Azelastine

Azelastine is a prescription and over-the-counter medication used for the treatment of seasonal and perennial allergic rhinitis, and vasomotor rhinitis.

• Azelastine is available under the following different brand names: Astelin Nasal Spray, Astepro, Astepro Allergy, Children's Astepro Allergy

Adult and pediatric dosage

Nasal spray

• 0.1% (137mcg/spray) (Astelin Nasal Spray [Rx]; Astepro [Rx], generic [Rx])
• 0.15% (205.5mcg/spray) (Astepro Allergy [OTC]; Children’s Astepro Allergy [OTC]; generic [Rx])

Seasonal Allergic Rhinitis

Adult dosage

• Astelin 0.1%: 1-2 sprays per nostril every 12 hours, OR
• Astepro 0.15%: 2 sprays per nostril every day

Pediatric dosage

• Astelin
  • Children below 5 years: Safety and efficacy not established
  • Children between 5 to 11 years: 1 spray per nostril every 12 hours
  • Children above 12 years: 1-2 sprays per nostril every 12 hours
• Astepro
  • Children below 2 years: Safety and efficacy not established
  • Children between 2 to 5 years: 0.1%; 1 spray per nostril every 12 hours
  • Children between 6-12 years: 0.1% or 0.15%; 1 spray per nostril every 12 hours
  • Children above 12 years
    • 0.1% or 0.15%: 1 or 2 sprays per nostril every 12 hours, or
    • 0.15%: 2 sprays per nostril every day

Perennial Allergic Rhinitis

Adult dosage

• Astepro 0.15%: 2 sprays per nostril every 12 hours
• Pediatric dosage
• Astepro
  • Children below 6 months: Safety and efficacy not established
  • Children between 6 months to 5 years: 0.1%; 1 spray per nostril every 12 hours
  • Children between 6 to 11 years: 0.1% or 0.15%; 1 spray per nostril every 12 hours
  • Children above 12 years: 0.15%; 2 sprays per nostril every 12 hours

Vasomotor Rhinitis

Adult dosage

• Astelin 0.1%: 2 sprays per nostril every 12 hours

Pediatric dosage

• Astelin
  • Children below 12 years: Safety and efficacy not established
  • Children above 12 years: 2 sprays per nostril every 12 hours

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Azelastine include:

• bitter taste in the mouth,
• drowsiness,
• tiredness,
• headache,
• dizziness,
• sneezing,
• nasal irritation,
• nosebleeds,
• nausea,
• dry mouth, and
• weight gain.

Serious side effects of Azelastine include:

• hives,
• difficult breathing, and
• swelling of the face, lips, tongue, or throat.

Rare side effects of Azelastine include:

• none 

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Azelastine has severe interactions with the following drugs:
  • calcium/magnesium/potassium/sodium oxybates
  • sodium oxybate
• Azelastine has serious interactions with the following drugs:
  • clonidine
  • fedratinib
  • lonafarnib
  • stiripentol
• Azelastine has moderate interactions with at least 185 other drugs.
• Azelastine has minor interactions with the following drugs:
  • ashwagandha
  • brimonidine
  • eucalyptus
  • nettle
  • ruxolitinib
  • ruxolitinib topical
  • sage
  • Siberian ginseng

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• Documented hypersensitivity

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Azelastine?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Azelastine?”

Cautions

• May cause CNS depression/drowsiness; use caution when performing tasks requiring mental alertness e.g., operating heavy machinery
• Avoid administering concurrent CNS depressants that may add to somnolence
• Caution in premature newborns and neonates

Pregnancy and Lactation

• Limited data from postmarketing experience over decades of use in pregnant women have not identified any drug-associated risks of miscarriage, birth defects, or other adverse maternal or fetal outcomes

Lactation

• There are no data on presence in human milk, effects on the breastfed infant, or milk production; breastfed infants should be monitored for signs of milk rejection during use by lactating women; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on the breastfed infant from the drug or underlying maternal condition