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Compare Azelastine vs. Afrin

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Azelastine nasal spray and oxymetazoline nasal spray are both used to treat nasal symptoms, but they belong to different medication classes. Azelastine, available as a generic and under the brand name Astepro Allergy, is an antihistamine that treats allergy-related nasal symptoms like runny or stuffy nose. Oxymetazoline, found in brands like Afrin and Mucinex Sinus-Max, is an alpha adrenergic receptor agonist that provides short-term relief of nasal and sinus congestion. Azelastine is available by prescription in two strengths (0.1% and 0.15%) and can be used for both seasonal and year-round allergies, while oxymetazoline is available over-the-counter and should not be used for more than three days due to the risk of rebound congestion. Azelastine is typically used twice a day, whereas oxymetazoline is used every 10 to 12 hours but not more than twice in 24 hours. Common side effects of azelastine include a bitter taste and sleepiness, while oxymetazoline may cause burning or stinging in the nose. Azelastine can cause drowsiness, so you should avoid alcohol and other sedatives, while oxymetazoline should be used cautiously if you have high blood pressure or other health conditions.

  • Azelastine nasal spray
    Oxymetazoline (Afrin)
  • Azelastine nasal spray
    Oxymetazoline (Afrin)

  • Summary of Azelastine vs. Afrin

    Summary for Antihistamine
    Prescription only

    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. <br/> Note: Azelastine 0.15% nasal spray is also available over the counter under the brand name Astepro Allergy.

    Summary for Alpha adrenergic receptor agonist

    Oxymetazoline (Afrin) is a nasal decongestant spray. More specifically, it's an alpha-1 receptor agonist. Oxymetazoline (Afrin) is sprayed into the nostrils up to twice daily to help relieve stuffy noses. But you should avoid using it for longer than 3 days in a row because doing so can raise the risk for rebound congestion. There are oxymetazoline products for children and adults that differ in dosage, so read the label on your specific product to make sure it's appropriate for you. Some side effects of this medication might include mild burning or stinging in the nose.

  • Indications of Azelastine vs. Afrin

    Indications 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
    Indications for
    •Short-term relief of nasal and sinus congestion and pressure

  • Pros and Cons of Azelastine vs. Afrin

    Pros and Const for Antihistamine
    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
    Pros and Const for Alpha adrenergic receptor agonist
    Pros
    •Starts working within minutes and lasts for up to 12 hours
    •Typically fewer side effects than oral decongestants
    •Children's product can be used by those as young as 2 years old (check product labeling)
    •Available over the counter and as a lower-cost generic
    Cons
    •Some nasal spray might drip out of nose, which can be messy
    •Can't use longer than 3 days due to rebound congestion
    •Might not be a good choice for people with high blood pressure
    •Not recommended during pregnancy

  • Common Side Effects of Azelastine vs. Afrin

    Common Side Effects for

    Azelastine 0.1% nasal spray:

    •Bitter taste in the mouth (20%)
    •Headache (15%)
    •Sleepiness (12%)
    •Nasal burning (4%)

    Azelastine 0.15% nasal spray:

    •Bitter taste in the mouth (4%)
    •Nasal discomfort (4%)
    Common Side Effects for
    •Burning in the nose
    •Stinging in the nose
    •Rebound nasal congestion (if using longer than 3 days)

  • Warnings of Azelastine vs. Afrin

    Common Side Effects for
    •Possible sleepiness and difficulty concentrating
    Common Side Effects for
    •Rebound congestion
    •Might not be safe for people with certain medical conditions
    •For use in the nose only

  • Prices with our coupons for Azelastine vs. Afrin

    Learn more about Azelastine nasal spray
    Learn more about Oxymetazoline

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