Azelastine Nasal Spray

Azelastine nasal spray is a prescription antihistamine used to treat allergy-related nasal symptoms such as sneezing, congestion, and runny nose. It’s available under the brand names Astepro and Astelin, as well as in generic forms—offering a cost-effective option for patients seeking relief from seasonal or year-round allergic rhinitis. This medication works by blocking histamine, the chemical in your body responsible for triggering allergic reactions.

What sets Azelastine apart from oral antihistamines is its ability to provide targeted nasal relief with a rapid onset—most users experience symptom improvement within 15 to 30 minutes of use. Its effects can last up to 12 hours, which makes it suitable for once or twice daily dosing, depending on the prescribed strength (0.1% or 0.15%). Azelastine can be used in children as young as 6 months old for year-round allergies, though dosage varies by age group. It’s important to follow your doctor’s instructions carefully to avoid potential side effects like drowsiness, bitter taste, or nasal irritation.

Avoid alcohol or other sedating medications while using this spray, as they can intensify drowsiness. For best results, the spray should be used exactly as directed—primed before first use and after periods of non-use, with the head tilted forward during application to reduce unpleasant taste. Whether used alone or as part of a combination therapy with intranasal steroids, Azelastine offers fast and effective relief. Speak with your doctor to determine if Azelastine nasal spray is the right solution for managing your allergy symptoms.

• Azelastine nasal spray is a prescription medication used to treat nasal allergy symptoms. It helps relieve common allergy-related issues, such as:
  • Sneezing
  • Runny nose
  • Nasal congestion (in some cases)
• Azelastine is used for both:
  • Seasonal allergic rhinitis (allergies that occur during certain times of the year)
  • Perennial allergic rhinitis (year-round allergies)

What Are the Forms & Strengths of Azelastine Nasal Spray?

Azelastine is available as a liquid nasal spray designed to be used inside the nose. It comes in the following two strengths:

• 0.1% strength
• 0.15% strength

These strengths refer to the concentration of the active ingredient (azelastine) in the spray. Your doctor will recommend the right strength based on your age and allergy symptoms.

What Is the Recommended Dosage of Azelastine Nasal Spray?

All possible dosages and drug forms may not be included here. Talk to your doctor if you are unsure about your dosage.

Dosage of Azelastine Nasal Spray for Seasonal Allergic Rhinitis (Nasal Allergies)

• Adults (18 years and older):
  • You can use:
    • 1 or 2 sprays in each nostril, twice a day (using 0.1% or 0.15%)
    • OR you may take 2 sprays in each nostril, once a day (only if using 0.15%)
• Teens (12 to 17 years old):
  • You can use:
    • 1 or 2 sprays in each nostril, twice a day (using 0.1% or 0.15%)
    • OR you may take 2 sprays in each nostril, once a day (only if using 0.15%)
• Children (6 to 11 years old): Use 1 spray in each nostril, twice a day (You can use either 0.1% or 0.15%)
• Young Children (2 to 5 years old): Use 1 spray in each nostril, twice a day (Only the 0.1% strength should be used)
• Children under 2 years old: Do not use Azelastine nasal spray. It’s not approved for children below age 2.

Dosage of Azelastine Nasal Spray for Year-Round Allergic Rhinitis (Nasal Allergies)

• Adults (18 years and older): Use 2 sprays in each nostril, twice a day (Use the 0.15% strength)
• Teens (12 to 17 years old): Use 2 sprays in each nostril, twice a day (Use the 0.15% strength)
• Children (6 to 11 years old): Use 1 spray in each nostril, twice a day (Use either 0.1% or 0.15% strength)
• Young Children (6 months to 5 years old): Use 1 spray in each nostril, twice a day (Only the 0.1% strength is recommended)
• Infants (Under 6 months old): Azelastine nasal spray is not recommended for babies under 6 months, as its safety and effectiveness haven't been confirmed for this age group.

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they'll customize your dosage accordingly.]

To get the best results from Azelastine nasal spray, it's important to use it exactly as your doctor tells you. Using more than recommended or using it too often can increase your chances of side effects. Below are simple steps and precautions to help you use the spray safely and effectively.

• Follow your doctor’s instructions carefully. Don’t use more spray or use it more often than prescribed.
• This medicine is meant for use only in the nose. Avoid getting it in your eyes or mouth. If this happens, rinse the area with water and contact your doctor.
• Don’t use Azelastine for other nose problems, like nose injuries, surgery, or ulcers, without your doctor’s approval.
• Always read the patient information leaflet that comes with the spray. Ask your doctor or pharmacist if anything is unclear.

How to Use the Spray:

• Prime the spray before first use by pressing it down fully 6 times until a fine mist appears.
• Prime again if you haven’t used it for 3 days or more, or after cleaning the spray—just 2 sprays are usually enough.
• Gently blow your nose before using the spray to clear your nostrils.
• Tilt your head down, like you're looking at your toes. Insert the spray tip into one nostril, aiming it toward the back of your nose while keeping the bottle upright.
• Close the other nostril with your finger. Press the pump once and sniff in gently at the same time.
• Repeat in the other nostril. If your doctor has prescribed 2 sprays per nostril, repeat the steps again.
• Don’t blow your nose or tip your head back right after spraying. This helps the medicine stay in place and work better.
• After using, wipe the nozzle with a clean tissue and replace the cap securely.
• Avoid drinking alcohol while using this medicine, as it may make you more drowsy.

By following these steps, you can make sure the medicine works well and avoid unnecessary side effects. If anything feels uncomfortable or unclear, don’t hesitate to reach out to your doctor for help.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They'll adjust it as needed over time.]

Azelastine is part of a group of medications called antihistamines, which are commonly used to treat allergy symptoms. It works by blocking the effects of histamine—a chemical your body releases during an allergic reaction. Histamine is what causes symptoms like sneezing, a runny nose, or nasal itching. By stopping histamine from doing its job, Azelastine helps reduce these symptoms and makes it easier to breathe and feel more comfortable during allergy flare-ups.

Azelastine nasal spray may cause drowsiness, so be cautious when driving or doing anything that requires focus. It can also cause other side effects, which are mild and serious too.

More Common Side Effects of Azelastine Nasal Spray: These side effects often go away after a few days or weeks. If they don’t improve or become more uncomfortable, contact your doctor or pharmacist.

• Fever: A mild fever may occur as your body adjusts. Stay hydrated and rest. If it gets high or doesn’t go away, contact your doctor.
• Bitter taste in your mouth: This can happen if the spray drips down your throat. Tilting your head slightly downward while spraying may help avoid this.
• Nose pain or discomfort: This can be from the spray or irritation in your nasal passages. Using a saline spray before azelastine may reduce the sting.
• Nosebleeds: These are usually minor. Try using a humidifier at home or applying a little petroleum jelly inside the nostrils.
• Headache: A common side effect. Rest, hydration, and over-the-counter pain relief can help unless it persists.
• Sneezing: This may happen right after using the spray and often settles with regular use.
• Drowsiness: This is a known side effect. Avoid alcohol or sedatives, and see how your body reacts before driving.
• Upper respiratory tract infection, cough, sore throat: These are generally mild. Drink warm fluids and rest. Let your doctor know if symptoms worsen.
• Vomiting: Uncommon but possible. If it happens more than once, contact your doctor.
• Ear infection: Rare, but report any ear pain or hearing issues to your doctor.
• Skin rash: Watch for any allergic reactions. If a rash spreads or becomes itchy or severe, seek medical advice.

Serious Side Effects of Azelastine Nasal Spray: Along with its helpful effects, Azelastine nasal spray may cause some unwanted reactions. Not everyone will experience these, but if they do happen, you should speak with your doctor right away as some may need medical care. Check with your doctor immediately if any of the following side effects occur while taking Azelastine nasal:

• Heavy nosebleeds: This may be a sign of nasal irritation. Avoid blowing your nose too hard, and let your doctor know if bleeding continues.
• Burning or discomfort inside the nose: This might happen after spraying. Using a saline rinse before applying Azelastine may help soothe the nose.
• Ear congestion: You might feel a fullness in the ears. If it doesn’t go away, a doctor can check for any infection or fluid build-up.
• Chills, cough, fever, sore throat, body aches or pain, headache, loss of voice: These could mean a respiratory infection. Rest, fluids, and contacting your doctor if symptoms get worse is important.
• Trouble breathing, chest tightness: These can be signs of an allergic reaction. Stop using the spray and get emergency help right away.
• Unusual tiredness or weakness: If you feel more tired than usual, let your doctor know—it could signal your body isn't tolerating the medicine well.
• Blood in the urine: This is uncommon but serious. See a doctor immediately if you notice this.
• Blurred vision or other change in vision, eye pain or redness: These may suggest an eye reaction. Avoid getting the spray in your eyes, and contact your doctor if it happens.
• Hives, itching, or skin rash: These could be signs of an allergic reaction. Stop using the spray and get medical help if the rash spreads or worsens.
• Rapid heartbeat: If your heart suddenly beats faster than normal, contact your doctor. This could mean the medication is affecting your heart.
• Sores in the mouth or on the lips: These might be allergic or immune-related reactions. Avoid spicy or acidic foods and consult your doctor promptly.

If any of these symptoms appear, don’t ignore them—your doctor may need to change your medication or offer treatment to manage the reaction.

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

While Azelastine nasal spray is effective for treating allergy symptoms, there are a few important warnings you should know about. Being aware of how this medication might affect your body will help you use it safely. Below are key warnings to keep in mind before and during treatment.

• Alcohol Interaction Warning: Drinking alcohol while using Azelastine can make drowsiness worse.
  • Avoid alcoholic beverages and be cautious with other medications that may cause sleepiness.
  • Combining them can make you feel excessively tired or groggy.
• Drowsiness Warning: Azelastine may cause drowsiness or sleepiness in some people.
  • Avoid driving, operating machinery, or doing anything that requires full alertness until you know how the medicine affects you.
  • Do not take it before activities that need your focus, especially when trying it for the first time.
• Warning for Women Who Are Breastfeeding: Azelastine may pass into breast milk and could affect your baby.
  • Talk to your doctor before using this medicine if you’re breastfeeding.
  • Your doctor may help you decide whether to stop breastfeeding or use a different medication.
• Warning for Pregnant Women: We don’t yet know for sure if Azelastine is safe to use during pregnancy.
  • Animal studies showed some risks to unborn babies, but we don’t know if the same would happen in humans.
  • Talk to your doctor if you're pregnant or planning to become pregnant.
  • This medicine should only be used if the benefits outweigh any potential risks.
  • Let your doctor know right away if you become pregnant while using it.

To get the best results from Azelastine nasal spray and avoid unnecessary side effects, it’s important to take a few precautions. These safety tips will help ensure the medicine works properly while protecting your overall health. Always follow your doctor’s advice and let them know if you experience anything unusual during treatment.

• Use only as directed: Don’t use more sprays than prescribed or use it more often than instructed. Doing so can increase the risk of side effects without giving you better results.
• Avoid alcohol: It can make the drowsiness caused by Azelastine worse. It’s best to avoid alcoholic drinks while using this medicine.
• Be cautious with other drowsy medications: If you're taking sleep aids, allergy meds, or anything else that makes you sleepy, talk to your doctor first. Combining them with Azelastine can make you feel very tired or dizzy.
• Don’t drive or use heavy machines right away: This medicine may make you drowsy. Wait until you know how it affects you before doing anything that needs full focus.
• Don’t get it in your eyes or mouth: This spray is only for your nose. If it accidentally gets in your eyes or mouth, rinse with water and call your doctor if you feel discomfort.
• Tell your doctor if you’re pregnant or breastfeeding: Azelastine might not be safe for pregnant or nursing mothers. Always check with your doctor before using it in these situations.

Don’t use it for other nose problems: If you have a nose injury, recent surgery, or ulcers inside your nose, don’t use Azelastine without first speaking to your doctor.

Using Azelastine nasal spray regularly helps manage your allergy symptoms effectively. But if you accidentally miss a dose, don’t worry—just follow these simple steps to stay on track. Taking extra doses to make up for a missed one can be harmful, so it’s important to handle it the right way.

• Take the missed dose as soon as you remember, unless it’s almost time for your next scheduled dose.
• If it’s just a few hours before your next dose, skip the missed one and go back to your regular schedule.
• Never take two doses at once to make up for a missed dose—this could cause unwanted side effects.
• If you’re unsure what to do, or if you miss doses frequently, talk to your doctor or pharmacist for guidance.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

Taking more Azelastine nasal spray than prescribed can lead to too much medicine in your system, which may cause unwanted or harmful effects. It’s important to use the spray exactly as directed. If you think you’ve used too much, take action right away to stay safe.

• Using too much Azelastine may cause side effects, such as feeling very sleepy or overly drowsy.
• If you think you’ve taken more than the recommended dose, call your doctor right away for advice.
• You can also contact the American Association of Poison Control Centers at 800-222-1222 or use their online tool for help.
• If your symptoms feel severe, like extreme sleepiness, confusion, or trouble breathing, call 911 or go to the nearest emergency room immediately.

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

To keep Azelastine nasal spray safe and effective, it’s important to store it properly. Proper storage helps the medicine work as it should and prevents it from becoming less effective or unsafe to use. Below are some simple storage tips to follow:

• Store Azelastine at room temperature, between 68°F and 77°F (20°C to 25°C).
• Keep the bottle standing upright to prevent leakage or damage.
• Do not freeze the spray. Freezing can affect how well the medicine works.
• Keep the medicine out of reach of children to avoid accidental use.
• Do not keep expired medicine or medication you no longer need.
• Ask your pharmacist or doctor how to safely dispose of unused spray—don’t throw it in the trash or flush it unless advised.
• Store in a closed container, away from heat, moisture, and direct sunlight.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Some medicines can affect how Azelastine nasal spray works, or Azelastine may affect how other medicines work. That’s why it’s important to tell your doctor about everything you take, including prescription drugs, over-the-counter medicines, and supplements. In some cases, certain combinations of medicines may not be recommended, but your doctor might still prescribe them with adjusted doses or extra monitoring. Below are some medicines that may interact with Azelastine.

• Medicines Usually Not Recommended with Azelastine: These medications can increase the risk of serious side effects when used with Azelastine. Your doctor may still prescribe them if necessary, but may adjust your dosage or monitor you closely.
  • Amifampridine: It is used for nerve and muscle disorders.
  • Bupropion: It is often prescribed for depression or to help quit smoking.
  • Donepezil: It is used to treat symptoms of Alzheimer’s disease.
  • Hydroxychloroquine: It is used for autoimmune diseases like lupus or rheumatoid arthritis.
  • Pitolisant: It is used to treat sleep disorders such as narcolepsy.
• Medicines That May Increase Side Effects When Combined with Azelastine: These medicines may raise the chance of drowsiness or other side effects. Your doctor may adjust the dose or give special instructions.
  • Cimetidine: It is often used to treat heartburn and stomach ulcers.

Always keep your doctor updated on any new medications you start or stop. This helps avoid unwanted side effects and ensures your treatment is as safe and effective as possible.

What Are the Other Azelastine Nasal Spray Interactions?

Azelastine nasal spray is widely used to treat allergy symptoms, but like many medications, it can interact with other substances—even those outside of traditional prescription drugs. Here's what you should know:

• Alcohol: Azelastine can cause drowsiness or dizziness, and drinking alcohol can worsen these effects. Combining both may increase the risk of feeling excessively sleepy or less alert, so it's best to limit or avoid alcohol while using this spray—especially if you're planning to drive or operate machinery.
• Food: There are no known interactions between food and Azelastine nasal spray. You can eat normally while using this medication. However, using the spray correctly (with your head tilted forward) helps prevent a bitter taste in your mouth, which can affect your appetite temporarily.
• Caffeine and Energy Drinks: While there’s no direct interaction, caffeine may worsen side effects like nervousness or restlessness if you’re sensitive to them. If you feel jittery after using the spray, consider cutting back on caffeinated beverages.
• Vitamins and Nutritional Supplements: There are no major interactions reported with common vitamins (like Vitamin C, D, or multivitamins). However:
  • Vitamin D and omega-3 supplements can support immune health, which may help allergy control overall.
  • Always let your doctor know about any supplements you take, just in case they overlap with your condition.
• Vaccines: There are no known direct interactions between Azelastine nasal spray and vaccines, including flu shots and COVID-19 vaccines. You can usually continue using the spray during your vaccination period unless your doctor advises otherwise.
• Lab Tests: Azelastine is not known to interfere with most standard lab tests. However:
  • It’s always good practice to let the lab technician or your doctor know you’re using it—especially before allergy testing. Antihistamines can affect skin prick test results, so you may need to stop the spray a few days before testing.
• Smoking: While smoking doesn't directly interact with Azelastine, it can worsen allergy symptoms and nasal irritation, potentially reducing the effectiveness of the medication.
• Herbal Products: Use caution with herbs that affect the nervous system or the immune response:
  • St. John’s Wort (used for mood) may increase drowsiness when combined with Azelastine.
  • Echinacea (used for immunity) could potentially overstimulate allergic responses.

If you’re using herbal remedies regularly, speak to your doctor or pharmacist before combining them with this spray.

[Note: This isn't a complete list, and there could be other drugs that interact with Azelastine Nasal Spray. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

Sometimes, switching to a different medication may be necessary if Azelastine nasal spray isn’t providing enough relief or if you’re experiencing unwanted side effects. This decision should always be made with your doctor, who can evaluate your symptoms, monitor your response, and suggest the most suitable option based on your health needs. There are several other nasal sprays and allergy medications that work in similar ways to Azelastine. These alternatives may help manage your symptoms more effectively. Some commonly used alternatives to Azelastine nasal spray include:

• Flonase (fluticasone)
• Nasonex (mometasone)
• Beconase AQ, Qnasl (beclomethasone)
• Nasacort (triamcinolone)
• Omnaris, Zetonna (ciclesonide)
• Patanase (olopatadine)
• Atrovent Nasal Spray (ipratropium bromide)
• Xyzal or Zyrtec (levocetirizine or cetirizine)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

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