My Preference: Nasonex or Flonase—What's the Difference?
As someone who suffers from a perpetually runny nose (I'm allergic to just about everything, it seems), I've become a big fan of Nasonex and Flonase. They're both very similar corticosteroid nasal sprays that reduce inflammation, and thereby mucus production, in the nose.
So what's the difference between them? According to my doctor, not much. He gave me a sample of Nasonex to start, and when I told him it was working for me, he moved me to Flonase, since it's available as a generic and is much less expensive.
When I asked him if the two were any different, he shook his head, "No." In terms of efficacy, I would agree with him that they are virtually indistinguishable from each other.
Nasonex = Mometasone furoate
Nasonex's active ingredient is the corticosteroid mometasone furoate, with a chemical formula of C27H30O6Cl2. It is absorbed and metabolized intranasally, meaning its activity is generally within the nose tissues when you use the nose spray. Its systemic bioavailability, or how much it affects the whole body outside the nose, is almost negligible. The half-life is 5.8 hours, meaning that it takes that long to eliminate half of the concentration of the drug from the body.
The FDA approved the drug in 1997.
Flonase = Fluticasone propionate
Flonase's active ingredient, fluticasone propionate (C25H31F3O5S), is remarkably similar to what's in Nasonex. Both have similar intranasal bioavailability and metabolism, and negligible systemic bioavailability. Fluticasone's elimination half-life is quite a bit longer at approx 10 hours.
It was also approved by the FDA, just a few years prior, in 1994.
So what's the difference?
As a consumer and sufferer of allergic rhinitis (i.e., runny nose), not much!
The biggest difference, as explained by my doctor, is price.You can get generic Flonase for $73.79 at my local Walgreens (a 120-spray bottle), while a similar 120-spray bottle of Nasonex costs $154.99.
Naturally, insurance will bring these down, but the generic will almost always be less expensive. And with an undetectable difference in efficacy, I'm sticking with my generic Flonase.