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.
