azelastine
Azelastine nasal spray is an antihistamine that treats allergies and nasal symptoms, such as runny or stuffy nose. The 0.1% and 0.15% strengths of the azelastine nasal spray are available with a prescription for adults and children. It's sprayed into the nostrils typically twice a day. Prescription azelastine nasal spray is a lower-cost generic. Possible side effects include a bitter taste in the mouth and nasal discomfort.
Note: Azelastine 0.15% nasal spray is also available over the counter under the brand name Astepro Allergy.
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What is Azelastine nasal spray?
What is Azelastine nasal spray used for?
Seasonal allergy symptoms related to the nose
Year-round allergy symptoms related to the nose - azelastine 0.15% spray only
Runny or stuffy nose that isn't caused by allergies - azelastine 0.1% spray only
How Azelastine nasal spray works
Azelastine is an antihistamine. It works in your nose to block histamine, a natural chemical in your body that causes runny nose, itching, and sneezing. By blocking histamine, azelastine helps relieve these nasal symptoms.
Drug Facts
What are the side effects of Azelastine nasal spray?
Common Side Effects
- Bitter taste in the mouth (20%)
- Headache (15%)
- Sleepiness (12%)
- Nasal burning (4%)
- Bitter taste in the mouth (4%)
- Nasal discomfort (4%)
Other Side Effects
- Sneezing
- Runny nose
- Nosebleed
- Dry mouth
- Sore throat
- Nausea
- Tiredness
- Dizziness
Source: DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Bitter taste in mouth
headaches
temporary eye burning or stinging
Less common
Burning, dry or itching eyes
blurred vision, temporary
chills
eye discharge or excessive tearing
general feeling of discomfort or illness
hoarseness or other voice changes
itching skin
joint pain
loss of appetite
muscle aches and pains
redness, pain, swelling of eye, eyelid, or inner lining of eyelid
shivering
sweating
tender, swollen glands in neck
trouble in swallowing
trouble sleeping
unusual tiredness or weakness
vomiting
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Azelastine nasal spray
Pros
Works well to relieve nasal symptoms during allergy season
Might work faster than steroid nasal sprays and some oral antihistamines
Sprayed directly into the nose
Available in two different strengths (0.1% and 0.15%)
Cons
Doesn't have a counter to keep track of the number of sprays you have left in the bottle
Can leave a bitter taste in your mouth (but it goes away)
Can cause sleepiness in some people
Might need to use twice a day
Pharmacist tips for Azelastine nasal spray
Read the instructions so you know how to use the azelastine nasal spray properly. Only use the azelastine nasal spray in your nose. Don't spray the medication into your eyes or mouth to avoid side effects.
Before you use azelastine nasal spray for the first time, spray 4 times into the air (for the 0.1% strength) or 6 times (for the 0.15% strength) until you see a fine mist of medication. This is called priming, and it helps make sure enough medication comes out when you need to use it.
When you haven't used azelastine nasal spray for 3 or more days, spray 2 times into the air or until a fine mist appears before you use the nasal spray.
As you spray azelastine into your nostril, breathe in lightly through your nose. Tilt your head forward to keep the medication from going down your throat. These steps can help lessen any bitter taste in your mouth from the medication.
If needed, wait a few minutes after you use the azelastine nasal spray to blow your nose. This makes sure the medication stays in your nose instead of getting onto your tissue.
Check the package labeling or medication box for the total number of sprays that your azelastine nasal spray bottle has. Throw your bottle away after you've used the total number of sprays it says on the bottle because you might not get a full dose of medication with each additional spray.
Avoid drinking alcohol and taking other medications that make you feel sleepy while you're using the azelastine nasal spray. This combination can make you feel drowsier and could lead to falls or other dangerous accidents.
Avoid driving until you know how the azelastine nasal spray affects you. This medication might make you sleepy, which can put you at risk for accidents if you can't focus well.
There isn't enough information to know for sure whether the azelastine nasal spray is safe to use while pregnant, but experts believe that it's likely safe based on animal studies and what we know about antihistamines that are taken by mouth. Discuss with your primary care provider about the risks and benefits of using the azelastine nasal spray if you're pregnant or planning to become pregnant.
Get medical help or call a poison control center at 1-800-222-1222 right away if you accidentally use too much of the azelastine nasal spray or if a child accidentally swallows the medication.
More on Azelastine nasal spray tips
Frequently asked questions about Azelastine nasal spray
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What are the risks and warnings for Azelastine nasal spray?
Azelastine nasal spray can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Possible sleepiness and difficulty concentrating
Risk factors: Drinking alcohol while using azelastine nasal spray | Taking other medications that make you less alert
There's a chance that some people might feel sleepy after they use azelastine nasal spray. Sleepiness can potentially lower how well you can focus, think, and react quickly. Be careful and avoid activities that require you to be alert, such as driving a car or operating machinery, until you know how this medication affects you. Avoid drinking alcohol or taking medications that can make you feel sleepy while you're using azelastine nasal spray.
Azelastine nasal spray dosage forms
Typical dosing for Azelastine nasal spray
Seasonal allergies
Adults and children 12 years and older: The typical dose is 1 or 2 sprays in each nostril twice a day.
Children ages 5 to 11 years old: The typical dose is 1 spray in each nostril twice a day.
Runny or stuffy nose not due to allergies
Adults and children 12 years and older: The typical dose is 2 sprays in each nostril twice a day.
Seasonal allergies
Adults and children 12 years and older: The typical dose is 1 or 2 sprays in each nostril twice a day, or 2 sprays in each nostril once a day.
Children ages 6 to 11 years old: The typical dose is 1 spray in each nostril twice a day.
Year-round allergies:
Adults and children 12 years and older: The typical dose is 2 sprays in each nostril twice a day.
Children ages 6 to 11 years old: The typical dose is 1 spray in each nostril twice a day.
Interactions between Azelastine nasal spray and other drugs
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How much does Azelastine nasal spray cost?
What are alternatives to Azelastine nasal spray?
Seasonal allergy symptoms related to the nose
Year-round allergy symptoms related to the nose - azelastine 0.15% spray only
Runny or stuffy nose that isn't caused by allergies - azelastine 0.1% spray only
Congestion
Runny nose
Sneezing
Itchy nose
Itchy, watery eyes
What is the latest news about Azelastine nasal spray?
Azelastine nasal spray images
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References
Best studies we foundAvKARE. (2024). Azelastine hydrochloride- azelastine spray, metered [package insert]. DailyMed.
Ellis, A. K., et al. (2013). A four-way, double-blind, randomized, placebo controlled study to determine the efficacy and speed of azelastine nasal spray, versus loratadine, and cetirizine in adult subjects with allergen-induced seasonal allergic rhinitis. Allergy, Asthma & Clinical Immunology.
Horak, F. (2008). Effectiveness of twice daily azelastine nasal spray in patients with seasonal allergic rhinitis. Therapeutics and Clinical Risk Management.
Horbal, J. M., et al. (2010). Azelastine HCl: A review of the old and new formulations. Clinical Medicine Insights.
Leader, P., et al. (2023). Vasomotor rhinitis. StatPearls.
Padagis Israel Pharmaceuticals Ltd. (2021). Azelastine HCl Nasal- azelastine hcl spray [package insert]. DailyMed.
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