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Azelastine nasal

Adult dosage (ages 18 years and older)

Azelastine, Nasal Spray

Azelastine nasal spray is a prescription drug. It’s available as the brand-name drugs Astepro and Astelin. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, the brand-name drug and the generic version may be available in different forms and strengths.

Azelastine nasal spray may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it’s used

Azelastine nasal spray is used to provide relief from allergy symptoms. These can include sneezing and runny nose.

How it works

Azelastine belongs to a class of drugs called antihistamines. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Azelastine works by inhibiting the release of a chemical called histamine from the cells in your body. This helps relieve allergic symptoms such as sneezing or runny nose.

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Azelastine nasal spray may cause drowsiness. It may also cause other side effects.

More common side effects

The more common side effects of azelastine nasal spray can include:

  • fever
  • bitter taste in your mouth
  • nose pain or discomfort
  • nosebleeds
  • headache
  • sneezing
  • drowsiness
  • upper respiratory tract infection
  • cough
  • vomiting
  • ear infection
  • skin rash
  • sore throat

These effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Azelastine nasal spray can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Drug forms and strengths

Generic: Azelastine

Brand: Astepro

Brand: Astelin

Dosage for seasonal allergic rhinitis (nasal allergies)

Adult dosage (ages 18 years and older)

  • Typical dosage for 0.1% or 0.15%: 1 or 2 sprays per nostril, 2 times per day, OR
  • Typical dosage for 0.15%: 2 sprays per nostril, once per day.
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Child dosage (ages 12–17 years)

  • Typical dosage for 0.1% or 0.15%: 1 or 2 sprays per nostril, 2 times per day, OR
  • Typical dosage for 0.15%: 2 sprays per nostril, once per day.

Child dosage (ages 6–11 years)

  • Typical dosage for 0.1% or 0.15%: 1 spray per nostril, 2 times per day.

Child dosage (ages 2–5 years)

  • Typical dosage for 0.1%: 1 spray per nostril, 2 times per day.

Child dosage (ages 0–1 years)

Azelastine nasal spray should not be used to treat seasonal allergies in children younger than 2 years of age.

Dosage for year-round allergic rhinitis (nasal allergies)

Adult dosage (ages 18 years and older)

  • Typical dosage for 0.15%: 2 sprays per nostril, 2 times per day.

Child dosage (ages 12–17 years)

  • Typical dosage for 0.15%: 2 sprays per nostril, 2 times per day.

Child dosage (ages 6–11 years)

  • Typical dosage for 0.1% or 0.15%: 1 spray per nostril, 2 times per day.

Child dosage (ages 6 months–5 years)

  • Typical dosage for 0.1%: 1 spray per nostril, 2 times per day.

Child dosage (ages 0–6 months)

It hasn’t been confirmed that azelastine nasal spray is safe and effective for use in children younger than 6 months in the treatment of year-round allergies.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

This drug comes with several warnings.

Drowsiness warning

Azelastine nasal spray causes drowsiness. Don’t drive, use machinery, or do other dangerous activities until you know how azelastine affects you.

Also, don’t drink alcohol or take other medications that may make you feel drowsy while using this drug. It may make your drowsiness worse.

Alcohol interaction warning

Don’t drink alcohol or take other medications that may cause drowsiness while using azelastine nasal spray. It may make your drowsiness worse.

Warning for pregnant women

There haven’t been enough studies done in humans to be certain how this drug might affect a fetus.

Research in animals has shown negative effects to the fetus when the mother takes the drug. However, animal studies don’t always predict the way humans would respond.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

Call your doctor if you become pregnant while taking this drug.

Warning for women who are breastfeeding

Azelastine may pass into breast milk and cause side effects in a child who is breastfed.

Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

Azelastine is used for long-term treatment. It comes with risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all: Your allergy symptoms may return. You may continue to have a runny or stuffy nose.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include drowsiness.

If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

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How to tell if the drug is working: Your allergy symptoms should improve. These include sneezing or a runny nose.

Keep these considerations in mind if your doctor prescribes azelastine for you.

General

Take this drug at the time(s) recommended by your doctor.

Storage

  • Keep azelastine nasal spray at a temperature between 68°F and 77°F (20°C to 25°C).
  • Store the azelastine bottle in an upright position.
  • Don’t freeze azelastine.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

  • Your doctor or pharmacist will show you how to use the nasal spray correctly.
  • Spray azelastine into your nose only. Don’t spray it into your eyes or mouth.

Availability

Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Last medically reviewed on October 12, 2018

Azelastine nasal

Generic name: azelastine nasal [ a-ZEL-uh-steen ]
Brand names: Astepro, Astelin, Childrens Astepro Allergy, Astepro Allergy
Dosage form: nasal spray (137 mcg/inh; 205.5 mcg/inh)
Drug class: Nasal antihistamines and decongestants

Medically reviewed by Drugs.com on Jun 21, 2021. Written by Cerner Multum.

What is azelastine nasal?

Azelastine nasal (for the nose) is an antihistamine that is used to treat sneezing, runny or stuffy nose, itching, and other nasal symptoms of allergies.

Azelastine nasal is for use in adults and children at least 6 years old.

Azelastine nasal may also be used for purposes not listed in this medication guide.

Warnings

Follow all directions on the label and package. Use exactly as directed.

Before taking this medicine

Ask a doctor before using azelastine nasal if you are pregnant or breastfeeding.

How should I use azelastine nasal?

Use exactly as directed on the label, or as prescribed by your doctor.

Before your first use, squeeze the bottle 2 or more times away from your face, until a fine mist appears. Repeat this whenever the nasal spray hasn’t been used for longer than 3 days.

To use the nasal spray:

  • With your head upright insert the tip of the bottle into the nostril and press your other nostril closed. Breathe in and gently spray the medicine into your nose. Use in your other nostril if directed.
  • If the spray gets in your eyes or mouth or on your skin, rinse with water.
  • Do not blow your nose for a few minutes.
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Do not allow a young child to use this medicine without help from an adult.

Call your doctor if your symptoms do not improve, or if they get worse.

Store this medicine in an upright position at room temperature. Do not freeze.

Throw away the medicine after you have used 200 sprays, even if there is still medicine left in the bottle.

What happens if I miss a dose?

Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

Using too much azelastine nasal spray may cause drowsiness.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the medicine. Swallowing azelastine nasal could cause serious harm to a child.

What should I avoid while taking azelastine nasal?

Avoid getting azelastine nasal in your eyes.

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Avoid drinking alcohol.

Azelastine nasal side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have signs of an ear infection:

  • ear pain or full feeling;
  • drainage from the ear;
  • trouble hearing; or
  • fever.

Common side effects of azelastine nasal may include:

  • drowsiness, tiredness;
  • a bitter taste in your mouth;
  • mouth or throat pain;
  • nasal pain or discomfort, nosebleeds;
  • cold symptoms such as stuffy nose, sneezing, cough, sore throat;
  • fever, headache;
  • vomiting; or
  • skin itching around your nose.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Azelastine nasal dosing information

Usual Adult Dose for Allergic Rhinitis:

0.1% spray: 1 or 2 sprays in each nostril twice a day
0.15% spray: 1 or 2 sprays in each nostril twice a day or 2 sprays in each nostril once a day

0.15% spray: 2 sprays in each nostril twice a day

Use: Perennial allergic rhinitis

Usual Pediatric Dose for Allergic Rhinitis:

2 to 5 years:
0.1% spray: 1 spray in each nostril twice a day
6 to 11 years:
0.1% spray and 0.15% spray: 1 spray in each nostril twice a day

Use: Seasonal allergic rhinitis

6 months to 5 years:
0.1% spray: 1 spray in each nostril twice a day
6 to 11 years:
0.1% spray and 0.15% spray: 1 spray in each nostril twice a day

Use: Perennial allergic rhinitis

What other drugs will affect azelastine nasal?

Using azelastine nasal with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Other drugs may affect azelastine nasal, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.

Where can I get more information?

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

More about azelastine nasal

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