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Azelastine nasal spray vs. fluticasone nasal spray: A detailed guide

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FAQCostBrand namesUsesDosageSide effectsWarningsAsk your doctor
Azelastine nasal spray and fluticasone nasal spray are prescription drugs used to treat rhinitis symptoms, including a stuffy or runny nose. You spray these medications into your nostrils once or twice per day.
Medically reviewed by Amber R. Watson, PharmD
Updated on

This article explains how azelastine nasal spray and fluticasone nasal spray are similar and different. You can view detailed articles about azelastine nasal spray and fluticasone if you’d like more information about these drugs.

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Questions about azelastine and fluticasone

Below, you’ll find answers to some common questions about azelastine nasal spray and fluticasone nasal spray.

Is it safe to use azelastine and fluticasone together?

Yes, it’s safe to use azelastine nasal spray and fluticasone nasal spray together. A prescription nasal spray is available that combines both of these active ingredients to treat rhinitis symptoms. (An active ingredient is what makes a medication work.)

The brand name of this combination product is Dymista. There’s also a generic version of Dymista, called azelastine/fluticasone nasal spray. This product may have different uses or dosages than what your doctor prescribes for the separate nasal sprays.

If you have questions about using azelastine nasal spray and fluticasone nasal spray together, talk with your doctor or pharmacist. They can discuss with you whether to combine them based on your condition and health history. Do not start using azelastine nasal spray and fluticasone nasal spray together without first talking with your doctor or pharmacist.

Between azelastine and fluticasone, is one a better treatment for rhinitis?

Doctors may prescribe either azelastine nasal spray or fluticasone nasal spray to treat rhinitis. In studies, azelastine nasal spray and fluticasone nasal spray were both effective for this purpose.

These medications contain different active ingredients which work in different ways. As a result, they may differ in side effects and are used for different age groups.

Keep in mind that your results from using azelastine nasal spray or fluticasone nasal spray may differ from those seen in studies.

Your doctor can help determine whether one option is better for your condition than the other. They will make their recommendation based on your specific needs and health factors.

Talk with your doctor if you’d like to learn more about which drug is right for you. Also see this article for more details about how various nasal sprays for allergies compare.

Cost of azelastine and fluticasone

As with the cost of other medications, the cost of azelastine nasal spray and fluticasone nasal spray can vary. Their price may be affected by:

  • whether they’re covered by health insurance, if you have coverage
  • the pharmacy they’re purchased from
  • your dosage and the quantity of medication prescribed

Coupons and cost savings

To view drug prices when Optum Perks coupons are applied, see this coupon page for azelastine nasal spray and this coupon page for fluticasone nasal spray. You can also check with your doctor, pharmacist, or insurance provider.

The options described in this article may also help you save on your prescription.

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Note: Optum Perks coupons cannot be used with insurance copays or benefits.

Brand-name versions

Below is information about whether azelastine nasal spray or fluticasone nasal spray is available in a brand-name version.

Azelastine nasal spray and fluticasone nasal spray are generic medications. A generic medication is an identical copy of the active ingredient in a brand-name medication.

Generics usually cost less than brand-name drugs. And they’re thought to be as safe and effective as the brand-name versions.

Here’s a summary about brand names of azelastine nasal spray and fluticasone nasal spray:

 azelastine nasal sprayfluticasone nasal spray
Active ingredientazelastinefluticasone
Available as a brand name?nono

If you have questions about your azelastine nasal spray or fluticasone nasal spray prescription, let your doctor or pharmacist know. There are also brand-name or generic versions of these drugs available over the counter (OTC). Whether those are an option for you depends on the condition being treated and your dosage. Talk with your doctor or pharmacist to learn more about the OTC versions of these drugs.

Uses of azelastine and fluticasone

Here’s a summary of azelastine nasal spray’s and fluticasone nasal spray’s approved uses:

 azelastine nasal sprayfluticasone nasal spray
Approved uses• symptoms of rhinitis due to seasonal allergies
• symptoms of a certain type of nonallergic rhinitis
• symptoms of year-round nonallergic rhinitis
Prescribed toadults and children ages 5 years and older (seasonal allergies) or ages 12 years and older (nonallergic rhinitis)adults and children ages 4 years and older

If you’d like to know more about using either medication for your condition, ask your doctor. They can recommend whether azelastine nasal spray or fluticasone nasal spray is an option to consider.

Dosage of azelastine and fluticasone

Below is dosage information for the conditions that both azelastine nasal spray and fluticasone nasal spray are prescribed to treat. To find detailed dosage information for all conditions that azelastine nasal spray and fluticasone nasal spray treat, see these articles about azelastine nasal spray and fluticasone nasal spray dosage.

The following dosages are provided by the drugmakers of azelastine nasal spray and fluticasone nasal spray. If your doctor prescribes either medication, you should follow the dosage they prescribe. They’ll advise the dosage that’s best for your condition. Do not adjust your dosage without first talking with your doctor.

Azelastine nasal spray’s dosage

Below is a summary of azelastine nasal spray’s recommended dosages in adults and children. Each spray provides 137 micrograms (mcg) of azelastine.

Condition/PurposeRecommended doseFrequency
symptoms of a certain type of nonallergic rhinitis in adults and children ages 12 and oldertwo sprays in each nostriltwice per day

Fluticasone nasal spray’s dosage

Below is a summary of fluticasone nasal spray’s recommended dosages in adults and children. Each spray provides 50 micrograms (mcg) of fluticasone.

ConditionHow it’s usedRecommended starting doseFrequency
symptoms of year-round nonallergic rhinitis in adultsnasal spray two sprays in each nostril*once per day
symptoms of year-round nonallergic rhinitis in children ages 4 years and oldernasal sprayone spray in each nostril†once per day

* The doses listed above are recommended starting doses. Adults may be able to reduce their dose to one spray in each nostril once per day for ongoing treatment after the first few days of using fluticasone nasal spray.
The doses listed above are recommended starting doses. Children ages 4 years and older who don’t see benefit from this starting dose may increase to two sprays in each nostril once per day. Once symptoms are manageable, the dosage should be decreased to one spray in each nostril once per day.

Side effects of azelastine and fluticasone

Azelastine nasal spray and fluticasone nasal spray may cause mild or serious side effects. Some of the more common mild side effects of each drug are listed below. Serious side effects of azelastine nasal spray and fluticasone nasal spray are also listed.

Keep in mind that your side effects may differ from those listed below. They can vary based on your overall health, any other medications you take, and your age.

This article doesn’t include all possible side effects of these medications. To find more information, you can view the prescribing information for azelastine nasal spray and fluticasone nasal spray. You can also check out this overview article about azelastine nasal spray and this side effects article about fluticasone nasal spray.

Mild side effects

Below are some of the mild side effects reported with azelastine nasal spray and fluticasone nasal spray:

 azelastine nasal sprayfluticasone nasal spray
bitter taste
headache✓ 
sleepiness
nasal burning
sore throat
nosebleed
nausea and vomiting
mild allergic reaction

Serious side effects

Below are some of the serious side effects reported with azelastine nasal spray and fluticasone nasal spray:

 azelastine nasal sprayfluticasone nasal spray
nasal problems, including perforated septum (a hole in the tissue that divides the nose)
glaucoma or cataracts
slowed growth in children
low steroid hormone levels (adrenal insufficiency)
serious allergic reaction

For a lot of drugs, serious side effects are possible, but they’re not common. If you have serious side effects from azelastine or fluticasone, call your doctor right away. If your symptoms are severe or you’re having a medical emergency, call 911 or a local emergency number.

Warnings for azelastine and fluticasone

Doctors may not recommend some medications for you if you have certain factors affecting your health. These are referred to as a drug’s warnings.

Azelastine and fluticasone should not be used or should be used cautiously by certain people.

Warnings for azelastine and fluticasone are summarized below. Before using either medication, talk with your doctor about your health conditions, past surgeries, and any medications you take. Your doctor can recommend whether either drug is safe for you.

 azelastine nasal sprayfluticasone nasal spray
nasal sores, surgery, injury, or other problems✓ 
eye problems, such as glaucoma or cataracts✓ 
immune system problems
certain types of infections, including eye herpes and tuberculosis
allergic reaction to either drug or any of their ingredients✓ ✓ 
currently pregnant or planning to become pregnant✓ 
currently breastfeeding or planning to breastfeed✓ ✓ 

You can view more detailed articles about azelastine nasal spray and fluticasone if you’d like to know more about warnings for these drugs. You can also view the prescribing information for azelastine nasal spray and fluticasone nasal spray.

What to ask your doctor

If you’re trying to decide whether azelastine nasal spray or fluticasone nasal spray is better for you, talk with your doctor. They can recommend the best option.

Here’s a list of questions you may want to ask your doctor:

  • Is azelastine nasal spray or fluticasone nasal spray a better treatment for my condition? Why?
  • How long will it take to see the effects of azelastine nasal spray or fluticasone nasal spray?
  • Is it safe to use an OTC version of azelastine nasal spray or fluticasone nasal spray instead of the prescription version?
  • Does azelastine nasal spray or fluticasone nasal spray interact with any other drugs that I’m taking?

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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