Flonase vs Nasacort (Fluticasone propionate vs. Triamcinolone)

March 12, 2016 8:58 AM

In the USA Flonase and Nasacort are now OTC and roughly the same price. I'm looking for personal experiences and/or links to any good studies suggesting one is better than the other.

My personal take - I've tried both (about 1 month with Flonase, and 6 months with Nasacort):
Both seem to work for me for treating symptoms of cat allergy.
Flonase has a mild floral smell/taste, whereas Nasacort has none.
I feel like i've experienced headaches using both products but have not discovered a clear pattern, and not enough to cause me to stop using either product.
The worst symptom: I developed a pretty bad multi-day nosebleed (epistaxis) using Nasacort, but did not with Flonase (however, I used nasacort 6x as long as flonase so this may not be a fair comparison).

The clinical trials for both do suggest there might be a slightly higher rate of epistaxis with nasacort:

http://www.drugs.com/pro/nasacort.html
http://www.drugs.com/pro/flonase.html

Side Effect: Epistaxis  
  
                                    Difference
              Drug vs. Placebo  Absolute   Relative
    Flonase    6.0%      5.4%   0.6%        11.1%
    NasaCort  11.0%      9.3%   1.7%        18.3%

Anyone who has used both products and has an opinion about differences, please add your thoughts.

posted by soylent00FF00 to Health & Fitness (12 answers total)

All the nasal corticosteroids cause nosebleeds. Personally, I get slightly fewer with Nasonex than I do with either Flonase or NasaCort, but it's not a big difference.

My anecdata, take it for what it's worth, is that what makes a bigger difference for me is applying a small amount of lanolin to the inside of my nose with a Q-tip every morning, as recommended by one of my ENTs. This is the only thing that makes me able to handle long-term nasal corticosteroids of any variety without descending into Interminable Nosebleed Hell.
posted by pie ninja at 9:07 AM on March 12, 2016

I prefer Flonase over Nasocort. I like that Flonase has a scent, so that I can tell it actually sprayed into my nose.
posted by hydropsyche at 10:22 AM on March 12, 2016 [1 favorite]

My experience is that Flonase works for me and Nasacort doesn't. I don't mind the smell because it dissipates reasonably quickly, and lets me know that yes, I used it, because I'm likely to forget that I did so within 30 seconds. The only time I've experienced nosebleeds in well over a year of use is when I had a sinus infection recently, so I can't say if the Flonase contributed to it or not.

My husband finds they both work equally well for him, and he hasn't experienced any nosebleeds that can be attributed to it--i.e. 5 or 6 nosebleeds over the course of the 6 or so years he's been using it.
posted by telophase at 10:44 AM on March 12, 2016 [1 favorite]

Flonase works for me, while Nasacort does nada. I've tried both for months in the past, and I'll continue on with Flonase.
posted by heathrowga at 11:11 AM on March 12, 2016

Flonase has been much more effective for me than Nasacort, and I haven't experienced nosebleeds.

(Note: I have a ridiculously baroque sinus routine that includes saline sinus washes in the morning, humidifier at night, allegra pills, Flonase, and a host of backup medicines [decongestants; homeopathic nasal gels; etc]. If anyone develops some sort of cure all for sinus congestion and pain, I'm IN.)
posted by correcaminos at 11:59 AM on March 12, 2016

I think you're just going to have to try for yourself, the best you'd get even from a scientific study is a percentage possibility.

Personally, I got migraines with Nasacort (fortunately no pain, but the visual aura was unmistakeable) - I got several while taking it, and never got them again after I stopped.
Eventually steroids didn't do good things for me (they helped with the nose but weirdly made the lungs worse) so I stopped either one - sufficient amounts of pseudoephedrine work for me (but come with other risks).

And yeah, whoever thought flowers were a good scent for an allergy drug-- that person is a bit weird. Flonase makers, what gives?
posted by nat at 12:05 PM on March 12, 2016

Just to make sure you factor in all your options, I get generic fluticasone via prescription, and it's cheaper than Flonase.
posted by metasarah at 12:42 PM on March 12, 2016 [1 favorite]

I took them both when they were prescription. Nasacort gave me terrible nosebleeds from day two so I didn;t take it for long. Flonase worked, but after several months it gave me The Headache That Never Ends.

If it helps, my allergist doesn't prefer one or the other for effectiveness.

After my previous experiences I didn't want to try another steroid so now I use the generic for Astepro nasal spray. Doesn't work as well as a steroid, but since it is an antihistamine I can take it all the time or only use it when I need it and it still works just as well. The only side effect I get is a bit of dryness sometimes. Does taste a bit nasty. They put sweetener in it, which helps. No headaches. Better for me than taking oral antihistamines, as all of them give me some kind of signifigant side effects, but can be used with them. At one time I was taking Astepro, Allegra, Zyrtec, Patanol eyedrops, and Benedryl chewables as needed. For combined dust, cat, and multiple pollen allergies. Hoping to make do with just Astepro and minor misery this year, since I don't have a cat anymore.
posted by monopas at 1:06 PM on March 12, 2016 [1 favorite]

Yes, you just have to try them and see what works for you. Flonase works better for me and I don't mind the scent. Nasacort works too, just not as well. Neither causes nose bleeds for me (never had one ever). I use them for seasonal allergies, not pet allergies, so ymmv.
posted by jeffamaphone at 10:48 PM on March 12, 2016

And yet more anecdata: I've used both and get along with them just fine. Nasacort works much better for me. (Although ... maybe I need to keep better track of the headaches I've been getting every evening. They always come after I use the Nasacort. But I get lots of headaches and migraines, so...)

I use the Nasacort in combination with Zyrtec to help deal with my chronic and allergic rhinitis (doctor approved).
posted by bryon at 3:14 AM on March 13, 2016

I haven't had a sinus infection in the year and half its been since I switched from nasacort to Flonase. Prior to that I got one every quarter or so.
I do have dried blood in my nose in the morning once the radiators came on this winter, but now that the moisture is coming back in the air that seems to have leveled out.
posted by teleri025 at 12:16 PM on March 13, 2016

All the nasal corticosteroids cause nosebleeds.

Really? I am Mister Frequent Nose-is-Bleeding, and I didn't notice any increase when I started like a decade ago. (Still worth it to me, a guy with a permanently bent nose and awful turbinates and seasonal allergies.)

At some point I switched from brand name Flonase to generic fluticasone (like metasarah), and noticed no difference between them. *shrug* So YMMV, so I suggest you take the $7 gamble and try both.
posted by wenestvedt at 10:02 AM on March 14, 2016