II. Indications
-
Allergic Rhinitis or Vasomotor Rhinitis (intranasal Azelastine)
- Second-line agent
- FDA Approved for age >5 years (seasonal allergies) and >6 years (perennial allergies)
-
Allergic Conjunctivitis
- FDA Approved for age >=3 years
III. Mechanism
- See Antihistamine
- Second-generation Antihistamine (phthalazinone)
IV. Medications
- Azelastine Nasal (Astelin, Astepro): 0.1% and 0.15% (with 200 sprays/bottle)
- Azelastine Ophthalmic (Optivar): 0.05% solution (6 ml bottle)
- Combination: Fluticasone with Azelastine (Dymista)
- Expensive (up to $200/month) and add little to benefit of generic nasal Corticosteroids alone
- Alternatively, use OTC Azelastine (Astepro) and a generic generic nasal Corticosteroid
- (2022) Presc Lett 29(5): 25-6
V. Dosing
- Nasal (age >5-6 years old)
- One spray per nostril twice daily
- Adults and children age >12 years may increase to 2 sprays per nostril if needed
- Shake well before each use
- Ocular (age >= 3 years old)
- Use 1 drop in each each eye twice daily
VI. Adverse Effects: Nasal
-
Somnolence (11%)
- May affect safety in driving and hazardous activities
- Bitter Taste (20%)
- Headache (15%)
- Nasal burning (4%)
- Pharyngitis (4%)
VII. Adverse Effects: Ophthalmic
- Eye burning or stinging (30%, transient)
- Headaches (15%)
- Bitter taste (10%)
VIII. Safety
- Pregnancy Category C
- Unknown safety in Lactation
IX. Resources
- Azelastine Hydrochloride Nasal Spray (DailyMed)
- Azelastine Hydrochloride Ophthalmic Solution (DailyMed)
Images: Related links to external sites (from Bing)
Related Studies
| azelastine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| AZELASTINE 0.1% (137 MCG) SPRY | Generic | $0.29 per ml |
| AZELASTINE 0.15% NASAL SPRAY | Generic | $0.92 per ml |
| AZELASTINE HCL 0.05% DROPS | Generic | $1.06 per ml |
Ontology: azelastine (C0052762)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C020976 |
| SnomedCT | 108644000, 372520005 |
| English | 4-(p-chlorobenzyl)-2-(N-methylperhydroazepinyl-(4))-1-(2H)-phthalazinone, azelastine, azelastine [Chemical/Ingredient], 4-(p-Chlorobenzyl)-2-(hexahydro-1-methyl-1H-azepin-4-yl)-1-(2H)-phthalazinone, AZELASTINE, Azelastine, Azelastine (product), Azelastine (substance) |
| Spanish | azelastina (producto), azelastina (sustancia), azelastina |
Ontology: azelastine nasal (C0717461)
| Concepts | Clinical Drug (T200) |
| English | azelastine nasal |
Ontology: Azelastine hydrochloride (C0771004)
| Definition (NCI) | The hydrochloride salt form of azelastine, a phthalazinone derivative with antihistaminergic activity. Azelastine hydrochloride competes with histamine for the H1 receptor, thereby diminishing the actions of histamine on effector cells and decreasing the histamine-mediated symptoms of allergic reaction, such as bronchoconstriction, vasodilation, increased capillary permeability and spasmodic contractions of gastrointestinal smooth muscle. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C020976 |
| SnomedCT | 331056008, 330538009, 391803007, 108646003 |
| English | 1(2H)-Phthalazinone, 4-((4-Chlorophenyl)methyl)-2-(hexahydro-1-methyl-1H-azepin-4-yl)-, Monohydrochloride, azelastine hydrochloride, azelastine hydrochloride (medication), antihistamines azelastine hydrochloride, Azelastine hydrochloride [eye], AZELASTINE HYDROCHLORIDE, azelastine hcl, azelastine HCl, Azelastine hydrochloride [eye] (product), Azelastine hydrochloride - chemical (substance), Azelastine hydrochloride - chemical, Azelastine hydrochloride, Azelastine hydrochloride (substance), 4-((4-chlorophenyl)methyl)-2- (hexahydro-1-methyl-1H-azepin-4-yl)-1(2H)- phthalazinone HCl, Azelastine hydrochloride [dup] (substance), Azelastine hydrochloride [eye] (substance), Azelastine Hydrochloride |
| Spanish | clorhidrato de azelastina (uso oftálmico), clorhidrato de azelastina (uso oftálmico) (producto), clorhidrato de azelastina (ocular) (producto), clorhidrato de azelastina (ocular), clorhidrato de azelastina (sustancia), clorhidrato de azelastina |
Ontology: azelastine ophthalmic (C0875909)
| Concepts | Clinical Drug (T200) |
| English | azelastine ophthalmic |
