OTC Nasal Spray for Allergies: Which is the Best Choice? - GoodRx (2024)

Sneezing? Runny nose? Watery eyes? Sounds like you’ve got allergies. And whether it’s due to pollen, dust, or pet dander, you might be looking for a nasal spray to help manage your allergy symptoms.

But with so many different nasal sprays to choose from, finding the right one can feel overwhelming. Let’s break down the types of nasal sprays that are available over the counter (OTC) and find out which one works best.

Which OTC nasal spray works best for allergies?

There are three main types of OTC nasal sprays for allergy symptoms: steroids, antihistamines, and decongestants.

Steroid nasal sprays work best for treating allergy symptoms. They’re considered a first-choice treatment since they generally work better than antihistamines for congestion and reducing mucus.

Antihistamine nasal sprays can also be an effective choice. They work faster than steroid sprays and are more effective than oral antihistamines for treating nasal allergy symptoms.

Decongestant nasal sprays only treat congestion and should only be used for a very short time (up to 3 days). These should be reserved for situations like flying on an airplane or when your congestion is severe.

Can you combine different nasal sprays?

Yes, you can combine different types of OTC nasal sprays. In fact, steroid nasal sprays and antihistamine sprays might work better together. But you’ll need to wait 15 minutes between each type of spray. And using more sprays increases your chances of side effects, like nasal irritation.

Let’s look at each type of nasal spray in detail.

OTC steroid nasal sprays

Steroid nasal sprays work by calming your immune system’s response to the allergen that’s causing your symptoms. This helps to reduce swelling in your nasal passages and lessen the amount of mucus in your nose.

OTC steroid nasal sprays include:

• Flonase Allergy Relief (fluticasone propionate)

• Flonase Senismist (fluticasone furoate) — a finer, gentler spray than regular Flonase

• Nasonex (mometasone)

• Nasacort (triamcinolone)

• Rhinocort (budesonide)

Steroid nasal sprays work well, but you shouldn’t expect instant relief. You’ll need to use them daily and it may take a few weeks to see their full effect. If you have seasonal allergies, starting a steroid nasal spray a week or two before allergy season may be better for managing your symptoms.

OTC antihistamine nasal sprays

Antihistamine nasal sprays work by blocking histamine. Another class of nasal sprays, called mast cell stabilizers, affect special allergy cells (called mast cells). They’re not antihistamines, but they work in a similar way. Histamine and mast cells cause most allergy symptoms when they’re released. So blocking them helps treat a runny or itchy nose and sneezing.

These nasal sprays include:

• Astepro (azelastine), which blocks histamine

• NasalCrom (cromolyn sodium), which stabilizes mast cells

Antihistamine nasal sprays work quickly — within 15 minutes. Nasalcrom takes longer, providing relief in about 1 to 2 weeks. Both can be used to both treat and prevent symptoms.

OTC decongestant nasal sprays

Decongestant nasal sprays work by tightening blood vessels in your nose. They temporarily treat swollen nasal passages and congestion. They don’t treat other types of allergy symptoms, like runny nose or sneezing.

OTC decongestant nasal sprays are sold under many brand and generic names. A few popular examples are:

• Afrin (oxymetazoline)

• Sinex (oxymetazoline)

• Zicam Sinus Relief (oxymetazoline)

• Neo-Synephrine (phenylephrine)

Decongestant nasal sprays start working immediately. But there’s a catch — the effects are only temporary and typically fade within hours. You also shouldn’t use them for more than 3 days in a row. Otherwise, they can cause rebound congestion that can take up to 1 year to go away.

What’s the best dose of OTC nasal sprays for allergies?

The dosing for OTC nasal sprays differs depending on the medication. Most include directions for adults and children. Be sure to read the instructions carefully. You can also find separate children’s versions for products like Flonase, Nasonex, and Astepro.

Can you use a nasal spray every day?

Yes, most nasal sprays work best if you use them every day. But if you or your child need a steroid or antihistamine nasal spray for more than a couple months, it’s best to let your healthcare provider know. Adults can use some nasal sprays longer, but it’s still best to loop your provider in.

Keep in mind that even though you can use a decongestant nasal spray every day, you shouldn’t use them for more than 3 days in a row. This could lead to rebound congestion.

What are common side effects of OTC nasal sprays?

The most common side effects of OTC nasal sprays are nasal irritation and a bad taste in your mouth. Sometimes nasal irritation can cause nose bleeds. Talk to your healthcare provider if nosebleeds are severe or frequent. Aiming the spray away from the center of your nose can sometimes help.

When should you consider a prescription nasal spray for allergies?

There are some reasons your healthcare provider may recommend a prescription nasal spray for you. These may include:

• Cost. Not all OTC nasal sprays have generic options available. And insurance is also more likely to cover a prescription nasal spray. You also have access to more savings, such as GoodRx discounts, copay savings cards, and patient assistance programs for prescription nasal sprays.

• Combination sprays. If you need both a steroid and an antihistamine spray, your provider may prescribe a combination spray, like Dymista (azelastine / fluticasone) or Ryaltris (olopatadine / mometasone). These are often more convenient than two separate OTC sprays.

• For nasal polyps. Some prescription steroid nasal sprays treat nasal polyps (noncancerous growths inside the nose). OTC versions aren’t approved for this.

• Treatment failure. If you’ve tried OTC nasal sprays but they don’t seem to be working, a prescription option may be the next step.

Even if an OTC nasal spray is effective, be sure to let your healthcare provider know you’re using it. They may want to switch you to a prescription version depending on your symptoms and what’s causing them.