Fact Checked

Is Flonase an Antihistamine?

More than 50 million Americans have symptoms of allergies throughout allergy season and throughout the year, and these symptoms often interfere with carrying out daily activities that many of us take for granted. What was once a simple walk in the park becomes far more complicated when it’s spring and pollen levels are spiking, exacerbating allergy symptoms. Allergies are the most common health issue affecting children in the United States and are also the sixth most common chronic illness. Many people think of antihistamine medications as the first choice for relieving allergy symptoms, but not everyone understands which allergy medications are antihistamines and which are not. Popular decongestant medications like Zyrtec, Xyzal, Loratadine, Nasacort, Afrin, Azelastine, Cetirizine, Fexofenadine, Nasonex, and Flonase all have different pros and cons, but Flonase is one of the most popular drugs on the market today. Is Flonase an antihistamine, or does it fall into a different drug class?

What is Flonase?

Flonase is an over the counter nasal spray and nasal steroid that is used to treat symptoms of allergies. Flonase is also sold under the generic name fluticasone propionate. Flonase was first approved for the treatment of allergies by the U.S. Food and Drug Administration (FDA) in 1994, when it became available by prescription. In 2014, Flonase was made available for purchase over the counter for the treatment of allergies. 

Is Flonase an Antihistamine?

While most people associate antihistamines with allergy relief, Flonase is not an antihistamine. Flonase belongs to a class of drugs called corticosteroids; specifically,  it is a synthetic glucocorticoid steroid. When we are exposed to allergens, our bodies produce allergic substances that cause nasal symptoms and allergy symptoms like itchy, watery eyes,  nasal congestion, sneezing, and more. Antihistamine medications like Benadryl, Claritin, and Zyrtec only block Unlike antihistamine medications, such as Benadryl, Allegra, and Claritin, which stop one cause of allergic substances in the body (histamines), nasal corticosteroid sprays like Flonase block six key allergic substances, including histamines, to provide relief. Because Flonase is capable of blocking more allergic substances, it is capable of providing more comprehensive relief. Studies have shown that Flonase and other nasal corticosteroids provide more effective allergy symptom relief than oral antihistamines. 

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What Conditions is Flonase Used to Treat?

Allergic rhinitis, or hay fever, refers to a common group of symptoms that occur when an individual with allergies is exposed to an allergen. Allergens are substances in the environment that do not cause problems for most people but can produce a strong reaction in people who are allergic to them. Allergens are found in both indoor and outdoor environments, and people can be allergic to a variety of different substances. The immune system of a person with allergies responds to the presence of an allergen by attacking it, causing an inflammatory response. Inflammatory mediators, including histamines, are released during an allergy attack, causing a number of reactions that are commonly associated with hay fever, including runny nose, nasal congestion, sinus pressure, itchy/watery eyes, and itchy nose or throat. Inflammatory mediators cause these symptoms by binding to the receptors in cells in the nasal passages. 

The symptoms of allergic rhinitis can be triggered by many different substances. Indoor allergens like pet hair, pet dander, mold, smoke, dust mites, and perfumes are some of the most common causes of perennial (year-round) allergies. Outdoor allergens, including pollen that is produced by grasses, trees, weeds, and flowers, are more likely to cause seasonal allergies.  Some people experience only seasonal allergies, while others experience only perennial allergies. Some people are allergic to both indoor and outdoor allergens and experience some symptoms of allergic rhinitis seasonally and others perennially. 

How Does Flonase Work?

Glucocorticoid steroids like Flonase pack some extra punches that give them an advantage over antihistamines when it comes to controlling allergies. Glucocorticoid steroids decrease swelling and inflammation that is typically caused by allergic responses to allergens. Unlike antihistamines, which only block the allergic response caused by histamines, corticosteroids treat allergy symptoms by blocking allergic responses from six different types of cells in the nasal passages. As a result, glucocorticoid steroids are more effective at reducing and preventing symptoms of allergic rhinitis than antihistamines. Inflammation in the nasal passages during an allergy attack causes symptoms that include runny nose, sneezing, excess mucus production and other upper respiratory symptoms. Corticosteroids reduce the inflammation, which in turn reduces the symptoms. 

How Do I Use Flonase?

Flonase can be purchased over the counter under the brand name medication or in its generic form, fluticasone propionate. The medication is sold in the form of a nasal spray, and it delivers 50 mcg of the active ingredient, fluticasone propionate, regardless of whether the generic or brand name drug is purchased. Flonase is available in a formula that has been specially formulated for children, and it is also available as part of a new line of products called Flonase Sensimist. Flonase Sensimist was developed in response to patients that appreciate the effectiveness of Flonase but wanted to avoid a powerful spray or strong scent. Flonase Sensimist provides a gentle mist that does not include any alcohol or have a noticeable scent. The Sensimist line has also eliminated the occurrence of post nasal drip, which is a common side effect of nasal sprays. Adults can use Flonase for up to six months, while the maximum recommended duration for children is two months. Flonase is approved for use and adults and children ages 4 and older. 

How Much Does Flonase Cost?

Over the counter medications like Flonase are accessible and affordable for most patients because there are many options regarding where they can be purchased. Flonase can be found at any pharmacy, drug store, or big box store, and it is sold in a generic form as well as the brand name form. Patients who know that they will be using Flonase on a long term basis can purchase the generic version of the medication at a very low cost from warehouse membership clubs like Costco and Sam’s Club. Pharmacy discount cards like USA Rx can also provide additional savings; you can expect to pay about 12 to 13 dollars for the generic version of Flonase, which is about half of the cost of the brand name medication. One bottle of the medication usually contains 120 sprays. 

What Risks are Associated With Flonase?

Flonase is generally considered safe for use by most people, which is why it has been approved by the FDA for over the counter sales. Nonetheless, corticosteroid nasal sprays like Flonase do carry certain risks of use, which are often more notable for people with certain medical conditions. It’s important to give your doctor a complete medical history prior to using Flonase, particularly if you have any of the following conditions:

  • Eye infections caused by herpes

  • Liver problems

  • Nose sores, injury, or surgery

  • Eye infections

  • Tuberculosis

  • Any untreated viral, bacterial, or fungal infection

  • Recent exposure to chickenpox or measles

  • Eye problems such as cataracts or glaucoma

  • Weakened immune system

What Side Effects are Associated With Flonase?

Thanks to its excellent safety record and low incidence of side effects, Flonase was approved by the FDA in 2014 for over the counter sales. Most people will not experience any side effects while taking Flonase, but those who do will generally experience mild side effects that do not require medical attention. Common side effects of Flonase that usually do not include medical attention include:

  • Burning, irritation, or inflammation in the nose

  • Asthma symptoms

  • Headache

  • Bloody nose

  • Sore throat

  • Cough

Rarely, Flonase causes serious side effects that require medical attention, including allergic reactions. Although rare, it is also possible for both Flonase and Nasacort to cause serious side effects that may require medical attention, including allergic reactions. Serious side effects of Flonase that may require medical attention include:

  • Cataracts

  • Worsening of infections even with eye drops 

  • Nose bleeds and sores in the nose

  • Decreased wound healing

  • Severe allergic reaction

  • Slowed growth rate in children and adolescents

  • Puncture of the nasal septum

  • Glaucoma

What Drugs Does Flonase Interact With?

Flonase doesn’t interact with many prescription drugs, but it’s still important for patients to check the list of drug interactions for any medications they may be taking in order to ensure that using Flonase will not impact the effectiveness of their other medications. Make sure to check with your doctor or pharmacist if you have any questions about drug interactions between your current medications and Flonase or Nasacort, speak to your doctor or pharmacist. Flonase is known to interact with the following HIV medications:

  • Saquinavir

  • Atazanavir

  • Ritonavir

  • Indinavir

  • Nelfinavir

  • Lopinavir

Sources:

https://www.healthline.com/health/allergies/nasacort-vs-flonase 

https://www.drugs.com/medical-answers/flonase-nasacort-difference-3117146/ 

https://www.flonase.com/allergies/flonase-vs-nasacort/ 

https://www.rxlist.com/flonase_vs_nasacort/drugs-condition.htm 

https://www.verywellhealth.com/flonase-or-nasacort-nasal-allergies-83165 

https://pubmed.ncbi.nlm.nih.gov/30879006/ 

https://www.aafa.org/allergy-facts/ 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC28740/ 

https://medlineplus.gov/ency/article/000813.htm 

https://www.healthline.com/health/allergic-rhinitis 

https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020121s045lbl.pdf 

Published August 1st, 2020 by Bridget Reed
Fact Checked by Chris Riley

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