OTC Nasal Spray for Allergies: Which Are the Best? - 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 over-the-counter (OTC) nasal sprays for allergies and find out which one works best.

What are the best OTC nasal sprays for allergies?

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

Nasal steroid 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, such as an itchy or runny nose..

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, such as 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 24HR Allergy (mometasone)

• Nasacort Allergy 24 Hour (triamcinolone)

• Rhinocort Allergy (budesonide)

When it comes to Flonase versus Rhinocort or the other products, they’re all considered first-choice options for allergies. But they’re approved for different ages and come in different types of sprays. So choose the one that works best for you.

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. Histamine is released in response to allergens, and it causes allergy symptoms such as a runny nose and watery eyes. Blocking histamine helps lessen these symptoms.

Astepro Allergy (azelastine) is the most common antihistamine nasal spray. It works quickly — within 15 minutes, and it can be used to both treat and prevent allergy symptoms.

OTC mast cell stabilizers

Another class of nasal sprays, called mast cell stabilizers, affect special allergy cells called mast cells. Like histamine, mast cells can cause allergy symptoms when they’re released. So blocking them helps treat nasal allergy symptoms.

NasalCrom (cromolyn sodium) is an OTC mast cell stabilizer spray for allergies. It also both treats and prevents allergy symptoms, but it takes longer to work — about 1 to 2 weeks.

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, such as a runny nose or sneezing.

OTC decongestant nasal sprays are sold under many brand and generic names. Here are some of the best nasal sprays for congestion:

• 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.

Steroid Nasal Sprays

Antihistamine / Mast Cell Stabilizer Nasal Sprays

Decongestant Nasal Sprays

Can you use a nasal spray for allergies 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 of months, it’s best to let your primary care provider know. Adults can use some nasal sprays longer, but it’s still best to loop in a healthcare professional.

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 team 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 team may recommend a prescription nasal spray for you. These may include:

• Cost. Not all OTC nasal sprays have generic options. 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, prescription combination sprays, such as Dymista (azelastine / fluticasone) or Ryaltris (olopatadine / mometasone), are an option. These are often more convenient than using 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 team know you’re using it. They may want to switch you to a prescription version depending on your symptoms and what’s causing them.