These sprays are non-addictive and typically do not cause any long term changes to the nasal passages.

Is there anything better than Flonase? ›

Official answer. Nasacort and Flonase are equally effective, safe, and well tolerated for the treatment of allergic rhinitis. Therefore the choice of either Nasacort or Flonase comes down to personal preference, availability or price.

What is the best nasal spray Consumer Reports? ›

Antihistamine nasal sprays: If you've been faithfully using a nasal steroid for a couple of weeks and you're still uncomfortable, the guidelines recommend adding in a daily prescription nasal antihistamine spray, such as azelastine (Astelin, Astepro, and generic) or olopatadine (Patanase and generic).

What is the downside of Flonase? ›

Nasal side effects — such as nosebleeds, irritation, and burning — can happen, too. Most side effects are generally mild and can be managed at home. Serious Flonase side effects include vision changes, asthma symptoms, and thrush. Discuss these risks with your healthcare provider or pharmacist before using Flonase.

Why was Flonase discontinued? ›

Issues Voluntary Nationwide Recall of Fluticasone Propionate Nasal Spray USP 50 mcg Per Spray 120 Metered Sprays Due to Potential for Small Glass Particles.

Who should not use azelastine? ›

An adult should help children younger than 12 years old to use azelastine nasal spray. Children younger than 6 years of age should not use nonprescription (over the counter) azelastine nasal spray. Azelastine nasal spray is only for use in the nose.

Is it better to take FLONASE at night or in the morning? ›

Is it better to use FLONASE at night? In short, no. One daily dose of FLONASE Allergy Relief delivers 24-hour relief from your worst allergy symptoms. So, even if you take it in the morning, you're still covered for all night long, without pesky allergy symptoms.

Which is better, Afrin or FLONASE? ›

Is Afrin or Flonase better? Afrin provides a faster response to congestion with an onset of action within 10 minutes. It is not recommended for use longer than three days, however. Flonase is slower to relieve congestion symptoms but can be used safely long term.

Which medicine is best for allergic rhinitis? ›

Nasal sprays — Azelastine (brand names: Astelin, Astepro) and olopatadine (brand name: Patanase) are nasal antihistamine sprays that can be used daily or when needed to relieve symptoms of postnasal drip, congestion, and sneezing. These sprays start to work within minutes after use.

Which is the best nasal spray for a blocked nose? ›

For nasal congestion, we recommend Otrivine Sinusitis Relief Nasal Spray. The spray delivers an exact medicated dose of xylometazoline hydrochloride inside the nostril to relieve the nasal congestion as well as helping to ease the sinusitis pain and pressure that you may be feeling.

Which is more effective Flonase or Zyrtec? ›

FLONASE, a nasal spray, tends to be more effective for nasal symptoms like congestion, while Zyrtec, an oral antihistamine, may be better for symptoms like itching and hives. Individual responses vary, so personal trial is beneficial. What Should You Know About Allergies?

Which is better, Afrin or Flonase? ›

Is Afrin or Flonase better? Afrin provides a faster response to congestion with an onset of action within 10 minutes. It is not recommended for use longer than three days, however. Flonase is slower to relieve congestion symptoms but can be used safely long term.

Which is better, Flonase or Nasonex? ›

Official answer. The difference is Flonase is available over-the-counter (OTC) and Nasonex is prescription only. There is no difference in their effect or side effects. Flonase and Nasonex are both corticosteroid nasal sprays that are effective at treating hay fever, perennial allergic rhinitis and allergies.

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