Nasonex or Flonase: What's the Difference?

Nasonex (mometasone) and generic Flonase (fluticasone).
Nasonex (mometasone) and generic Flonase (fluticasone).

As a person who suffers from a perpetually runny nose (I'm allergic to just about everything, it seems), I've become a big fan of Nasonex and Flonase. They're both very similar corticosteroid nasal sprays that reduce inflammation, and thereby mucus production, in the nose.

So what's the difference between them? According to my doctor, not much. He gave me a sample of Nasonex to start, and when I told him it was working for me, he moved me to Flonase, since it's available as a generic and is much less expensive.

When I asked him if it was any different, he shook his head, "No." In terms of efficacy, I would agree with them that they are virtually indistinguishable from each other.

Chemical structure of mometasone furoate.
Chemical structure of mometasone furoate. | Source

Nasonex = Mometasone furoate

Nasonex's active ingredient is the corticosteroid mometasone furoate, with a chemical formula of C27H30O6Cl2. It is absorbed and metabolized intranasally, meaning its activity is generally within the nose tissues when you use the nose spray. Its systemic bioavailability, or how much it affects the whole body outside the nose, is almost negligible. The half-life is 5.8 hours, meaning that it takes that long to eliminate half of the concentration of the drug from the body.

The FDA approved the drug in 1997.

Chemical structure of fluticasone proprionate.
Chemical structure of fluticasone proprionate. | Source

Flonase = Fluticasone propionate

Flonase's active ingredient, fluticasone propionate (C25H31F3O5S), is remarkably similar to what's in Nasonex. Both have similar intranasal bioavailability and metabolism, and negligible systemic bioavailability. Fluticasone's elimination half-life is quite a bit longer at approx 10 hours.

It was also approved by the FDA, just a few years prior, in 1994.

So what's the difference?

As a consumer and sufferer of allergic rhinitis (i.e. runny nose), not much!

The biggest difference, as explained by my doctor, is price.You can get generic Flonase for $73.79 at my local Walgreens (a 120-spray bottle), while a similar 120-spray bottle of Nasonex costs $154.99.

Naturally, insurance will bring these down, but the generic will almost always be more inexpensive. And with an undetectable difference in efficacy, I'm sticking with my generic Flonase.

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Comments 34 comments

Daughter Of Maat profile image

Daughter Of Maat 4 years ago from Rural Central Florida

Great hub. Your info is right on specifically your chemistry knowledge, which is awesome and surprising at the same time. Do you actually have a background in pharmacy? I'm curious because your article was excellent. :D

livelonger profile image

livelonger 4 years ago from San Francisco Author

Thank you, DoM! No, I'm not a pharmacist, but I did get my degree in chemical engineering. :)

Lwelch profile image

Lwelch 4 years ago from USA

Thank you! I have wondered that myself. Been using fluticasone for years and wondering if another would be better. This year's pollen counts are trying to break my brain!

Simone Smith profile image

Simone Smith 4 years ago from San Francisco

I used to take Nasonex along with Claritin when I was a kid and suffering from severe allergies. I hadn't realized how EXPENSIVE those nasal sprays could get! Thank goodness for insurance, eh?

Thanks for breaking down the great comparison- I wish my doctor had explained those things to me! Grrr...

Also, I love the term "allergic rhinitis." YAY!

livelonger profile image

livelonger 4 years ago from San Francisco Author

Lwelch: I can sympathize!

Simone: The term "allergic rhinitis" is synonymous with frustration for me. ;) But, yeah, thankfully we have these sorts of sprays, and that insurance can get you a discount!

Mmargie1966 profile image

Mmargie1966 4 years ago from Gainesville, GA

Excellent hub. I use flonase and zyrtec, which is otc. (both generic)

I didn't realize how little the difference was between the two sprays. I think I'll just stick with what I have. It works for me.

robie2 profile image

robie2 4 years ago from Central New Jersey

This is a subject of some interest to me. Since moving to the Delaware River Valley a dozen years ago I, who never suffered from allergies before, have had the post nasal drip from hell along with allergy headaches, runny nose and sinusitis. I know I'm allergic to cat dander and mold, but what else I'm allergic to I have not got a clue-- doesn't matter because we've got it all along the banks of the Delaware River :-) I've never used either Flonase or Nasinex. I keep my symptoms at bay by taking Claritin all allergy season long which works for me-- but I was interested to note how little difference there is between the two nasal sprays, except for the price. One is expensive and the other is astronomically expensive. Welcome to America:-) Very interesting and informative as always, Livelonger.

bryanbaldwin profile image

bryanbaldwin 4 years ago from Los Angeles

My dad has been addicted to 4 Way for about 20 years... what's up with that stuff?

livelonger profile image

livelonger 4 years ago from San Francisco Author

Thanks, Robie2. I also have flare-ups in certain parts of the country, and I've noticed (confirmed by skin prick tests) that certain allergies wax and wane. I'm now allergic to juniper trees (they're abundant here) and when I was a kid, I was really allergic to ragweed, which was all over the place in rural NJ in August.

Claritin is a great way to manage systemic allergies and all the problems they cause.

Thanks for stopping by and leaving a comment - always a pleasure! :)

Lwelch profile image

Lwelch 4 years ago from USA

Ragweed is evil!

livelonger profile image

livelonger 4 years ago from San Francisco Author

I agree it doesn't seem to do anything except provoke allergies. Does anything even eat the stuff?!

Daisy Mariposa profile image

Daisy Mariposa 4 years ago from Orange County (Southern California)


Thanks for publishing this very informative article. I've had allergic rhinitis since I was seven years old.

I use Fluticasone Propionate when I have difficulty breathing, and Ipratropium Bromide when I have a runny nose. The Ipratropium Bromide is the only medication I have ever used that works for that.

My ragweed allergy was off the chart when I was tested while living in New Jersey. Ragweed is closely related to sage, so that really bothers me in Southern California where I live now.

livelonger profile image

livelonger 4 years ago from San Francisco Author

Daisy - Thank you for your comment. Atrovent (ipratropium bromide) is great; I've used it, too. I even wrote a Hub about it.

Daisy Mariposa profile image

Daisy Mariposa 4 years ago from Orange County (Southern California)


I came back to read this article a second time. My allergenic rhinitis has been so bad the past few days, I can barely function. I've been trying to use Photoshop to create some parodies for a Hub, and my eye are so irritated, it's difficult to see the fine details.

sgbrown profile image

sgbrown 4 years ago from Southern Oklahoma

I am so glad I you wrote this hub! My husband has been on either one or the oher for several years. I am glad to find out there is little difference in the effectiveness. They both seem to work for him, but now I know more about them and their cost. Thank you for sharing the information! Voted up, useful and sharing. Have a wonderful day! :)

danielabram 4 years ago

I never thought I would be so interested about the differences between Nasonex and Flonase. Nice hub!

PD 2 years ago

I disagree...why there may seem like little difference between the two there can be a large difference for individual patients. Nasonex works almost immediately for us to reduce the swelling and post-nasal drip that causes my throat to swell and feel like it's closing. Flonase does not. Claritin does not. In fact, just about everything else is useless. The allergist noted that like others on this board I'm allergic to ragweed, pollen, and the NJ pines. I don't disagree with your chemical assessment or that they work the same for you - but, your experience isn't necessarily indicative of everyone's experience. The only way to tell which is better for each individual is for that person to use both and decide which works best for them.

Also, secondary ingredients and overall dosage of main ingredients can change how a medication interacts and how effective it can be. While your chemical background is impressive and helps you understand how it absorbs in the system only a pharmacological/medical background can tell you how the ingredients and their dosage interacts with one another when addressing the issues they are designed for.

Flonase is not a generic or brand name version of Nasonex and therefor not the same medication. To tout them as similar and nearly interchangeable because they both address your particular issue, without warning readers that it may not be the case for everyone, or even medically diagnosing the particular issues you have (there are many causes of allergic rhinitis and not all react the same to irritants, in the symptoms they produce, the severity of those symptoms, or to the medications design to treat them) is negligent at best. I appreciate you sharing your personal experience, but I don't think your qualified to tout it as anything but YOUR personal experience.

livelonger profile image

livelonger 2 years ago from San Francisco Author

I shared my experience AND the opinion of my doctor (yes, an MD), who said they are pretty much the same. Please reread the second and third paragraphs. Thank you for your comment.

travellingtrio 2 years ago

Not everything works the same for everyone. For me, the alcohol that is in Flonase had the most horrible smell that I could not stand it. It also made me get horrible nose bleeds. My ENT has had me on Nasonex for years because of this. After cauterizing a bloody nose a few times, I switched to Nasonex and do not look back. Also, my problem is the horrible congestion and polyps. From what he says, only Nasonex has been tested for polyps. Whatever his reason, I am a much happier person now than before. I use a coupon and it is actually a better copay than my generic copay. So for me, it is a win-win!

Lynn Mischke profile image

Lynn Mischke 2 years ago from Newhall, Iowa

Travellingtrio, your experiences with the these two meds mirrors mine almost exactly! Flonase worked for me if I didn't mind the horrible headaches and daily severe nosebleeds. Stopped using it within 4 days.

I have a new GP that has a great deal of experience with allergy treatment. She knew that my problems were common for Flonase and asked lots of questions, and suggested several different approaches. When she found out about my mother's battles with allergies, sinus infections and multiple surgeries for polyps, she suggested using a combination of Zyrtec and Nasonex. The combo is great. The only thing that worked better was adding Singulair to the mix but caused me to only sleep 2 hrs at a stretch and have progressively more disturbing dreams. The benefit wasn't worth the cost.

shorthairdave 2 years ago

Travellingtrio and Lynn have both started to nail down the difference between Nasonex and Flonase. Nasonex aqueous means that it is formulated with a water base whereas most of the other nasal corticosteroids have an alcohol base. The alcohol does not seem to bother most people, however there are a few who react to it. One of the side effects includes drying of the mucous membranes, and that can increase the risk of easy bleeding.

roy2098 24 months ago

I also have had much better results with Nasonex. I don't have to take it every day for results and can simply use it as needed, sometimes only in one nostril.

bw 23 months ago

Thaks for all the feedback. I obviously react to the alcohol in the generic for Flonase, and now I remember why I stopped using it. I am trying Nasonex at the present but it is so expensaive I probably won't continue. I will look for a coupon to see if that helps, or maybe give the generic one more chance.

AntiFl 22 months ago

Do NOT take flonase or anything containing fluoride! It's not worth wrecking your health just to temporarily improve your allergies when there are better ways...

Suresh 22 months ago

Thank you for the information.

My insurance company recently informed me that they are not going to allow Nasonex (which is expensive for me too) and so I moved to flonase.

But, one thing I observed is flonase causes sneezes as a side affect (at least

Paul 21 months ago

Has anyone ever had an issue with inflammation of glands in your face (nose and cheeks) while taking any Nadal sprays..I believe Nasonex and Avamys has an ingredient which I'm allergic to..

Bobby63 21 months ago

I have had allergies since I was 17 years old and am now a lot older, so have been dealing with a long time. I took three shots a week for almost 20 years and take allegra every day, and I now use Nasacort, when I did use Nasonex, and had trouble with my insurance and tried to find cheaper so when Nasacort became non RX I tried it and it seemed to work. I checked online and it is the same ass Nasonex, but first gen of product. I asked my doctor and he said it was yes the same and I could take it. It is cheap and with the allegra nonRX I now use both of these two things and works great. I have other things I do that most people probably never heard of and maybe one day will share.

Ingrid 18 months ago

So happy to have found this site and to see how many other folks suffer as I do. I acquired adult-onset asthma at age 43 (69 now), later, developed an allergy to alcohol and finally was prescribed Advair as Proventil was not enough. More lately, the sinus problems have taken over and I was prescribed Nasonex which worked just fine. I was asking my pharmacist if Advair was going to have a generic soon. He said yes but I could save money now by going to the generic, Flonase. I started it last summer but was bad off all summer long which I attributed to more sensitivity to grasses. However, when Nasacort became OTC and claimed to have no alcohol, I realized the problem with Flonase. Still, Nasacort is not helping that much, lots of sneezing for me too which indicates an allergic reaction. I am guessing I need to go back to Nasonex.

Thanks for being here.

Claire 18 months ago

I live in north Florida, where we have a lot of seasonal allergens and very, very rainy and humid summers with resulting mold. My symptoms have been almost exclusively nasal congestion and debilitating fatigue. At best, Flonase would give me a few hours of relief, while Nasonex gives me almost 24 hours. Everyone is different, of course (and too bad the cheaper one didn't work better, lol).

Jennifer 15 months ago

My daughter used Nasonex for a couple years, and it was literally life-changing for her. This year our insurance stopped covering Nasonex, so she had to switch to Flonase. (The cash price for Nasonex at our pharmacy is $250.) This year, she has annoying allergy symptoms even with consistent use of Flonase and Zyrtec. She misses Nasonex!

Thanks 8 months ago

Thanks for the explanation.

I went to CVS to pick up my prescription of Nasonex and came back with nothing. It was more than $255 and I refused to pay.

randomau 5 months ago

:O Is that price current? You can get Nasonex & Flixonase for less that $40AUD over-the-counter in Australia

gigi 3 months ago

I know that Flonase is about $25.00 at Walmart.

Ryde4ever 7 weeks ago

These are 2 different chemical compound s that work similarly. So different people will experience different results. A few years ago I found the best combo for my year around allergies. Allegra 24 hr and Nasonex. Then all the insurance changes came along and Nasonex was too expensive. Flonase was my option. After a few years of off and on severe sinus headaches I finally realized it was the Flonase. My doctor pushed through an approval through the insurance. Headaches are rare now that I am on Nasonex. I will be able to use it until the end of the year since I have hit my out of pocket on insurance. Probably have to quit due to the cost when next year's insurance starts up and high deductible hits again. Maybe I'll try Nasacort but no way I am going back to Flonase. Btw - Flonase works great for my wife and son. So don't be afraid to try different products. Unless they are the exact same chemical compound they are not the same.

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