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Olopatadine vs. Azelastine

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

Key takeaways

Olopatadine (Pataday) and azelastine (Astelin) are both antihistamines used to treat allergy symptoms, but they differ in their application and specific uses. Olopatadine is an over-the-counter eye drop used for relieving eye itching and redness due to allergies, while azelastine is a prescription nasal spray that treats nasal symptoms like a runny or stuffy nose. Olopatadine is available in three strengths (0.1%, 0.2%, and 0.7%) and is typically applied once or twice daily, depending on the strength. Azelastine comes in two strengths (0.1% and 0.15%) and is usually sprayed into the nostrils twice a day. Olopatadine is available over the counter, whereas azelastine requires a prescription, although the 0.15% strength is also available over the counter. Common side effects of olopatadine include blurry vision and dry eye, while azelastine may cause a bitter taste, headache, and sleepiness. Additionally, azelastine can interact with alcohol and other medications that cause drowsiness, increasing the risk of sleepiness and difficulty concentrating.

Olopatadine

(Pataday)

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azelastine nasal spray

 

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Summary for Olopatadine

Over-the-counter

Olopatadine (Pataday) is an over-the-counter (OTC) allergy eye drop for adults and children 2 years and up. It works as an antihistamine to help relieve itchy and red eyes from allergies. There are 3 types of olopatadine eye drops (Pataday). There's a lower-strength version that's used twice a day. Regular-strength and extra-strength versions that are used once a day are also available. Some side effects include blurry vision and dry eye.

Indications for Olopatadine

Pros and Cons for Olopatadine

Pros

  • Works within minutes to help relieve itchy and red eyes from allergies
  • Safe for children over 2 years old
  • Available over the counter

Cons

  • Not for irritation caused by eye infections, contact lenses, or dry eye
  • Contains preservatives, which can cause eye irritation
  • Must take out contact lenses first before using

Common Side Effects for Olopatadine

  • Blurry vision
  • Burning or stinging in the eye
  • Feeling like something is in the eye
  • Common cold symptoms
  • Sore throat

Warnings for Olopatadine

  • For use in the eyes only
  • Remove contact lenses before use

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 Olopatadine vs. Azelastine

Price Card Drug Icon
Olopatadine1 eye dropper / 5ml of 0.1%
$10.91$17.12
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Azelastine1 nasal spray / 30ml of 137mcg/spray
$19.97$33.36
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