Rhinitis & Nasal Congestion Treatments

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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.
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 recommended. 5−11yrs: 1 spray per nostril twice daily. ≥12yrs: 1 or 2 sprays per nostril twice daily
Vasomotor rhinitis: <11yrs: Not recommended. ≥12yrs: 2 sprays per nostril twice daily.
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.
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).
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.
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 (as furoate mono-
hydrate)
Nasonex Rx 50mcg/
 
spray
Allergic rhinitis: <2yrs: Not recommended. 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 recommended. ≥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 Nasal Spray Full Force3 OTC 0.05% <6yrs: Individualize. ≥6yrs: 2−3 sprays in each nostril not more than every 10−12hrs; max 2 doses/day.
Mucinex Nasal Spray Moisture Smart4

Vicks Sinex 12 Hour Nasal Spray1,3,5,6 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 12 Hour Ultrafine 
Mist
1,3,5,6


phenyle-
phrine HCl
Vicks Sinex Nasal Spray1,3,5,6 OTC 0.5% Children: Not recommended.
Adults: 2−3 sprays in each nostril not more than every 4hrs; max 3 days.
Vicks Sinex Ultrafine 
Mist
1,3,5,6


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. Please see drug monographs or visit www.eMPR.com.

(Rev. 4/2017)

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