Rhinitis & Nasal Congestion Treatments

RHINITIS & NASAL CONGESTION TREATMENTS
Generic	Brand		Strength	Usual Dose
ANTICHOLINERGIC
ipratropium bromide	Atrovent Nasal Spray 0.03%	Rx	21mcg/ spray	<6yrs: Not recommended. ≥6yrs: 2 sprays in each nostril 2−3 times daily.
ipratropium bromide	Atrovent Nasal Spray 0.06%	Rx	42mcg/ spray	<5yrs: Not recommended. 5−11yrs: 2 sprays in each nostril 3 times daily. ≥12yrs: 2 sprays in each nostril 3−4 times daily.
ANTIHISTAMINE
azelastine HCl	Astelin¹	Rx	137mcg/ spray	Seasonal allergic rhinitis: <5yrs: Not established. 5−11yrs: 1 spray per nostril twice daily. ≥12yrs: 2 sprays per nostril twice daily Vasomotor rhinitis: <11yrs: Not established. ≥12yrs: 2 sprays per nostril twice daily.
azelastine HCl	Astepro 0.15%¹	Rx	205.5mcg/ spray	Seasonal allergic rhinitis: 6−11yrs: 1 spray per nostril twice daily. ≥12yrs: 1 or 2 sprays per nostril twice daily or 2 sprays per nostril once daily. Perennial allergic rhinitis: 6−11yrs: 1 spray per nostril twice daily. ≥12yrs: 2 sprays per nostril twice daily.
olopatadine HCl	Patanase¹	Rx	665mcg/ spray	<6yrs: Not recommended. 6−11yrs: 1 spray per nostril twice daily. ≥12yrs: 2 sprays per nostril twice daily.
ANTIHISTAMINE + STEROID
azelastine HCl + fluticasone propionate	Dymista	Rx	137mcg/ 50mcg per spray	<6yrs: Not established. ≥6yrs: 1 spray per nostril twice daily.
MAST CELL STABILIZER
cromolyn sodium	Nasalcrom	OTC	5.2mg/ spray	<2yrs: Not recommended. ≥2yrs: 1 spray in each nostril every 4−6hrs. Prevention: Begin 1wk before exposure to known allergen.
STEROID
beclometh– asone dipropionate	Beconase AQ	Rx	42mcg/ spray	<6yrs: Not recommended. ≥6yrs: 1–2 sprays in each nostril twice daily; max 2 sprays in each nostril twice daily. Reevaluate if no improvement in 3wks.
beclometh– asone dipropionate	Qnasl	Rx	40mcg/ spray, 80mcg/ spray	<4yrs: Not established. 4−11yrs: 1 spray (40mcg) in each nostril once daily; max: 2 sprays/day. ≥12yrs: 2 sprays (80mcg) in each nostril once daily; max: 4 sprays/day.
budesonide	Rhinocort Allergy Spray	OTC	32mcg/ spray	<6yrs: Not recommended. 6−<12yrs: Initially 1 spray in each nostril once daily; increase to 2 sprays per nostril once daily if no improvement; reduce to 1 spray in each nostril once daily when symptoms improve. ≥12yrs: Use 2 sprays per nostril once daily; reduce to 1 spray in each nostril once daily when symptoms improve.
ciclesonide	Omnaris	Rx	50mcg/ spray	Seasonal allergic rhinitis: <6yrs: Not recommended. ≥6yrs: 2 sprays in each nostril once daily (200mcg/day). Perennial Allergic Rhinitis: ≥12yrs: 2 sprays in each nostril once daily (200mcg/day).
ciclesonide	Zetonna	Rx	37mcg/ spray	Children: Not recommended. Adults: One actuation in each nostril once daily (37mcg/actuation); max 74mcg/day.
flunisolide	—	Rx	25mcg/ spray	<6yrs: Not recommended. 6−14yrs: Initially 1 spray per nostril 3 times daily or 2 sprays twice daily; max 4 sprays/nostril daily. ≥15yrs: Initially 2 sprays per nostril twice daily; max 8 sprays/nostril daily.
fluticasone furoate	Flonase Sensimist²	OTC	27.5mcg/ spray	<2yrs: Not recommended. 2−11yrs: 1 spray in each nostril once daily. ≥12yrs: Initially 2 sprays in each nostril once daily for Week 1, then 1 or 2 sprays in each nostril once daily as needed for Week 2 through 6mos.
fluticasone propionate	Flonase	Rx	50mcg/ spray	<4yrs: Not established. ≥4yrs: Initially 1 spray per nostril once daily; may increase to 2 sprays per nostril once daily. Maintenance: 1 spray per nostril once daily; max 2 sprays per nostril daily. ≥12yrs: Initially 2 sprays per nostril once daily or 1 spray per nostril twice daily. Maintenance: May reduce to 1 spray per nostril daily; max 2 sprays per nostril daily. Seasonal allergic rhinitis: ≥12yrs: 2 sprays per nostril once daily as needed.
fluticasone propionate	Flonase Allergy Relief	OTC	50mcg/ spray	<4yrs: Not recommended. ≥4yrs: 1 spray in each nostril once daily. Reevaluate after 2mos. ≥12yrs: Initially 2 sprays in each nostril once daily for Week 1, then 1 or 2 sprays in each nostril once daily as needed for Week 2 through 6mos. Reevaluate after 6mos.
mometasone furoate	Nasonex	Rx	50mcg/ spray	Allergic rhinitis: <2yrs: Not established. 2−11yrs: 1 spray per nostril once daily. ≥12yrs: 2 sprays per nostril once daily; prophylaxis: begin 2−4wks prior to anticipated start of pollen season. Nasal polyps: <18yrs: Not established. ≥18yrs: 2 sprays per nostril 1−2 times daily.
triamcinolone acetonide	—	Rx	55mcg/ spray	<2yrs: Not recommended. 2−5yrs: 1 spray in each nostril once daily. 6−12yrs: 1 spray in each nostril once daily; max 2 sprays in each nostril once daily. Reduce dose as condition improves. ≥12yrs: 2 sprays in each nostril once daily. Reduce dose as condition improves.
	Children’s Nasacort Allergy 24hr	OTC
	Nasacort Allergy 24hr
SYMPATHOMIMETIC
oxymeta– zoline HCl	Afrin No Drip Extra Moisturizing	OTC	0.05%	<6yrs: Individualize. ≥6yrs: 2−3 sprays in each nostril not more than every 10−12hrs; max 2 doses/day.
	Afrin No Drip Original
	Afrin No Drip Severe Congestion³
	Afrin No Drip Sinus
	Afrin Original
	Dristan 12‑Hr Nasal Spray	OTC	0.05%	Children: Individualize. Adults: 2−3 sprays in each nostril not more than every 10−12hrs; max 2 doses/day.
	Mucinex Sinus-Max Full Force Nasal Spray^1,3,5,6	OTC	0.05%	<6yrs: Not recommended. ≥6yrs: 2–3 sprays in each nostril not more than every 10–12hrs; max 2 doses/24hrs for 3 days.
	Vicks Sinex Severe Nasal Spray¹	OTC	0.05%	<6yrs: Not recommended. ≥6yrs: 2−3 sprays in each nostril not more than every 10−12hrs; max 2 doses/24hrs for 3 days.
	Vicks Sinex Severe Ultra Fine Mist¹
tetrahydroz– oline HCl	Tyzine¹	Rx	0.1%	<6yrs: see Contraindications. ≥6yrs: 2−4 drops in each nostril as needed; max: every 3hrs.
NOTES
¹Contains benzalkonium chloride ²Alcohol-free ³Contains menthol ⁴Contains aloe ⁵Contains camphor ⁶Contains eucalyptol Not an inclusive list of medications or dosing details. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling. (Rev. 8/2019)

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