Uses
Seasonal Allergic Rhinitis
Symptomatic treatment of seasonal allergic rhinitis (e.g., hay fever). Intranasal azelastine is at least as effective as oral antihistamines (e.g., cetirizine) or intranasal corticosteroids. May provide improvement of ocular manifestations, possibly secondary to systemic absorption of the drug.
Nonallergic Rhinitis
Symptomatic treatment of nonallergic (vasomotor) rhinitis.
Allergic Conjunctivitis
Symptomatic relief of ocular itching associated with allergic conjunctivitis.
Dosage and Administration
Administration
Administer nasal solution intranasally twice daily, using a spray pump.
Apply ophthalmic solution topically to the eye twice daily. Ophthalmic solution is not for injection or oral use.
Intranasal Administration
Before initial use, prime the pump until a fine mist appears, using up to 4 actuations of the pump. Administration of solution in a stream of liquid rather than as a mist may fail to provide maximum benefit and may cause discomfort.
If inhaler has not been used for ≥3 days, reprime pump with 2 actuations or until a fine mist appears. Reprime pump when the spray pump is inserted into the second bottle.
To actuate the pump, hold the bottle in one hand, with 2 fingers on the shoulders of the pump unit and the thumb on the bottom of the bottle. Press the bottom firmly and rapidly upward with the thumb to produce a fine mist.
Prior to administration, gently blow the nose to clear nasal passages. Insert nasal spray tip ¼ to ½ inch into a nostril, tilt head slightly forward while holding the bottle vertically upright, and aim spray tip toward the back of the nose. Rapidly and firmly press and actuate pump into the nostril while holding the other nostril closed, gently sniffing at the same time; do not tilt head back after dosing.
Repeat procedure for the other nostril. Provide a second spray into each nostril, beginning with the first nostril. Alternate nostrils between each actuation of nasal spray.
Use caution to avoid spraying nasal spray into the eyes.
Ophthalmic Administration
Remove soft contact lenses prior to administration of each dose (since benzalkonium chloride may be absorbed by the lenses); may reinsert lenses 10 minutes after administration if eyes are not red.
Avoid contamination of the solution container.
Dosage
Available as azelastine hydrochloride; dosage expressed in terms of the salt.
When properly primed, the nasal spray pump delivers approximately 100 metered doses per bottle.
Pediatric Patients
Seasonal Allergic Rhinitis
Intranasal
Children ≥12 years of age: 2 sprays (274 mcg) in each nostril twice daily.
Children 5–11 years of age: 1 spray (137 mcg) in each nostril twice daily.
Nonallergic Rhinitis
Intranasal
Children ≥12 years of age: 2 sprays (274 mcg) in each nostril twice daily.
Allergic Conjunctivitis
Ophthalmic
Children ≥3 years of age: 1 drop of a 0.05% solution in the affected eye(s) twice daily.
Adults
Seasonal Allergic Rhinitis
Intranasal
2 sprays (274 mcg) in each nostril twice daily.
Nonallergic Rhinitis
Intranasal
2 sprays (274 mcg) in each nostril twice daily.
Allergic Conjunctivitis
Ophthalmic
1 drop of a 0.05% solution in the affected eye(s) twice daily.
Special Populations
Geriatric Patients
Cautious dosing of nasal solution recommended.
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