Azelastine | Side Effects, Dosage, Uses & More
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Generic Name:

azelastine, Nasal solution, spray

All Brands

  • Astelin (Discontinued)
  • Astepro
A discontinued drug is a drug that has been taken off the market due to safety issues, shortage of raw materials, or low market demand.
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Highlights for azelastine

Nasal solution, spray
1

Azelastine nasal spray is a prescription drug used to treat allergy symptoms in the nose. These can include sneezing or runny nose.

2

Azelastine nasal spray is available as a generic drug. It’s also available as the brand-name drug Astepro.

3

The more common side effects of this drug can include nose pain or discomfort, fever, or a bitter taste in the mouth.

4

Azelastine causes drowsiness. Don’t drink alcohol or take other medicines that may cause you to feel drowsy while using azelastine. It may make your drowsiness worse.

5

Azelastine nasal spray may be used with other medications to treat your allergy symptoms.

IMPORTANT INFORMATION

Drowsiness

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.

What is azelastine?

Azelastine nasal spray is a prescription drug. It’s available as the brand-name drug Astepro. It’s also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in all strengths or forms as the brand-name version. Talk to your doctor to see if the generic version will work for you.

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 include sneezing and runny nose.

How it works

Azelastine belongs to a class of drugs called antihistamines.

More Details

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 Side Effects

Nasal solution, spray

More Common Side Effects

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

  • fever

  • bitter taste in the mouth

  • nose pain or discomfort

  • nosebleeds

  • headache

  • sneezing

  • drowsiness

  • upper respiratory tract infection

  • cough

  • vomiting

  • ear infection

  • skin rash

  • sore throat

If these effects are mild, they 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.

Pharmacist's Advice
Healthline Pharmacist Editorial Team

Azelastine nasal spray may cause drowsiness.

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.
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azelastine May Interact with Other Medications

Nasal solution, spray

Azelastine 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.

Alcohol interaction

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

Medications that might interact with this drug

Antifungal drugs

When used with azelastine nasal spray, certain drugs used to treat fungal infections can increase the levels of azelastine in your body. This raises your risk of side effects from azelastine. Examples of these drugs include:

  • ketoconazole
  • itraconazole
  • fluconazole

Stomach acid drugs

Cimetidine is used to treat problems with stomach acid. When used with azelastine nasal spray, it can cause increased amounts of azelastine in your body. This raises your risk of side effects.

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.
Azelastine warnings
Pregnant women
Pregnant women

Azelastine is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

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.

Women who are breast-feeding
Women who are breast-feeding

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

Talk to your doctor if you breast-feed your child. You may need to decide whether to stop breast-feeding or stop taking this medication.

call doctor
When to call the doctor

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

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How to Take azelastine (Dosage)

Nasal solution, spray

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

What are you taking this medication for?

Seasonal allergic rhinitis (nasal allergies)

Brand: Astepro nasal spray

Form: Nasal spray
Strengths: 0.15%

Generic: Azelastine nasal spray

Form: Nasal spray
Strengths: 0.15%, 0.1%
Adult dosage (ages 18 years and older)

Typical dosage:

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

Typical dosage:

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

Year-round allergic rhinitis (nasal allergies)

Brand: Astepro nasal spray

Form: Nasal spray
Strengths: 0.15%

Generic: Azelastine nasal spray

Form: Nasal spray
Strengths: 0.15%, 0.1%
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 people 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 to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Azelastine nasal spray 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 local poison control center. 

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.

How to tell if the drug is working

Your allergy symptoms should improve. These include sneezing or a runny nose.

Azelastine nasal spray is used for long-term treatment.

Important considerations for taking azelastine
timing
Take this drug at the time(s) recommended by your doctor
storage
Store this drug carefully
See Details
refillable
A prescription for this medication is refillable
See Details
travel
Travel
See Details
self-management
Self-management
See Details
not usually stocked
Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead.
prior authorization
Insurance
See Details

Store this drug carefully

  • 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.

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 box 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.

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.

Are there any alternatives?

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.

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How Much Does azelastine Cost?

Nasal solution, spray

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Lowest price for azelastine

Walmart $28.04
Membership warehouse $30.32
Kroger Pharmacy $35.26
These prices represent the lowest priced national pharmacies for azelastine on GoodRx. They may be lower than your insurance.

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These prices represent the lowest priced national pharmacies for azelastine on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on November 10, 2015

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.
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