Key takeaways
Epinastine (Elestat) and azelastine (Astepro) are both antihistamine medications used to treat allergy symptoms but there are some differences. Epinastine is an eye drop used to prevent eye itchiness from allergies, while azelastine is a nasal spray used to treat nasal symptoms like a runny or stuffy nose. Epinastine is applied directly to the eyes twice a day. Azelastine nasal spray comes in two strengths (0.1% and 0.15%) and is available by prescription, with the 0.15% strength also available over the counter. Both have generic formulations available. Epinastine's common side effects include a burning feeling in the eye and eye redness, whereas azelastine can cause a bitter taste in the mouth and sleepiness. Unlike epinastine, azelastine may interact with alcohol and other medications that cause drowsiness, so you should be cautious when using it.
