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Elestat vs. Azelastine

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

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.

Epinastine

 

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azelastine nasal spray

 

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Summary for Elestat

Prescription only

Epinastine hydrochloride is an antihistamine eye drop medication. It's used to prevent eye itchiness that's related to allergies. The eye drops are available by prescription for adults and children 2 years of age and older. The medication is placed directly into the eyes twice a day. Side effects include a burning feeling in the eye and eye redness.

Indications for Elestat

Pros and Cons for Elestat

Pros

  • Works within 5 minutes
  • Applied directly to the eye(s), so there aren't many side effects
  • Can be used by children ages 2 years and older

Cons

  • Must use twice a day
  • Requires a prescription from a healthcare professional
  • Only approved for preventing eye itchiness from allergies

Common Side Effects for Elestat

  • Burning feeling in the eye (up to 10%)
  • Eye redness (up to 10%)
  • Small bumps around the eye (up to 10%)
  • Itchy eye (up to 10%)
  • Upper respiratory tract infection (e.g., common cold; 10%))

Warnings for Elestat

  • For use in the eye only
  • Risk for bacterial infections in the eye if you use contaminated medication
  • Don't use while wearing contact lenses

Summary for Azelastine

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.

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

Indications for Azelastine

  • 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

Pros and Cons for Azelastine

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

Common Side Effects for Azelastine

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%)

Warnings for Azelastine

  • Possible sleepiness and difficulty concentrating

Prices with our coupons for Elestat vs. Azelastine

Price Card Drug Icon
Epinastine1 eye dropper / 5ml of 0.05%
$30.93$132.99
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Azelastine1 nasal spray / 30ml of 137mcg/spray
$19.97$33.18
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