One Rx bottle combines the fast antihistamine with the daily-control steroid.
BP ByBestAllergyNasalSprays Editorial Team — Clinical Pharmacy, Editorial Pool BI Reviewed byBestAllergyNasalSprays Editorial Team — Adult Allergy & Immunology, Editorial Pool
Content updated
Evidence reviewed
First published
Literature review current through
Dymista is an FDA-approved fixed-dose combination nasal spray containing azelastine HCl 137 mcg and fluticasone propionate 50 mcg per spray, indicated for seasonal allergic rhinitis in patients 6 and olderExpertIn a Phase III RCT (Carr 2012), the azelastine + fluticasone combination spray (MP29-02 / Dymista) produced significantly greater nasal-symptom relief than either agent alone or placebo in patients with moderate-to-severe seasonal allergic rhinitisExpertCombining azelastine and fluticasone propionate (whether co-administered or as the co-formulated product Dymista / MP29-02) produces greater allergic-rhinitis symptom relief than either agent alone, demonstrated in three Phase III RCTs in moderate-to-severe seasonal allergic rhinitis (n=3,398)ExpertIn a 1-year randomized open-label safety study of Dymista (MP29-02) in 612 patients with chronic rhinitis (Berger 2014), treatment-related adverse events were low (9.4%) and comparable to fluticasone propionate alone, with no septal perforations and no clinically meaningful cortisol changes — supporting sustained daily useExpertDymista’s cash price typically ranges from about $50 to $260 per month depending on the pharmacy, and is often substantially lower with insurance coverage or a GoodRx couponExpert
Context & alternatives
For eligible patients 13+ with multi-symptom, year-round, or failed-OTC rhinitis, Allermi is our #1 overall pick: a compounded telehealth Rx that goes beyond Dymista’s 2-active formula, adding ipratropium (for drip and runny nose) and micro-dosed oxymetazoline (for congestion, paired with a steroid to blunt rebound). Allergist-designed, telehealth Rx, ~$45/month. Not sure if you qualify? Check eligibility in 60 seconds.
Dymista is the FDA-approved fixed-dose combo of the two OTC components: Flonase and Astepro. If insurance covers Dymista and you prefer an FDA-approved fixed-dose product, it’s a clean single-bottle option; if not, stacking OTC Flonase + Astepro is pharmacologically equivalent (see the Flonase vs Astepro discussion).
Best fit for Dymista: moderate-severe AR with congestion as a dominant symptom in patients age 6+ (Dymista’s FDA-approved floor) who want an FDA-approved fixed-dose Rx product specifically.
