Prescription Nasal Corticosteroid Sprays Available
Multiple intranasal corticosteroid sprays are available by prescription, including fluticasone propionate, fluticasone furoate, mometasone furoate, budesonide, beclomethasone dipropionate, and ciclesonide. 1
Specific Prescription Formulations
Fluticasone Preparations
- Fluticasone propionate (Flonase): Available as 50 mcg per spray in aqueous formulation, approved for ages ≥4 years 1, 2
- Fluticasone furoate (Veramyst): Available as 27.5 mcg per spray in suspension formulation, approved for ages ≥2 years 1
Other Prescription Options
- Mometasone furoate (Nasonex): Available as 50 mcg per spray in aqueous formulation, approved for ages ≥2 years for allergic rhinitis and ages ≥18 years for nasal polyps 1, 3
- Budesonide (Rhinocort AQ): Available as 32 mcg per spray in aqueous formulation, approved for ages ≥6 years 1
- Beclomethasone dipropionate: Available as 42 mcg per spray in aqueous formulation, approved for ages ≥4 years 1
- Ciclesonide (Omnaris): Available as 50 mcg per spray in aqueous suspension, approved for ages ≥6 years 1
- Ciclesonide (Zetonna): Available as 37 mcg per spray in HFA-propelled aerosol formulation, approved for ages ≥12 years 1
Important Clinical Distinctions
Over-the-Counter vs. Prescription Status
While some formulations like triamcinolone acetonide (Nasacort Allergy 24HR) have transitioned to over-the-counter availability, the medications listed above remain available by prescription, though some may also have OTC versions 1
Age-Specific Considerations
The youngest approved age varies significantly by formulation: mometasone furoate and fluticasone furoate can be used starting at age 2 years, while ciclesonide (Zetonna) requires patients to be at least 12 years old 1
Common Side Effects Across All Formulations
All prescription intranasal corticosteroids share similar adverse effect profiles, including epistaxis, headache, pharyngitis, nasal burning or irritation, and nasopharyngitis 1, 2. Local side effects such as nasal irritation and bleeding are rare when proper administration technique is used, with patients directed to spray away from the nasal septum 1
Safety Profile
Studies demonstrate that intranasal corticosteroids at recommended doses show no clinically significant effects on the hypothalamic-pituitary-adrenal axis, growth (except beclomethasone dipropionate at doses exceeding recommendations), bone density, or ocular pressure 1