Nasonex (mometasone) and Flonase (fluticasone) are both corticosteroid nasal sprays with largely overlapping indications, and Nasonex carries a few additional FDA-approved uses, including nasal polyps and seasonal allergy prevention, that Flonase’s label doesn’t specifically list. This guide compares their approved uses and practical differences.
This is general information, not medical advice.
Nasonex vs Flonase at a glance
| Nasonex (mometasone furoate) | Flonase (fluticasone propionate) | |
|---|---|---|
| Drug class | Corticosteroid nasal spray | Corticosteroid nasal spray |
| Approved for | Allergic rhinitis symptoms, seasonal allergy prophylaxis (12+), nasal polyps (18+) | Allergy and non-allergy nasal symptoms |
| Approved ages | 2 years and older (allergy symptoms) | 4 years and older (OTC formulations) |
| Availability | Prescription (as Nasonex brand; generic mometasone available) | Available OTC and by prescription depending on formulation |
Nasonex’s broader labeled indication list
Nasonex’s FDA label specifically lists four distinct indications: treatment of nasal symptoms of allergic rhinitis in patients 2 and older, treatment of nasal congestion associated with seasonal allergic rhinitis in patients 2 and older, prophylaxis (prevention) of seasonal allergic rhinitis in patients 12 and older, and treatment of nasal polyps in patients 18 and older. This prevention-specific indication, treating before symptoms start in patients with known seasonal allergies, and the nasal polyps indication are notable additional approved uses beyond what’s typically listed for Flonase.
Shared mechanism
Both are synthetic corticosteroids reducing nasal inflammation through the same general mechanism, delivering the drug directly to nasal tissue to calm the immune response responsible for allergy symptoms. Neither works instantly; both require days of consistent use to reach full effect, similar to the broader nasal corticosteroid class.
Brand discontinuation note
It’s worth noting that brand-name Nasonex nasal spray was discontinued by its manufacturer (per a notification to FDA in December 2020), though the FDA has confirmed this wasn’t for safety or effectiveness reasons, and generic mometasone furoate nasal spray remains available and approved as a therapeutic equivalent.
What each covers that the other doesn’t specifically list
Nasonex’s nasal polyps indication (ages 18+) means it’s specifically documented as a treatment option for that particular condition, useful information for patients whose allergic rhinitis has led to or coexists with nasal polyps.
Flonase has broader OTC availability across multiple product lines and formulations (including versions for non-allergy nasal symptoms specifically), giving it wider self-directed accessibility without necessarily requiring a prescription, depending on the specific product and use case.
Side effects
Both share the standard nasal corticosteroid side effects: nasal irritation, dryness, occasional nosebleeds, and headache in some users. Clinical pharmacology studies on mometasone furoate nasal spray have specifically assessed effects on adrenal function at various pediatric daily doses, part of the routine safety evaluation nasal corticosteroids undergo, particularly relevant for long-term use in children.
Who each might suit
Factors that may point toward Nasonex (or its generic mometasone):
- Nasal polyps specifically, given its documented approval for that condition
- A desire to start treatment before allergy season begins, given its specific seasonal prophylaxis indication (ages 12+)
Factors that may point toward Flonase:
- Wanting an easily accessible OTC option without needing a prescription
- Established good response to fluticasone specifically
Frequently asked questions
Is brand-name Nasonex still available?
The brand was discontinued by its manufacturer in 2020, though the FDA confirmed this wasn’t for safety or effectiveness reasons; generic mometasone furoate nasal spray remains available.
Can Nasonex treat nasal polyps?
Yes, it’s specifically FDA-approved for treatment of nasal polyps in patients 18 and older, an indication not typically listed for Flonase.
Can either be used to prevent allergy symptoms before they start?
Nasonex has a specific prophylaxis (prevention) indication for seasonal allergic rhinitis in patients 12 and older, meaning it can be started before symptom onset for that specific use.
Which is available without a prescription?
Flonase has widely available OTC formulations; Nasonex (or generic mometasone) is generally prescription-only.
How long do these sprays take to work?
Like other nasal corticosteroids, both take days of consistent use to reach full effect rather than working instantly.
12 thoughts on “Nasonex vs Flonase: Extra Approved Uses”