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Dymista vs. Patanase: A Comparison of Allergic Rhinitis Nasal Sprays

Written by Andrew Le, MD

UpdatedMay 29, 2024

Dymista and Patanase are two nasal spray medications used to treat symptoms of allergic rhinitis, commonly known as hay fever. Dymista contains an antihistamine and a steroid, while Patanase contains only the antihistamine olopatadine.

This article compares key aspects of Dymista and Patanase, including their mechanisms of action, dosages, efficacy based on research studies, potential side effects, and costs for cash-paying customers. It provides a comprehensive analysis to inform treatment decisions regarding these nasal spray options for managing allergies.

🔑 Key Takeaways

  • Dymista is a combination nasal spray containing an antihistamine (azelastine) and a steroid (fluticasone), while Patanase contains only the antihistamine olopatadine.
  • Both Dymista and Patanase are administered as nasal sprays with age-specific dosage guidelines - Dymista requires one spray per nostril twice daily for those over 6 while shaking the bottle first, and Patanase ranges from one to two sprays per nostril twice daily depending on age, needing priming and shaking beforehand.
  • Studies show Dymista provides rapid, sustained relief of allergic rhinitis symptoms and improves quality of life. Patanase also effectively treats seasonal and perennial allergic rhinitis.
  • Potential side effects of both medications include headaches, nosebleeds, and altered sense of taste. Steroids like fluticasone can also impact growth in children.
  • For cash-paying customers, a 30.5-gram supply of Patanase costs around $314, while a 23-gram supply of Dymista costs about $230. Generic versions and discounts can reduce costs.
  • Cuverd is a prescription savings service that searches for discounts better than similar services.
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1. Mechanism of Action

Dymista and Patanase alleviate allergic rhinitis symptoms through different mechanisms of action. Understanding how these nasal sprays work provides insight into their clinical applications and safety profiles.


Dymista nasal spray comprises a combination of azelastine and fluticasone. Azelastine, classified as an antihistamine, plays a crucial role in diminishing the effects of histamine in the body. This addresses symptoms like:

On the other hand, fluticasone, categorized as a steroid, prevents the release of substances that lead to inflammation. Including both components provides Dymista with a dual mechanism of action, effectively alleviating allergic rhinitis symptoms caused by seasonal allergies.


Patanase nasal spray, in contrast, contains olopatadine, which acts as an antihistamine as its sole active ingredient. Olopatadine works to reduce the effects of histamine, specifically targeting symptoms such as:

  • Sneezing
  • Itching
  • Watery eyes
  • Runny nose

Unlike Dymista, Patanase does not include a steroid component in its formulation. The focus on antihistamine action makes Patanase a valuable option for managing nasal symptoms associated with seasonal allergies.

2. Dosage and Administration

Proper usage and dosage are imperative for Dymista and Patanase to reach optimal efficacy. Instructions vary based on the medication and the patient's age.


Dymista is administered as a nasal spray, and its usage should strictly adhere to the prescribed guidelines provided by a healthcare professional.

The recommended dosage for adults with allergic rhinitis involves applying one spray in each nostril twice daily.

Similarly, the dosage for children aged 6 years and older is one spray in each nostril twice daily. Users must follow the Instructions for Use provided with the medicine, ensuring proper administration.

The nasal spray bottle should be gently shaken before each use, and care must be taken to avoid contact with the eyes or mouth.

Dymista should be stored upright at room temperature, and the medication should be discarded after 120 sprays, even if some medicine remains in the bottle.


Patanase is also administered as a nasal spray, and the dosage instructions vary based on age.

For adults, the recommended dosage involves two sprays in each nostril twice a day. Pediatric dosages differ, with children aged 6 to 11 years advised to use one spray in each nostril twice a day, while those 12 years and older should use two sprays in each nostril twice a day.

Before the initial use, the nasal spray should be shaken well and primed with five sprays into the air, with an additional priming of two sprays if the medicine has not been used for more than seven days.

Proper administration involves inserting the spray tip into the nostril, pumping the spray, and inhaling gently. The nozzle should be cleaned, and the pump primed with at least two sprays if more than seven days have passed since the last use.

The medication should be stored at room temperature, away from moisture and heat, and the bottle should be discarded after 240 sprays.

3. Efficacy in Allergy Symptoms

Clinical studies show how well Dymista and Patanase relieve seasonal and perennial allergic rhinitis in real-world settings. The research explores symptom improvements and quality of life impacts.


One study indicates that Dymista (MP-AzeFlu) effectively relieves persistent allergic rhinitis (PER) symptoms in a real-world clinical setting in Sweden. The study indicates a rapid and sustained improvement in symptom severity, as assessed by the Visual Analogue Scale (VAS). The percentage of patients reporting well or partly-controlled symptoms reached 89.3% on Day 1, and there was a significant decrease in VAS scores from baseline to Day 42.

Additionally, the study suggests that Dymista not only provides symptom relief but is also associated with improved sleep quality, contributing to an overall improvement in the quality of life for patients. Combining azelastine hydrochloride and fluticasone propionate in a single device appears well-tolerated and effective in managing moderate to severe seasonal and perennial allergic rhinitis.

Another study on azelastine/fluticasone propionate (AZ/FP) nasal spray (Dymista) showed that it significantly improved nasal congestion in patients with seasonal allergic rhinitis. The spray was compared to a placebo and individual treatments with AZ or FP. AZ/FP was statistically better than placebo and monotherapy in reducing nasal symptoms.

These studies suggest that Dymista is a promising option for individuals dealing with persistent allergic rhinitis, offering both rapid symptom relief and improved overall quality of life.


Olopatadine nasal spray (Patanase) has effectively treated seasonal allergic rhinitis (SAR). With a rapid onset of action and efficacy comparable to intranasal steroid sprays, Patanase has received FDA approval for SAR in patients 6 years and older. Notably, it has improved the quality of life, work performance, and daily activities of individuals with SAR.

In the context of perennial allergic rhinitis (PAR), a randomized, placebo-controlled, double-masked, parallel-group study assessed the safety and efficacy of Olopatadine nasal spray over one year. The results revealed that Olopatadine was superior to placebo in relief, as indicated by the mean response to patient-rated relief across all visits.

Moreover, Olopatadine demonstrated a more than 50% increase in symptom-free days compared to the placebo group. The reported side effects, such as bloody nose and bad/bitter taste, were mild and transient, with no adverse cardiovascular effects observed, including no impact on QT interval (heartbeat component).

Collectively, these findings suggest that Olopatadine nasal spray, in the form of Patanase, is not only a rapid and effective solution for managing allergic rhinitis but also maintains its efficacy and safety profile over a prolonged treatment period, making it a promising option for individuals with both seasonal and perennial allergic rhinitis.

4. Side Effects

While effective, Dymista and Patanase also carry risks of side effects. Recognizing common, serious, and long-term reactions guide safe administration and determines when medical attention is warranted.


Dymista, like any medication, may cause side effects, and it is crucial to be aware of potential reactions.

Serious side effects that require immediate medical attention include:

  • Severe drowsiness
  • Severe or ongoing nosebleeds
  • Crusting around the nostrils
  • Redness, sores, or white patches in the mouth or throat
  • Blurred vision
  • Eye pain
  • Signs of low adrenal gland hormones

Common side effects may include:

  • Headaches
  • Nosebleeds
  • Altered sense of taste


If any side effects persist or worsen, it's essential to consult with a healthcare professional. It's noteworthy that steroid medications like fluticasone in Dymista can impact growth in children, and any concerns about growth should be discussed with a doctor.


Patanase, as an antihistamine nasal spray, also has potential side effects.

Immediate medical attention is warranted for signs of an allergic reaction, such as:

Other serious side effects include:

  • Nosebleeds
  • Painful sores inside the nose
  • Fever
  • Pain or burning during urination

Common side effects may encompass:

  • Runny or stuffy nose
  • Nosebleeds
  • Cough
  • Throat pain
  • Bitter taste in the mouth
  • Drowsiness
  • Headache
  • Fever
  • Rash
  • Painful urination

As with any medication, persistent or severe side effects should be promptly reported to a healthcare professional.

5. Cost

The out-of-pocket costs of prescription nasal sprays often influence treatment decisions. Comparing Dymista and Patanase prices for cash-paying patients provides helpful context.


Patanase nasal spray (665 mcg/inh) costs approximately $314 for a supply of 30.5 grams. However, it's essential to note that these prices are for cash-paying customers and may not be valid with insurance plans.

A generic version of Patanase is available, with prices starting from $101.30 for 30.5 grams. Additionally, various discount options, such as printable coupons, rebates, savings, or copay cards, help reduce the overall cost for individuals.


Dymista nasal spray (137 mcg-50 mcg/inh) is priced at around $230 for a supply of 23 grams. Like Patanase, these prices are for cash-paying customers and may not apply to insurance plans.

A generic version of Dymista is available, with prices starting from $66.33 for 23 grams. Dymista offers discounts, including printable coupons, rebates, savings, or copay cards.

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Dymista and Patanase are both effective nasal spray treatments for allergic rhinitis symptoms. Dymista offers dual antihistamine and anti-inflammatory action, while Patanase contains the antihistamine olopatadine. Research shows they provide rapid, sustained symptom relief.

Potential side effects are similar, but Dymista contains a steroid that may impact child growth. Patanase avoids steroids.

For cash-paying patients, Patanase costs more, at around $314 for 30.5 grams versus $230 for 23 grams of Dymista. With insurance and discounts, costs are reduced.

The choice depends on patient factors, but both represent solid prescription options for managing allergic rhinitis.

FAQs on Dymista and Patanase

How long does it take for Dymista and Patanase to work?

Both medications begin working within 15 minutes to 1 hour, with maximum benefit achieved after several days of regular use.

Can Dymista and Patanase be used together?

No, Dymista and Patanase should not be used together since they contain medications to reduce allergy symptoms, and no evidence shows added benefit.

Should the nasal applicator be cleaned after using Dymista or Patanase?

Yes, cleaning the applicator as directed is essential to prevent clogging. Avoid touching tip before or after use to limit contamination.

Are Dymista and Patanase nasal sprays safe for use during pregnancy?

No, these nasal sprays have not been adequately studied for safety in pregnancy and should only be used if needed and under medical supervision. Discuss with your doctor.

Illustration of a healthcare provider asking questions on a smart phone.
Allergy treatment - Online visit
Get virtual care from a licensed clinician—no appointment needed
Illustration of a healthcare provider asking questions on a smart phone.
  • $29 one-time assessment
  • No video call or appointment necessary
  • Personalized treatment plan prescribed for your condition