| Name | Common brand name(s) and strength | Generic available | Available without a prescription (OTC) | Usual adult dose per nostril | Lower age limit when used in children (years)* | Usual pediatric dose per nostril | Type of preparation (alcohol content)¶ |
| Second-generation (systemic bioavailability <1% or undetectable) | |||||||
| Ciclesonide | Omnaris (50 mcg/spray) | No | No | Two sprays once daily | 2 years | 2 to 11 years: One or two sprays once daily ≥12 years: Two sprays once daily | Aqueous suspension pump spray |
| Zetonna (37 mcg/spray) | No | No | One spray once daily | 12 years | ≥12 years: One spray once daily | Pressurized aerosol spray (3.4% alcohol) | |
| Fluticasone furoate | Flonase Sensimist (OTC) (27.5 mcg/spray) | No | Yes | Two sprays once daily | 2 years | One or two sprays once daily; in children 2 to 11 years, start with one spray once daily | Aqueous suspension pump spray |
| Fluticasone propionate | Flonase Allergy Relief (OTC) (50 mcg/spray) | Yes | Yes | Two sprays once daily or one spray twice daily | 4 years | 4 to 11 years: One spray once daily ≥12 years: Two sprays once daily or one spray twice daily | Aqueous suspension pump spray (0.25% alcohol) |
| Mometasone | Nasonex 24HR Allergy (OTC) (50 mcg/spray) | Yes | Yes | Two sprays once daily | 2 years | 2 to 11 years: One spray once daily ≥12 years: Two sprays once daily | Aqueous suspension pump spray |
| First-generation (systemic bioavailability 10 to 50%) | |||||||
| Beclomethasone | Beconase AQ (42 mcg/spray) | No | No | One or two sprays twice daily | 6 years | One or two sprays twice daily; in children 6 to 11 years, start with one spray twice daily | Aqueous suspension pump spray (0.25% alcohol) |
| Pediatric: Qnasl Children's (40 mcg/spray) Adolescent/adult: Qnasl (80 mcg/spray) | No | No | Two sprays once daily using 80 mcg/spray product | 4 years | 4 to 11 years: One spray once daily using 40 mcg/spray product ≥12 years: Two sprays once daily using 80 mcg/spray product | Pressurized aerosol spray (8% alcohol) | |
| Budesonide | Generic (formerly Rhinocort Allergy) (OTC) (32 mcg/spray) | Yes | Yes | One to two sprays once daily | 6 years | One to two sprays once daily; in children 6 to 11 years, start with one spray twice daily | Aqueous suspension pump spray |
| Flunisolide | Generic (formerly Nasalide) (25 mcg/spray) | Yes | No | Two sprays two or three times daily (maximum two sprays four times daily) | 6 years | 6 to 14 years: One spray three times daily or two sprays twice daily ≥15 years: Two sprays two or three times daily (maximum two sprays four times daily) | Aqueous suspension pump spray (contains propylene glycol, a possible irritant) |
| Triamcinolone | GoodSense Nasal Allergy (OTC), Nasacort Allergy 24 Hr (OTC) (55 mcg/spray) | Yes | Yes | Two sprays once daily | 2 years | 2 to 5 years: One spray once daily ≥6 years: One to two sprays once daily; in children 6 to 11 years, start with one spray once daily | Aqueous suspension pump spray |
Nasal sprays work best when they are administered properly and the medication remains in the nose rather than draining down the back of the throat. Note that the recommended techniques for the aqueous and aerosol sprays are different. If the nose is crusted or contains mucus, it should first be cleaned with a saline nasal spray prior to use of intranasal sprays. Some people find that holding the other nostril closed with a finger improves their ability to draw the spray into the upper nose.
Once symptoms are controlled, the daily dose can be reduced to the lowest dose that maintains control.
Dosing and product descriptions are based upon products available in the United States and some other countries. Product descriptions in other countries may differ in some detail. Consult the Lexicomp drug monographs and local product information for additional detail.OTC: over-the-counter (available without a prescription in the United States and some other countries).
* Lowest age use may differ from approved product labeling.
¶ Alcohol may contribute to dryness or irritation.