Azelastine Nasal Spray (Astepro)

What is Azelastine nasal spray?

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.

What is Azelastine used for?

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.

How Azelastine works

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.

When is Azelastine prescribed?

Azelastine may be prescribed for people with allergies that produce nasal symptoms, which they find difficult to manage with over the counter antihistamines. 

How long does it take Azelastine to work?

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.

Active ingredients

Azelastine nasal spray contains 0.1% Azelastine in an aqueous solution. 

Inactive ingredients

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. 
 

Which ingredients can cause an allergic reaction?

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. 

How to use Azelastine nasal spray

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. 

1. Before using the spray, blow your nose. 
2. To use the spray, look down towards the floor and insert the tip of the bottle into your nostril. 
3. Hold the spray bottle upright and direct it towards the back of your nose. 
4. Keep your head down, hold your other nostril closed with your finger, while gently pressing down the pump and inhaling through your nose.  
5. Repeat with the other nostril.
6. After using the spray, clean the end of the bottle with a dry tissue and avoid blowing your nose or tilting your head back for several minutes. 
    

How often can you use Azelastine nasal spray?

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.

When to use Azelastine nasal spray

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.
 

Can Azelastine be used long term?

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.

Azelastine side effects

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:

• Visual changes, eye pain or redness in the eyes
• Blood in your urine
• Coughing
• Rash, hives or itching of the skin
• Sores in or around the mouth
• Chest tightness or difficulty breathing
• Rapid heart rate

Drug interactions

Azelastine may interact with several different medications, including:

• Betahistine dihydrochloride
• Isocarboxazid
• Phenelzine
• Tranylcypromine

It is important that you always tell the prescribing physician about any medications, recreational drugs, or alternative treatments that you are taking.
 

Can Azelastine and Fluticasone be used together?

Azelastine and Fluticasone are available in a combined nasal spray called Dymista, but can also be supplied as individual sprays. 

Can you take Azelastine when pregnant?

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 or Fluticasone nasal spray

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. 

Azelastine vs Loratadine

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.