Reviewed by Dr Roy Kedem, MD
Information last reviewed 08/03/20
Azelastine is an antihistamine nasal spray. It is inserted into the nose to relieve nasal allergy symptoms, such as congestion, sneezing, and a runny nose.
Azelastine can be used on allergies that affect the nose and/or sinuses. It is not effective for allergic reactions of the skin or digestive tract. Allergies to pollen, dust mites, and animals commonly produce nasal symptoms, which Azelastine can help to resolve.
Azelastine, like many allergy medications, is an antihistamine. Histamine is a substance produced by your body when you come into contact with an allergen. It is histamine that produces the symptoms of an allergic reaction, such as a rash, itchy eyes, sneezing etc. Antihistamines reduce the histamine levels in your body, so when you’re exposed to an allergen, your body reacts less severely. This helps to reduce the symptoms of an allergic reaction.
Azelastine may be prescribed for people with allergies that produce nasal symptoms, which they find difficult to manage with over the counter antihistamines.
Azelastine can start to provide relief from some allergy symptoms within 15 minutes. There is currently a clinical trial in place to determine exactly how long it takes for Azelastine nasal spray to relieve nasal allergy symptoms.
Azelastine nasal spray contains 0.1% Azelastine in an aqueous solution.
Azelastine nasal spray also contains the following inactive ingredients: Benzalkonium chloride (125 mcg/mL), edetate disodium, hypromellose, citric acid, dibasic sodium phosphate, sodium chloride, and purified water.
Please note: these ingredients may vary between different manufacturers.
There are no active or inactive ingredients in the nasal spray associated with causes of allergic reaction in users, hence a severe allergic reaction is rare. However, the nasal spray can cause a burning sensation inside the nose after the first few uses. Symptoms of a severe allergic reaction are hives, swelling of the face, dizziness, itchy sensation in the throat and trouble breathing. Get emergency medical attention if you notice any of the symptoms of a severe allergic reaction.
When using Azelastine nasal spray for the first time, you will need to prime the spray. Holding the bottle in your hand, you should press down the pump until you see the spray come out. Then the spray is ready to use.
You should always use Azelastine as instructed by the prescribing doctor. You will usually be prescribed 1-2 sprays in each nostril, once or twice a day.
Azelastine starts to work within 15 minutes and lasts approximately 12 hours. If you are using this medication twice daily, you should try to use it at approximately the same time each day. If you are prescribed a once-daily dose, you would have more flexibility as to when you take the medication. Just make sure you space your doses out as much as possible.
You may need to use Azelastine daily for an extended period if your symptoms are persistent. If your symptoms are intermittent or if your allergies have a specific, identified trigger which you are not continuously exposed to, Azelastine can be used as needed, due to its rapid rate of onset.
Azelastine nasal spray is a long term treatment. Therefore, it is safe for long term use. If you stop taking Azelastine, your symptoms are likely to return. You should always speak to your doctor before discontinuing your medication.
Common side effects of Azelastine are a bitter taste in the mouth and drowsiness. If you experience drowsiness, you should avoid driving after taking Azelastine.
If you experience any of the following side effects, you should seek medical advice:
Azelastine may interact with several different medications, including:
It is important that you always tell the prescribing physician about any medications, recreational drugs, or alternative treatments that you are taking.
Azelastine and Fluticasone are available in a combined nasal spray called Dymista, but can also be supplied as individual sprays.
Azelastine nasal spray has not been widely tested in pregnant women; however, it has been found that there was no harm to the fetus or mother at 15 times the recommended dose. Azelastine will only be prescribed if the benefits outweigh the potential risks, but this would be at the discretion of the obstetrician. Therefore, you should inform your doctor if you think you might be pregnant or plan to become pregnant.
Azelastine is an antihistamine spray, whereas Fluticasone is a corticosteroid nasal spray. Antihistamine and corticosteroids have similar effects but work through different mechanisms. Corticosteroids work by reducing inflammation in the nose, which leads to nasal allergy symptoms. However, antihistamines work by reducing the levels of histamine, a substance that causes the body to overreact in response to allergens. Dymista nasal spray contains both Azelastine and Fluticasone.
Both Loratadine and Azelastine are antihistamines that can help to alleviate allergy symptoms. Loratadine is taken as a tablet once a day, whereas Azelastine is a nasal spray that can be taken once or twice a day (depending on the prescription). Azelastine is designed to target the allergic symptoms that affect the nose and sinuses, whereas Loratadine has a more general effect, so it can also help to reduce allergic symptoms such as rashes and swelling.
Azelastine and Flonase are not the same. Azelastine is an antihistamine nasal spray, whereas Flonase contains the active ingredient Fluticasone, a corticosteroid.
Azelastine nasal spray is made by a number of different pharmaceutical companies. The branded versions of Azelastine, known as Astelin and Astepro, are manufactured by MedPointe and MEDA, respectively.
Azelastine is not a steroid; it is an antihistamine.
Azelastine is the generic version of Astelin and Astepro. They contain the same active ingredients but may contain different inactive ingredients.
It is unusual to develop a yeast infection from an antihistamine alone, but if using Azelastine combined with Fluticasone (a corticosteroid), a yeast infection is more likely. Azelastine-Fluticasone can suppress the immune system generally and within the nasal passages. This can allow fungal organisms such as candida to thrive where they would normally be kept in check.
Symptoms of a fungal yeast infection can be identical to chronic or acute sinusitis, including congestion, pain, and fever. You may also develop more severe complications such as erosion or ulcers in the nasal passages, headaches, and confusion. If you suspect you may have a fungal sinus infection, you should seek in-person treatment at the earliest possible time.
Disclaimer: This is not medical advice. You and your physician will determine if and how you should take any medication prescribed to you following a medical consultation.
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