Astepro vs. Flonase for Allergies

Astepro and Flonase are two different nasal spray medications used to treat symptoms like runny nose, itchy nose, and congestion. Astepro contains an antihistamine, while Flonase is a steroid medication. The effects of the two medications are similar, but they work differently. Astepro blocks histamines, while Flonase decreases inflammation in the nasal passages.

Although these medications are effective on their own, it is generally considered safe to use both if you aren’t experiencing complete relief with just one. Your healthcare provider may recommend this or prescribe Dymista (azelastine hydrochloride and fluticasone propionate), a nasal spray composed of generic forms of both medications.

This article goes over the differences between Astepro and Flonase, and when you might need to use these nasal spray medications together.

What Is Flonase?

Flonase (fluticasone propionate) is a nasal spray that contains a corticosteroid. Corticosteroids help reduce inflammation in the nasal passages. This helps relieve symptoms like nasal congestion and runny nose. 

Non-prescription Flonase is used to treat the symptoms of nasal allergies. Fluticasone propionate, the generic of Flonase, is also sold in another delivery system, called Xhance, by prescription only for people with chronic nasal symptoms that are not caused by an allergic reaction.

Flonase can cause side effects, including nosebleeds or nose tenderness. People who take nasal steroids long-term can be at risk for glaucoma (increased pressure in the eye that can damage the optic nerve) and cataracts (clouding of the lens of the eye).

Children under the age of 4 should not use Flonase. If you’ve recently had nasal surgery or have any injuries to your nose, ask your healthcare provider before using this medication. You should also inform your healthcare provider if you are pregnant or if you have any of the following conditions:

• Glaucoma
• A herpes infection in the eye
• A viral infection such as chicken pox or measles

Make sure your healthcare provider knows about any other medication you are taking, including supplements.

What Is Astepro?

Astepro (azelastine nasal) is a nasal spray that contains an antihistamine. Astepro is available OTC and is used to treat the symptoms of nasal allergies. The antihistamine in Astepro blocks a chemical called histamine, which is responsible for allergy symptoms like sneezing and runny nose.

Only generic azelastine is available by prescription, as the brand Astelin has been discontinued in the U.S. Prescription azelastine is used to treat congestion and other nasal symptoms caused by non-allergic conditions.

Astepro (azelastine 0.15%) nasal spray has been approved for nonprescription use in those 6 years and older. Azelastine 0.1% is a prescription version approved for use in younger children.

This type of nasal spray can cause:

• Bitter taste
• Headaches
• Drowsiness
• Tingling
• Nasal burning
• Sore throat

Because this medication can make you drowsy, you should avoid operating machinery until you know how you respond to it.

Check with your healthcare provider if you have any injuries to your nose, if you have sores in your nose, or if you have recently had nasal surgery. Make sure your healthcare provider knows about any other medications you’re taking, including supplements.

 Flonase vs. Astepro

Combining Flonase and Astepro

Using Flonase with azelastine is considered a second-line option, which means that the combined treatment approach is only used when you don’t experience adequate improvement of your symptoms with use of just one of these sprays.

Whether or not that level of treatment is necessary to tame your symptoms depends, in part, on the severity of your allergies. Symptoms are generally so bothersome and noticeable that you should be able to judge your response to treatment well.

Combining Flonase and Astepro is considered safe and does not add to side effects outlined for each medication.

Dymista

Combination drugs like Dymista include more than one medication. The advantage of this type of treatment is that it is faster and more convenient to use a single medication than to use them separately.

The disadvantage is that you get a fixed dose of each component, so you and your healthcare provider can’t make adjustments to one drug without affecting the other. Also, this medication is sometimes not covered by insurance.

If your healthcare provider prescribes Dymista, you would also take it on a schedule to prevent your symptoms from occurring.

The most common side effects of Dymista, as reported by the manufacturer, include:

This medication can also cause sleepiness or drowsiness, so you need to be careful about driving or using heavy machinery.