Fluticasone vs Mometasone Nasal Spray for Sinusitis: Which Is Used and Why
Two similar steroid sprays, one important naming confusion, and what Access Doctor actually supplies for sinus symptoms.
Part of our Sinusitis condition guide.
The headline: For sinusitis, Access Doctor supplies mometasone and beclometasone nasal sprays. We don't supply fluticasone for sinusitis. That's a formulary choice, not a verdict—the two drugs perform similarly, and this page explains where each fits.
Steroid Nasal Spray for Sinusitis
Where sinus symptoms have persisted past 10 days, a GPhC-registered pharmacist independent prescriber can assess you online and decide whether a steroid nasal spray is appropriate.
View Sinusitis Treatments →The short answer
Fluticasone and mometasone are both modern intranasal corticosteroids. Both work by reducing inflammation in the lining of the nose and sinuses, both are taken once daily, and both have very low systemic absorption.
Head-to-head, there's no convincing evidence that either is meaningfully more effective. The choice in practice comes down to what's licensed, what's stocked and what suits the individual—not potency.
| If you want to know | The answer |
|---|---|
| Which is stronger? | Not a useful question—both suppress nasal inflammation effectively at their licensed doses |
| Which does Access Doctor supply for sinusitis? | Mometasone and beclometasone |
| Which is more commonly used for hay fever? | Both, widely. Fluticasone furoate is common in that setting |
| Which has lower systemic absorption? | Both are very low. Mometasone is often cited as the lowest |
| Can I swap one for the other myself? | No—different products, doses and licensed indications |
The naming confusion worth clearing up
Fluticasone comes in two forms that are frequently mistaken for one another.
Fluticasone propionate
The older form. Found in some pharmacy-strength hay fever sprays and in prescription products. Usually a different dose and device.
Fluticasone furoate
The newer form, best known as Avamys. Different strength, different device, different licensed dosing.
They aren't interchangeable, and the numbers on the boxes don't compare directly. If a prescription says one and you're handed the other, query it.
Mometasone has a parallel trap of its own. Mometasone nasal spray and mometasone cream are entirely different products. The cream, sold as Elocon, is a skin steroid for eczema and other skin conditions. It must never go anywhere near your nose, and the nasal spray must never be used on skin.
Check the box, not the drug name. The same active ingredient appears in nasal sprays, inhalers, creams and eye preparations at completely different strengths. Matching the drug name isn't the same as matching the product.
Side-by-side comparison
| Fluticasone | Mometasone | Beclometasone | |
|---|---|---|---|
| Class | Intranasal corticosteroid | Intranasal corticosteroid | Intranasal corticosteroid |
| Frequency | Once daily | Once daily | Twice daily |
| Systemic absorption | Very low | Very low | Low, but higher than the other two |
| Taste | Generally minimal | Generally minimal | Some people notice it |
| Track record | Long | Long | Longest of the three |
| Supplied by Access Doctor for sinusitis | No | Yes | Yes |
For a fuller treatment of the mometasone and beclometasone choice specifically—which is the decision you'll actually face if you're being treated for sinusitis with us—see our guide on the best nasal spray for sinusitis.
What a steroid spray does in sinusitis
Worth being clear about, because it explains why it's not an alternative to an antibiotic.
Your sinuses drain through openings a few millimetres across. When the lining swells, those openings close. Mucus is then trapped in a sealed cavity, pressure builds, and the trapped mucus is where bacteria multiply.
A steroid nasal spray reduces that swelling and reopens the drainage channels. It treats the mechanical problem—blockage—rather than killing bacteria.
This is why a spray helps a great many cases that an antibiotic wouldn't. Most persistent sinusitis is a drainage problem, not an infection needing eradicating. Our guide on steroid spray vs antibiotics covers which situation is which.
Why we supply mometasone, not fluticasone
An honest answer: it's a formulary decision, not a clinical ranking.
- Mometasone has among the lowest systemic absorption of the intranasal steroids, which is reassuring for the several-week courses sinusitis sometimes needs
- Once-daily dosing supports adherence, and adherence is what determines whether these sprays work
- Beclometasone covers the alternative case—a twice-daily option with the longest track record, useful where mometasone doesn't suit
- A shorter formulary is safer. Two well-understood options that our prescribers use routinely produce fewer errors than five near-identical products
Fluticasone is a good drug. If your GP has prescribed it for you and it's working, there's no reason to change. This page isn't an argument against it.
If you're here about hay fever
This page is about sinusitis specifically. Steroid nasal sprays are used far more widely for allergic rhinitis, and that's a different clinical situation with different treatment lengths and expectations.
Our allergic rhinitis guides cover fluticasone furoate and hay fever treatment in detail, including seasonal timing and how sprays combine with antihistamines. Start there rather than applying sinusitis advice to a hay fever problem.
The two do overlap in one important way. Untreated allergic rhinitis keeps the nasal lining inflamed, which narrows the sinus drainage channels and predisposes to sinusitis. If you get recurrent sinus infections and also have hay fever, controlling the allergy is often what breaks the cycle.
Over-the-counter sprays and why they differ
Some steroid nasal sprays are available from a pharmacy without a prescription. They're licensed for hay fever and allergic rhinitis—not for sinusitis.
This is why sinusitis use is off-label. No steroid nasal spray is licensed in the UK specifically for acute sinusitis, so whichever one you're given—mometasone, beclometasone or fluticasone—using it for a sinus infection sits outside the product licence. NICE recommends it anyway and marks it as off-label in the guideline. That's normal and well evidenced, but you should be told, which is what this note is for.
Brand names are worth knowing, since they're what most people search for. Nasonex is mometasone. Beconase is beclometasone. Avamys is fluticasone furoate and Flixonase is fluticasone propionate. Generic versions contain the same active ingredients at the same strengths.
That distinction isn't bureaucratic. It matters because:
- The licensed course length and expected response differ between the two conditions
- Sinusitis has red flags that need ruling out, and a pharmacy counter purchase doesn't do that
- Using a spray while a genuine bacterial infection goes untreated delays the treatment you need
- Some over-the-counter sprays have age restrictions or maximum durations of use
If your symptoms are sinusitis rather than hay fever, speak to a pharmacist or complete a consultation rather than repurposing whatever's in the cupboard from last summer.
Don't confuse a steroid nasal spray with a decongestant spray. Decongestant sprays containing xylometazoline or oxymetazoline work within minutes but must not be used for more than about a week—longer use causes rebound congestion that's worse than the original problem. Steroid sprays work slowly and are safe for longer courses. They aren't substitutes for one another.
Technique—the part that decides whether it works
More people fail on technique than on drug choice. It takes thirty seconds to get right.
1
Blow your nose gently first
The spray needs to reach the lining, not sit on mucus.
2
Shake, and prime if needed
Prime a new bottle, or one unused for a while, until a fine mist appears.
3
Tilt your head slightly forward
Not back. Tipping your head back sends the spray straight down your throat, which is why people complain of taste.
4
Use the opposite hand and aim outwards
Right hand for the left nostril, left hand for the right. This naturally angles the nozzle away from the septum and towards the ear on that side. This single step prevents most nosebleeds.
5
Breathe in gently, and don't sniff hard
A hard sniff pulls the spray past the nasal lining and into your throat, where it does nothing.
6
Repeat on the other side, and don't blow your nose after
Give it time to be absorbed.
How long before it works
2–3 days
before any noticeable change
1–2 wks
for the full effect
Daily
use is what makes it work
This is the most common reason people think a steroid spray has failed. They expect a decongestant-like response within minutes, get nothing, and stop by day three.
Use it every day whether or not you feel blocked. It works by suppressing inflammation over time, and it can't do that intermittently.
Side effects and safety
Modern intranasal steroids deliver a small dose to the nasal lining, and very little reaches the bloodstream. The concerns associated with steroid tablets don't apply to normal use of these sprays.
| Effect | How common | What to do |
|---|---|---|
| Nasal dryness or irritation | Common | Usually settles. A saline spray beforehand can help |
| Sneezing just after the spray | Common | Normal. It doesn't mean the dose was lost |
| Nosebleeds | Occasional | Almost always technique—check your aim |
| Unpleasant taste | Occasional | Usually means the head is tipped back or the sniff is too hard |
| Headache | Uncommon | Mention it if persistent |
Tell the prescriber if you've recently had nasal surgery, an injury to the nose, an untreated nasal infection, glaucoma or cataracts, or if you already use a steroid inhaler, cream or tablets—the total steroid load is worth considering even when each individual dose is small.
Get a Steroid Nasal Spray Assessed
For adults 18 and over with sinus symptoms past 10 days. A GPhC-registered pharmacist independent prescriber reviews your consultation and decides whether mometasone, beclometasone, an antibiotic or none of these is appropriate.
Start Sinusitis Consultation →If it's not helping
Before concluding the drug is wrong, work through these in order:
- Have you used it every day for at least two weeks? Most apparent failures are early stopping.
- Is your technique right? Aiming at the septum, tipping the head back and sniffing hard all waste the dose.
- Is the nose too blocked for the spray to reach anything? A saline rinse first can make the difference.
- Is the problem actually bacterial? If symptoms are worsening rather than static, that changes the answer.
- Is the diagnosis right? Migraine, dental pain and allergic rhinitis all mimic sinusitis—see sinus headache vs migraine.
- Is there something structural? Nasal polyps or a deviated septum may need ENT assessment. See sinusitis that will not go away.
Seek urgent assessment for swelling or redness around an eye, a bulging eye, vision changes, a severe headache unlike your usual ones, neck stiffness or confusion. These are uncommon complications but need immediate attention regardless of what treatment you're on.
Frequently Asked Questions
Is fluticasone or mometasone better for sinusitis?
Neither is clearly better. Both are modern steroid nasal sprays with very low systemic absorption, both are taken once daily, and head-to-head studies do not show a meaningful difference in how well they reduce nasal inflammation. The practical difference for sinusitis in the UK is availability rather than potency, since mometasone is the more commonly supplied option for sinus symptoms.
Which steroid nasal spray does Access Doctor supply for sinusitis?
We supply mometasone and beclometasone nasal sprays for sinusitis in adults. We do not supply fluticasone for sinusitis. That is a formulary decision rather than a judgement that fluticasone is inferior. Mometasone is once daily with very low systemic absorption, and beclometasone offers a twice-daily alternative with a long track record, which covers the range of situations we see.
Are fluticasone propionate and fluticasone furoate the same thing?
No, and the distinction causes real confusion. They are two different salts of fluticasone with different strengths, different devices and different licensed uses. Fluticasone propionate is the older form and is available in some pharmacy-strength sprays for hay fever. Fluticasone furoate is the newer form found in Avamys. They are not interchangeable and the doses are not comparable.
Can I use a hay fever nasal spray for sinusitis?
Not without advice. Steroid nasal sprays sold over the counter are licensed for hay fever and allergic rhinitis, not for sinusitis, and the licensed indication matters because the treatment course and expected response are different. Using a hay fever spray for a sinus infection also risks leaving a genuine bacterial infection untreated. Speak to a pharmacist or complete a consultation rather than repurposing what is in the cupboard.
How long does a steroid nasal spray take to work for sinusitis?
Longer than most people expect. Some improvement may be noticeable within a few days, but the full effect usually takes one to two weeks of consistent daily use. This is the single most common reason people conclude a spray has not worked, when in reality it was stopped too early. Use it every day as directed rather than only on bad days.
Do steroid nasal sprays have the same side effects as steroid tablets?
No. Modern steroid nasal sprays deliver a small dose directly to the nasal lining, and very little enters the bloodstream. The side effects people worry about with steroid tablets, such as weight gain and bone thinning, are not associated with normal use of these sprays. The usual side effects are local: nasal dryness, irritation, sneezing after the spray and occasional nosebleeds.
Why do I get nosebleeds from my nasal spray?
Almost always technique. Most people aim the nozzle straight up or towards the middle of the nose, which directs the spray at the septum, the thin partition between the nostrils. That area bleeds easily. Aim outwards, towards the ear on the same side, using the opposite hand for each nostril. If nosebleeds continue after correcting technique, stop and seek advice.
Can I use a steroid nasal spray alongside antibiotics?
Yes, and they are sometimes prescribed together, because they address different problems. An antibiotic targets a bacterial infection while a steroid spray reduces the swelling blocking the sinus drainage channels. There is no interaction between them. Whether you need one, both or neither is a decision for the prescriber assessing your symptoms.
Completing the treatment
For sinusitis, Access Doctor supplies mometasone nasal spray for sinusitis and beclometasone nasal spray for sinusitis. Where a bacterial infection is genuinely likely, phenoxymethylpenicillin or doxycycline may be more appropriate, and the two are sometimes used together. All are prescription-only and follow an online consultation reviewed by a GPhC-registered pharmacist independent prescriber.
Steroid spray · Rx
Mometasone Nasal Spray for Sinusitis
Once daily, very low systemic absorption.
View product →Steroid spray · Rx
Beclometasone Nasal Spray for Sinusitis
Twice daily, with the longest track record.
View product →Antibiotic · Rx
Phenoxymethylpenicillin for Sinusitis
Where a bacterial sinus infection is genuinely likely.
View product →Antibiotic · Rx
Doxycycline Capsules for Sinusitis
Alternative where penicillin cannot be used.
View product →References
- National Institute for Health and Care Excellence. Sinusitis (acute): antimicrobial prescribing (NG79). nice.org.uk
- NICE Clinical Knowledge Summaries. Sinusitis. cks.nice.org.uk
- Joint Formulary Committee. British National Formulary: Mometasone furoate. bnf.nice.org.uk
- Joint Formulary Committee. British National Formulary: Fluticasone furoate. bnf.nice.org.uk
- Joint Formulary Committee. British National Formulary: Beclometasone dipropionate. bnf.nice.org.uk
- NHS. Steroid nasal sprays. nhs.uk
- NHS. Sinusitis (sinus infection). nhs.uk
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999.