Azelastine nasal spray for post nasal drip

Astelin (generic name: Azelastine Hydrochloride, brand name: Astepro) is an antihistamine that's used to relieve nasal symptoms like runny/itching/stuffy nose, sneezing, and post-nasal drip caused by short-term seasonal allergies, year-round allergic rhinitis (hay fever), or other nasal conditions. Astelin is recommended for adults and children who are at least 12 years of age.

Astelin was approved by the U.S. Food and Drug Administration (FDA) in 1996 to treat seasonal allergic rhinitis and in 2000 as a treatment for vasomotor rhinitis, also known as nonallergic rhinitis. Astepro differs from astelin in that it contains azelastine HCL, the active ingredient in azelastine nasal spray. As well, azelastine contains extra formulation ingredients that give it a sweeter, less bitter taste.

How Does It Work?

Astelin works in the same way as other antihistamine medications by blocking natural substances called histamines that irritate the nasal cavity and cause nasal symptoms. Histamines are the culprits behind signature allergic reactions like runny nose, itchy and watery eyes, and congestion. Common home allergens include pollen, molds, pet dander, and dust mites. By blocking histamine receptors in the body, antihistamines greatly reduce the chaos histamine can wreak on the nasal cavity.

Azelastine Nasal

Astelin differs from other allergic rhinitis and allergy medications in that it’s an intranasal spray that delivers antihistamine medication directly to the nasal cavity. In its nasal spray form, astelin is known as azelastine nasal or azelastine HCL. 

Like all nasal sprays, a spray pump delivers a fine mist that coats the nasal cavity with medication. When using astelin nasal spray for the first time, it's recommended that you first prime the mist; that is, squeeze down lightly on the spray pump a few times until you see a fine mist. 

Use astelin exactly as directed on the label, or as prescribed by your healthcare provider. Doctors recommend intranasal doses of 1 to 2 sprays into each nostril twice daily, or 2 sprays in each nostril once a day. Each spray delivers 137 to 205.5 micrograms of azelastine. Do not use in larger or smaller amounts or for longer than recommended. Should you miss a dose, skip the missed dose until it is time for your next dose. Never use two doses at one time. Store the bottle upright at room temperature with the pump tightly closed and out of the reach of children.

What Are the Side Effects of Astelin?

Some of the most common side effects are headaches, nasal burning, sneezing, dry mouth, asthma, myalgia, conjunctivitis, pharyngitis, dizziness, weight gain, dry mouth, nosebleeds, hives, watery eyes, drowsiness, and more. Astelin can also cause sleepiness, so avoid driving until you know how the medication will affect you. Use with alcohol or other central nervous system depressants is not recommended.

Ask your healthcare provider or pharmacist for more information on possible side effects or allergic reactions, or how astelin interacts with OTC or prescription drugs you may already be taking. An overdose of azelastine nasal is not deadly but like any overdose, it can be serious. In this event, seek medical attention or contact your local poison control center. The Poison Help Hotline is 1-800-222-1222. Adverse effects can be reported to the FDA at 1-800-FDA-1088.

Pregnancy Issues

Before using Astelin, tell your doctor if you are pregnant or plan to become pregnant. Using Astelin while you are breastfeeding may give breast milk a bitter taste. If you breastfeed while using this medicine, watch for signs that your baby is not nursing as well. Get professional medical advice about the best way to feed your baby if you are taking Astelin.

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  1. Azelastine nasal spray is available as a generic drug and as brand-name drugs. Brand names: Astepro and Astelin.
  2. Azelastine comes in the form of a nasal spray and eye drops.
  3. Azelastine nasal spray is a prescription drug used to treat allergy symptoms in the nose. These can include sneezing or runny nose.

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.

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

  • Form: nasal spray
  • Strengths: 0.1%, 0.15%

Brand: Astepro

  • Form: nasal spray
  • Strengths: 0.1%, 0.15%

Brand: Astelin

  • Form: nasal spray
  • Strengths: 0.1%

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.

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.

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.

Who should not use azelastine nasal spray?

Each spray contains 205.5 micrograms (mcg) of azelastine. Children younger than 6 years of age—Use is not recommended.

Can azelastine thicken mucus?

This observation also raises the question that azelastine might predispose to the development of bacterial upper respiratory infection. Possible causes might be irritation to the mucosal barrier, thickening of mucus, and/or interference with normal mucociliary function.

Which is better Flonase or azelastine?

Flonase (fluticasone) is a good first-choice treatment for allergies of the nose, but long-term use can increase the risk of nosebleeds. Astepro (azelastine) is good for relieving nasal symptoms during allergy season.

Does azelastine dry mucus?

Azelastine (Astelin, Astepro) is an intranasal antihistamine that can reduce nasal congestion and runny nose. It may cause sleepiness. But when it's taken with intranasal steroids, it works very well for postnasal drip. Ipratropium (Atrovent) works by stopping the production of mucus.