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 |