Version October 2024
| Name | Common brand name(s) and strength | Generic available | Available without a prescription (OTC) | Usual adult dose per nostril | Type of preparation (alcohol content)* |
| Second-generation (systemic bioavailability <1% or undetectable) | |||||
| Ciclesonide | Omnaris (50 mcg/spray) | No | No | Two sprays once daily | Aqueous suspension pump spray |
| Zetonna (37 mcg/spray) | No | No | One spray once daily | Pressurized aerosol spray (3.4% alcohol) | |
| Fluticasone furoate | Flonase Sensimist (OTC) (27.5 mcg/spray) | No | Yes | Two sprays once daily | Aqueous suspension pump spray |
| Fluticasone propionate | Flonase Allergy Relief (OTC) (50 mcg/spray) | Yes | Yes | Two sprays once daily or one spray twice daily | Aqueous suspension pump spray (0.25% alcohol) |
| Mometasone | Nasonex 24HR Allergy (OTC) (50 mcg/spray) | Yes | Yes | Two sprays once daily | Aqueous suspension pump spray |
| First-generation (systemic bioavailability 10 to 50%) | |||||
| Beclomethasone | Beconase AQ (42 mcg/spray) | No | No | One or two sprays twice daily | Aqueous suspension pump spray (0.25% alcohol) |
| Qnasl (80 mcg/spray) | No | No | Two sprays once daily | Pressurized aerosol spray (8% alcohol) | |
| Budesonide | Generic (formerly Rhinocort Allergy) (OTC) (32 mcg/spray) | Yes | Yes | One to two sprays once daily | Aqueous suspension pump spray |
| Flunisolide | Generic (formerly Nasalide) (25 mcg/spray) | Yes | No | Two sprays two or three times daily (maximum two sprays four times daily) | Aqueous suspension pump spray (contains propylene glycol, a possible irritant) |
| Triamcinolone | GoodSense Nasal Allergy (OTC), Nasacort Allergy 24HR (OTC) (55 mcg/spray) | Yes | Yes | Two sprays once daily | Aqueous suspension pump spray |
Nasal sprays work best when they are administered properly and the medication remains in the nose rather than draining down the back of the throat. Note that the recommended techniques for the aqueous and aerosol sprays are different. If the nose is crusted or contains mucus, it should first be cleaned with a saline nasal spray prior to use of intranasal sprays. Some people find that holding the other nostril closed with a finger improves their ability to draw the spray into the upper nose.
Once symptoms are controlled, the daily dose can be reduced to the lowest dose that maintains control.
Dosing and product descriptions are based upon products available in the United States and some other countries. Product descriptions in other countries may differ in some detail. Consult the UpToDate Lexidrug monographs and local product information for additional detail.OTC: over-the-counter (available without a prescription in the United States and some other countries).
* Alcohol may contribute to dryness or irritation.Do you want to add Medilib to your home screen?
