These ENT-Recommended OTC Nasal Sprays Can Curb Chronic and Seasonal Allergies (2024)

Allergies — and all the sneezing, runny noses, and itchy eyes that follow — can turn any beautiful day into an uncomfortable ordeal. Nasal sprays can provide direct allergy relief by decreasing inflammation, opening your nasal passages, and soothing bothersome symptoms like runny and stuffy noses or sneezing. Some accomplish this via natural ingredients—like saline—while others rely on synthetic versions of compounds that our bodies make, such as steroids.

But with countless options on the market, how do you choose the best nasal spray for your allergies? The good news is that most over-the-counter nasal sprays are safe and effective. According to allergist Dr. Allen J. Dozor, any differences between brands are minor and more related to how well the person tolerates the ingredients. Narrowing down your options requires working with your doctor to find the right combination to treat your specific allergies.

We've combed through the top-rated products on the market to find the seven best nasal sprays for allergies based on their effectiveness, safety, and ease of use. An ophthalmologist from our Medical Expert Board also reviewed this article for medical and scientific accuracy.

According to pharmacist Dr. Jennifer Bourgeois, there are several types of nasal sprays, each with a specific purpose and mechanism of action.

• Steroid nasal sprays: These sprays use intranasal corticosteroids like Fluticasone, budesonide, and mometasone to reduce inflammation. Examples include Flonase, Rhinocort, and Nasonex.
• Decongestant nasal sprays: These sprays contain active ingredients like oxymetazoline and phenylephrine that constrict blood vessels in the nasal passages, which can reduce swelling and congestion. Examples include Afrin and Neo-synephrine.
• Antihistamine nasal sprays: These sprays use ingredients like azelastine and olopatadine to reduce inflammation by blocking the effects of histamine. Examples include Astelin and Patanase.
• Saline sprays: These sprays use a saltwater solution to moisten nasal passages, thin mucus, and remove irritants. Examples include Simply Saline, Ayr, and Xlear.

What to Know Before You Shop

• What to Know About Nasal Sprays for Allergies
• How to Choose The Right Nasal Spray for Your Needs
• Ingredients to Look for in Nasal Sprays
• Ingredients to Avoid

• Best Overall: Flonase Allergy Relief Nasal Spray
• Best Budget: Amazon Basic Care Maximum Strength 12 Hour Nasal Spray
• Best Non-Steroid Spray: NasalCrom Nasal Spray
• Best for Runny Nose: Astepro Nasal Spray
• Best for Itchy Nose: Amazon Basic Care Premium Saline Nasal Moisturizing Spray
• Best for Congestion: Mucinex Sinus-Max Nasal Spray
• Best for Quick Relief: Afrin No Drip Severe Congestion Maximum Strength Nasal Spray

Why We Like It

Steroid nasal sprays are like the MVPs of allergy relief—and Flonase is the best of the best. It's 24-hour relief, non-drowsy, and addresses multiple allergic symptoms, including nasal congestion, sneezing, and itchy, watery eyes while being gentle enough on your nose for daily use. Which is great, considering that's what it takes to reap the full benefits of this spray.

You’ll get the most benefit from a nasal spray like this one by using it consistently, at least through your allergy season, says Dr. Dozer. She adds that adherence to consistent therapy is critical. According to Dr. Dozer, steroid sprays don't work right away, and some people find their nose temporarily feels more stuffy when they first start these sprays. Flonase is generally a bit pricier than other options. While some (slightly) lower-cost dupes are on the market, not many can match the all-day relief.

Product Details:

• Type of Spray: Steroid
• Active Ingredients: Fluticasone propionate
• Dosage: 144 sprays per day
• Duration of Action: 24 hours

Why We Like It

Amazon Basic Care Maximum Strength 12 Hour Nasal Spray is a highly-rated nasal spray is an Afrin dupe that temporarily relieves congestion from allergies and common colds. It's great to keep in your medicine cabinet for those unexpected stuffy nose days, and like most decongestants, the biggest perk of this spray is how quickly it works. Plus, you can't beat the price. Remember, however, that decongestants like this one from Amazon are not for daily use. If you have chronic allergies that last all season or all year, work with your doctor to find a more consistent remedy.

Product Details:

• Type of Spray: Decongestant
• Active Ingredients: Oxymetazoline
• Dosage: Unclear
• Duration of Action: 12 hours

Why We Like It

We love this nasal spray because it helps to block allergy symptoms before they begin and is steroid-free. Some allergy sufferers can't take steroids due to allergies, wounds that are healing, or because they are pregnant or trying to conceive. Luckily, there's a nasal spray alternative that's just as effective: NasalCrom. Unlike steroids, decongestants, antihistamines, and saline sprays, this brand is a mast cell inhibitor spray. It uses cromolyn sodium to not only relieve allergy symptoms like sneezing and runny, stuffy, or itchy noses—but also prevent them from happening in the first place.

Like Flonase, it's best used daily, especially if you have allergic rhinitis. But daily use is tolerable, as it's non-drowsy, doesn't give you the jitters, and is safe for kids as young as 2.

It’s Worth Noting

Nothing on the label mentions how long relief lasts, but the directions advise using it up to 3 to 4 times a day.

Product Details:

• Type of Spray: Mast cell inhibitor
• Active Ingredients: Cromolyn sodium
• Dosage: 200 sprays
• Duration of Action: Unclear

Why We Like It

Nothing is more annoying than a nose that won't stop running. While most antihistamines are targeted for sneezing and itching, Astepro has your back if the primary symptom of your allergies is a nose that leaks like a faucet. It gets to work in 30 minutes and lasts 24 hours—what's not to love? People with sensitive noses may have even more to love. Astepro's formula is free of steroids, fragrances, and alcohol, making it safe enough for kids as young as 6.

Do keep in mind that Astepro is not non-drowsy. So, if you take it, be careful while driving and avoid alcoholic drinks, sedatives, and anything else that could increase drowsiness.

Product Details:

• Type of Spray: Antihistamine
• Active Ingredients: Azelastine
• Dosage: 200 sprays
• Duration of Action: 24 hours

Why We Like It

An itchy nose is often a dry nose. And nothing will calm your irritated nasal passages quite like a shot of saline spray. While most of the saline nasal sprays you'll find at the drugstore are made using the same formula, we like Amazon's Basic Care brand for its unbeatable price and versatility. You can use it upright as a spray, hold it horizontally for a stream, or tip it upside down for drop. Its gentle formula should help re-moisturize your nose and soothe the itch. Whatever the situation calls for, this bottle has got you covered.

While this will relieve itchy symptoms in the moment, this spray isn’t a treatment on its own. Consult with your doctor on a medicated nasal spray that’s targeted to your specific allergies.

Product Details:

• Type of Spray: Saline
• Active Ingredients: Sodium chloride
• Dosage: Unclear
• Duration of Action: Unclear

Why We Like It

When you're so stuffed up that you forgot what it was like to smell, there is only one scent that will break through that tough mucus barrier: menthol. Mucinex's combination of decongestant oxymetazoline with menthol makes it the best nasal spray for severe congestion as well as sinus congestion and sinus pressure. It works fast and will last at least half the day, and it's priced so affordably that you can keep a bottle in your bag, at home, and in the office without breaking the bank.

Because Mucinex is a decongestant containing oxymetazoline, don't use it longer than three days or risk developing rhinitis medicamentosa, also known as rebound congestion.

Product Details:

• Type of Spray: Decongestant
• Active Ingredients: Oxymetazoline
• Dosage: Unclear
• Duration of Action: 12 hours

Why We Like It

There's a reason Afrin has been a household name for years—this stuff works, and it works fast. Its active ingredient, oxymetazoline, constricts the blood vessels in your nose to alleviate swelling and congestion quickly. It also has that soothing, cooling menthol in the mix and a special no-drip formula that won't leave you with an unpleasant aftertaste or feeling of liquid dripping down the back of your throat.

Like many others on this list, Afrin is a decongestant, so don’t use it for longer than three days. Also, because it’s targeted for temporary relief, you have to spray more often than other formulas.

Product Details:

• Type of Spray: Decongestant
• Active Ingredients: Oxymetazoline
• Dosage: Unclear
• Duration of Action: 12 hours

To find the best nasal spray for allergies, we consulted with allergists and pharmacists and combed through customer reviews to find the most effective products. We considered factors such as type of spray, active ingredients, dosage and duration of action, safety profile, use longevity, and side effects to provide a comprehensive review of each product.

• Type of spray: We included a mix of nasal spray types that provided immediate relief and served as long-term preventive solutions.
• Active ingredients: We looked for products with active ingredients proven to combat common allergy symptoms such as runny nose, congestion, and itching.
• Dosage: We only included products that offered the right dosage amount for the value.
• Duration of action: We included products that provided long-lasting relief without the need for frequent reapplication.

Our Experts

• Dr. Allen J. Dozor, professor of pediatrics and division chief of Pulmonology, Allergy, and Sleep Medicine at New York Medical College
• Dr. Jennifer Bourgeois, Pharm.D at SingleCare

• Side Effects and Interactions: While nasal sprays are generally considered safe, Dr. Dozer warns that they can still cause side effects such as burning, stinging, dryness, crusting of the nose, bleeding, and headaches. It's important to consult with a doctor if you have any other medical conditions or are taking other medications, especially other steroids.
• Safety: Under health care guidance, Dr. Bourgeois says using most nasal sprays daily, except for decongestants is generally safe. Those should only be used for three. However, over-the-counter nasal sprays are not intended for long-term use. So if your symptoms persist after a couple of weeks, contact your doctor. Some nasal sprays can be combined in certain situations, but that should only be done under the direction and supervision of a doctor.
• Dosage: Follow the recommended dosage instructions and do not exceed the recommended amount. Overusing nasal sprays can cause a rebound effect, worsening your symptoms in the long run.
• Duration of Action: Be aware of how long the spray is effective for. Some may only provide relief for a few hours, while others can last up to 24 hours.

Choosing the Right Nasal Spray for Your Needs

When it comes to finding the best nasal spray for allergies, Dr. Dozer and Dr. Bourgeois say several factors should be considered.

• Types of symptoms: If you experience nasal congestion, a saline or decongestant spray can provide relief. Don’t use a decongestant for over three days, as prolonged use can cause rebound congestion. If you’re sneezing or have an itchy nose, an antihistamine spray can reduce those symptoms. Steroid nasal sprays can help with nasal congestion, sneezing, and itching, but only if you use them consistently.
• Types of allergies: Nasal sprays can help with seasonal allergies to things like pollen, grass, or ragweed, perennial allergies to dust mites or pet dander, and non-allergic rhinitis. Patients with allergic rhinitis sometimes can’t tolerate nasal sprays, have unacceptable side effects, or do not find them effective.
• Medical conditions: You should always consult your doctor before using a nasal spray. People with glaucoma, who have recently undergone nasal surgery, and who are pregnant or breastfeeding should seek guidance from their healthcare provider.
• Potential interactions: While nasal sprays are generally safe to use, it’s important to consult your doctor before starting one, as they can interact with certain medications.

According to Dr. Bourgeois, the following ingredients are effective in treating different allergy symptoms:

• Fluticasone, budesonide and mometasone: These are the most popular intranasal corticosteroids found in nasal sprays. They work by reducing inflammation and mucus production and are effective in treating congestion, sneezing, and itching.
• Azelastine and olopatadine: Found in common antihistamine sprays, these ingredients block histamine receptors and effectively reduce symptoms such as runny nose, sneezing, and itching.
• Oxymetazoline: A decongestant found in Afrin No Drip Severe Congestion Nasal Spray that works by constricting blood vessels to provide quick relief for nasal congestion.
• Sodium chloride: Commonly found in saline nasal sprays, this ingredient moisturizes and flushes out irritants from the nose to provide relief for dryness and itching.

Ingredients to Avoid

While it's rare for someone to need to avoid a nasal spray, Dr. Dozer said that anyone who is already prescribed oral steroids should avoid any nasal sprays with steroids. Additionally, if steroid nasal sprays cause you so much irritation and drying that bleeding from the nose occurs, stop using it until further consultation with a doctor.

Shannon is a writer who focuses on health and wellness. She is a former editor for Healthline and Medical News Today, but now focuses on writing health and wellness content for brands like VeryWellFit, VeryWellHealth, Insider, and more.