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Rhinitis & Nasal Congestion Treatments
| RHINITIS & NASAL CONGESTION TREATMENTS | ||||
|---|---|---|---|---|
| Generic | Brand | Strength | Usual Dose | |
| ANTICHOLINERGIC | ||||
| ipratropium bromide1 | — | Rx | 21mcg/ spray |
<6yrs: Not recommended. ≥6yrs: 2 sprays in each nostril 2−3 times daily. |
| — | 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 | — | Rx | 137mcg/ spray |
Seasonal allergic rhinitis: <5yrs: Not established. 5−11yrs: 1 spray per nostril twice daily. ≥12yrs: 1–2 sprays per nostril twice daily. Vasomotor rhinitis: <11yrs: Not established. ≥12yrs: 2 sprays per nostril twice daily. |
| Astepro Allergy1 | OTC | 205.5mcg/ spray |
Seasonal allergic rhinitis: <6yrs: Not recommended. 6–11yrs: 1 spray per nostril every 12hrs; max 2 sprays per nostril per 24hrs. ≥12yrs: 1–2 sprays per nostril every 12hrs or 2 sprays per nostril once daily. | |
| Children’s Astepro Allergy1 | ||||
| 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 | Dymista1 | Rx | 137mcg/ 50mcg per spray |
<6yrs: Not established. ≥6yrs: 1 spray per nostril twice daily. |
| olopatadine HCl + mometasone furoate | Ryaltris1 | Rx | 665mcg/ 25mcg per spray |
<12yrs: Not established. ≥12yrs: 2 sprays in each nostril twice daily. |
| MAST CELL STABILIZER | ||||
| cromolyn sodium | Nasalcrom1 | 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 AQ1 | 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. |
| 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 |
<12yrs: Not established. ≥12yrs: One actuation in each nostril once daily (37mcg/actuation); max 74mcg/day. | |
| flunisolide1 | — | 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; may increase to 2 sprays 3 times 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 propionate1 | — | 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 Relief1 | 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 furoate1 | — | 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. |
| Nasonex 24hr Allergy1 | OTC | 50mcg/ spray |
<2yrs: Not recommended. 2–11yrs: 1 spray in each nostril once daily. Use for the shortest duration possible. ≥12yrs: 2 sprays in each nostril once 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. |
| Nasacort Allergy 24hr1 | OTC | |||
| SYMPATHOMIMETIC | ||||
| oxymeta– zoline HCl |
Afrin No Drip Extra Moisturizing1 | OTC | 0.05% | <6yrs: Individualize. ≥6yrs: 2−3 sprays in each nostril not more than every 10−12hrs; max 2 doses/day for max 3 days. |
| Afrin No Drip Original1 | ||||
| Afrin No Drip Severe Congestion1,3,5 | ||||
| Afrin No Drip Allergy Sinus1 | ||||
| Afrin Original1 | ||||
| Dristan 12‑Hr 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. | |
| Mucinex Sinus-Max Severe Nasal Congestion Relief1,3,4,5 | 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 | ||||
| NOTES | ||||
|
1Contains benzalkonium chloride 2Alcohol-free 3Contains menthol 4Contains camphor 5Contains 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. 3/2024) |
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