Medical Forum / Diseases and Disorders / Sinusitis / February 2007
flonase vs. nasonex
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MZB - 27 Jan 2007 20:32 GMT Any opinions??
Mel
Carole Scaggs - 27 Jan 2007 23:03 GMT I've used them both and find them equally effective. Flonase is out in a generic form now so if cost/insurance is an issue...
CS
> Any opinions?? > > Mel judy.n - 28 Jan 2007 15:27 GMT Both have preservatives and alcohol in them: brand name flonase had "masking perfume": nasonex is now scent free. Hypothetically nasonex is less bioavailable as a steroid. I used to use flonase, and liked it, but my allergist prefers rhinocort AQ because it has no benzylchonium chloride/scent/alcohol. The generic option is really nice for co-pays. Judy
> I've used them both and find them equally effective. Flonase is out in a > generic form now so if cost/insurance is an issue... [quoted text clipped - 4 lines] > > > Mel Murray Grossan - 28 Jan 2007 19:40 GMT On 1/28/07 7:27 AM, in article 1169998070.808300.10310@q2g2000cwa.googlegroups.com, "judy.n"
> Both have preservatives and alcohol in them: brand name flonase had > "masking perfume": nasonex is now scent free. Hypothetically nasonex [quoted text clipped - 12 lines] >> >>> Mel I have been favoring Rhinocort AQ but I am not sure that I see a significant difference. I don't see patients, "oh since I used Rhinonocort AQ I feel wonderful" Its not like when persons using benzalkonium saline switch to saline that is free of bzk. Then they ho longer get the burning, etc.
Steven L. - 29 Jan 2007 02:51 GMT > I have been favoring Rhinocort AQ but I am not sure that I see a significant > difference. I don't see patients, "oh since I used Rhinonocort AQ I feel > wonderful" It seems to be very idiosyncratic; on this newsgroup over the years, we've had patients swear by one steroid spray and claim that others bother them, but other patients had other preferences.
It might be due to extreme sensitivity to inert ingredients on the part of a few people. Or maybe it's just the placebo effect of brand loyalty, like when Madison Avenue discovered that consumers' evaluation of the performance of their detergent depends on the color of the package the detergent comes in; the exact same detergent in a blue package is rated as "more effective" than in some other colored package.
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Murray Grossan - 29 Jan 2007 16:25 GMT On 1/28/07 6:51 PM, in article Didvh.16330$yx6.3336@newsread2.news.pas.earthlink.net, "Steven L." <sdlitvin@earthlinkNOSPAM.net> wrote:
>> I have been favoring Rhinocort AQ but I am not sure that I see a significant >> difference. I don't see patients, "oh since I used Rhinonocort AQ I feel [quoted text clipped - 10 lines] > package the detergent comes in; the exact same detergent in a blue > package is rated as "more effective" than in some other colored package. This is true, except that in my practice we try very hard NOT to influence the patient via suggestion - This Brand Will Make YOU WELL! Not that we are altruistic or noble, its just that we ourselves want to find out if the damn thing works. How's this for trying not to influence the patient's response? : The FDA says this stuff is no good, but my wife says it works. Do you want the shot?
Steven L. - 31 Jan 2007 03:40 GMT > On 1/28/07 6:51 PM, in article > Didvh.16330$yx6.3336@newsread2.news.pas.earthlink.net, "Steven L." [quoted text clipped - 16 lines] > This is true, except that in my practice we try very hard NOT to influence > the patient via suggestion - This Brand Will Make YOU WELL! You're may not be doing it via suggestion, but the pharma companies are doing it with their websites and packaging. Take a look at some of the imagery they use.
Levitra.com uses a stylized flame and a macho looking guy standing there with his arms folded like Mr. Clean, for obvious reasons.
Before Diflucan went generic, Diflucan.com and its packaging had a pink motif, with pictures of women and lots of feminine-looking script and swirls. Diflucan is often prescribed for difficult vaginal candidiasis and the manufacturer was trying to make it look like a "woman thing." Would women believe the medication could help them if the imagery was more macho, with pictures of fighter jet planes and guys in macho occupations like cops and soldiers?
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Murray Grossan - 28 Jan 2007 19:41 GMT On 1/28/07 7:27 AM, in article 1169998070.808300.10310@q2g2000cwa.googlegroups.com, "judy.n"
> Both have preservatives and alcohol in them: brand name flonase had > "masking perfume": nasonex is now scent free. Hypothetically nasonex [quoted text clipped - 12 lines] >> >>> Mel Where is best place to purchase generic Flonase. I haven't seen a big price difference in California.
judy.n - 28 Jan 2007 22:42 GMT I think the generic price is still high--it didn't come up in the ePocrates database, but for patients with insurance, the copay will be dramatically lower for the generic version vs. all the brand names.
I thought of you yesterday: I went with my husband to the Yankee Dental conference in Boston, and a rep tried to sell him a 3-D CT scanner for the office. He showed us the fine cuts and the the ability to manipulate the image. Now, it's not cost-effective for a dentist with a small office, and the entire state of RI doesn't have a 3-D CT scanner--even in the university affiliated hospitals, but watching the images, I could see how you would get great results using it on your patients vs. a traditional sinus CT.
I personally had to go to Mass Eye and Ear to get a 3-D sinus CT, and they charged my insurance many thousands of dollars for it, this was back in 2000.
Personally, badk to nasal steroids, I prescribe the generic flonase a lot due to the low copay--even though I personally use the rhinocort. When I used flonase, I thought it was more effective than the rhinocort, but my physician wanted to avoid the bz. Judy
> On 1/28/07 7:27 AM, in article > 1169998070.808300.10...@q2g2000cwa.googlegroups.com, "judy.n" [quoted text clipped - 16 lines] > >>> MelWhere is best place to purchase generic Flonase. I haven't seen a big price > difference in California. Murray Grossan - 29 Jan 2007 16:17 GMT On 1/28/07 2:42 PM, in article 1170024159.690843.251830@a75g2000cwd.googlegroups.com, "judy.n"
> Now, it's not cost-effective for a dentist > with a small office, and the entire state of RI doesn't have a 3-D CT > scanner--even in the university affiliated hospitals, but watching the > images, I could see how you would get great results using it on your > patients vs. a traditional sinus CT. I think the CT digital scanner is fabulous. My dentist has it and the savings in time and the ease of showing the patient his pathology instantly is an advantage. Having the CT scanner for sinuses in the office - digital - not only saves the patients an extra two visits but also allows for much better Rx at the initial visit.
Terry Raymond - 30 Jan 2007 00:13 GMT > On 1/28/07 2:42 PM, in article > 1170024159.690843.251830@a75g2000cwd.googlegroups.com, "judy.n" [quoted text clipped - 11 lines] > saves the patients an extra two visits but also allows for much better > Rx at the initial visit. I asked my local ENT about the scanner, aside from not having enough demand for getting one, he also mentioned that he would be limited in how much he could charge for it use due to a combination of state and insurance regulations that encourge images to be examined by a radiologist.
 Signature Terry =========================================================== Terry Raymond Crafted Smalltalk 80 Lazywood Ln. Tiverton, RI 02878 (401) 624-4517 traymond at craftedsmalltalk nospam dot com <http://www.craftedsmalltalk.com> ===========================================================
judy.n - 30 Jan 2007 15:45 GMT Terry, I'm in RI also, and no one here--including the Miriam or RI Hospital has a 3-D scanner. The machine was impressive. Dentists use digital radiographs that aren't CT's-and they can manipulate those images. This year medicare has lowered reimbursement for CT's and increased reimbursement for visits, so the CT scanner is hard to afford unless you do lots of scans and can get reimbursed. Too bad, because the images were clearly superior to what we have now. They have the 3-D scanners at Mass Eye and Ear, and Lahey. Judy
> > On 1/28/07 2:42 PM, in article > > 1170024159.690843.251...@a75g2000cwd.googlegroups.com, "judy.n" [quoted text clipped - 26 lines] > <http://www.craftedsmalltalk.com> > =========================================================== Andy - 01 Feb 2007 23:19 GMT > Where is best place to purchase generic Flonase. I haven't seen a big price > difference in California. I haven't seen *any* difference in price between generic and brandname Flonase. I still pay the same $25 copay. I really expected the price to be lower for the generic...instead, I would pay more for Flonase, if I chose to go that way (which I don't).
rick@spamgmail.com - 29 Jan 2007 03:48 GMT >Both have preservatives and alcohol in them: brand name flonase had >"masking perfume": nasonex is now scent free. Hypothetically nasonex [quoted text clipped - 3 lines] >The generic option is really nice for co-pays. >Judy Judy, Murray, et al.,
Any difference between Nasonex (what I use now) and Flonase? Now that Flonase is generic, I can save $10 a month co-pay.
Thanks, Rick
>> I've used them both and find them equally effective. Flonase is out in a >> generic form now so if cost/insurance is an issue... [quoted text clipped - 4 lines] >> >> > Mel judy.n - 30 Jan 2007 15:46 GMT Rick, Nasonex has no scent or alcohol, flonase used to have both. Clinically, I used flonase and always liked it. It's work a try IMO. Judy
On Jan 28, 10:48 pm, r...@spamgmail.com wrote:
> >Both have preservatives and alcohol in them: brand name flonase had > >"masking perfume": nasonex is now scent free. Hypothetically nasonex [quoted text clipped - 18 lines] > > >> > Mel
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