Astelin (azelastine hydrochloride) is a prescription antihistamine nasal spray approved for the treatment of seasonal and perennial allergic rhinitis in adults and children 5 years of age and older. It works by blocking the action of histamine, a substance in the body that causes allergic symptoms. This medication provides targeted relief directly at the source of nasal allergy discomfort, offering a non-drowsy alternative for many patients seeking to manage sneezing, itchy or runny nose, and nasal congestion. Clinical studies support its efficacy in significantly reducing symptom scores, often within minutes of application, making it a valuable tool for both scheduled and as-needed allergy management.

Features

• Contains azelastine hydrochloride 137 mcg per spray
• Available in a metered-dose spray bottle delivering consistent medication
• Formulated as a clear, isotonic solution
• Preservative-free formulation in its single-dose packaging options
• Designed for nasal administration with a specialized spray tip
• Typically supplied in 30 mL bottles (approximately 200 metered sprays)

Benefits

• Provides rapid relief from nasal allergy symptoms, often within 15 minutes
• Reduces frequency and severity of sneezing, nasal itching, and runny nose
• Helps alleviate nasal congestion through anti-inflammatory effects
• Offers localized treatment with minimal systemic absorption
• Non-sedating formula allows for daytime use without drowsiness concerns
• Effective for both seasonal and year-round allergy sufferers

Common use

Astelin Nasal Spray is primarily prescribed for the management of symptoms associated with allergic rhinitis, including seasonal allergies (hay fever) and perennial allergies caused by indoor allergens such as dust mites, pet dander, and mold. Healthcare providers may also recommend it off-label for vasomotor rhinitis and as adjunctive therapy for nasal polyps. Patients typically use it during allergy seasons or throughout the year depending on their specific allergic triggers and symptom patterns.

Dosage and direction

For adults and children 12 years and older: 1 or 2 sprays per nostril twice daily. For children 5 to 11 years: 1 spray per nostril twice daily. Prime the pump before first use by releasing 4 sprays until a fine mist appears. Gently shake the bottle before each use. Blow nose gently to clear nostrils before administration. Tilt head slightly forward and insert tip into nostril, pointing toward the back of the nose rather than upward. Close the opposite nostril with finger and spray while breathing in gently through the nose. Repeat in other nostril. Avoid blowing nose for 15 minutes after application.

Precautions

Do not use if allergic to azelastine hydrochloride or any inactive ingredients. Use caution when driving or operating machinery until response to medication is known. Avoid alcohol as it may increase drowsiness. Inform your physician if you have kidney or liver disease. Not recommended for children under 5 years. Pregnancy Category C: use only if potential benefit justifies potential risk to fetus. Exercise caution in elderly patients who may be more sensitive to effects. Do not share nasal spray bottle with others to prevent contamination and infection spread.

Contraindications

Hypersensitivity to azelastine hydrochloride or any component of the formulation. Patients with severe renal impairment requiring dosage adjustment monitoring. History of severe adverse reactions to antihistamines. Concurrent use with central nervous system depressants without medical supervision. Not indicated for treatment of asthma exacerbations or status asthmaticus.

Possible side effects

Common side effects (≥2%) include bitter taste (20.3%), somnolence (11.5%), nasal burning (5.0%), headache (4.6%), pharyngitis (3.4%), and dry mouth (3.2%). Less frequent adverse reactions include dizziness, epistaxis, nasal ulceration, nausea, rhinitis, paroxysmal sneezing, and weight gain. Rare but serious side effects may include hypersensitivity reactions, bronchospasm, and vision changes. Most side effects are mild and transient, often diminishing with continued use.

Drug interaction

May potentiate effects of alcohol and other CNS depressants. No clinically significant interactions identified with lorazepam or erythromycin in clinical studies. Theoretical potential for additive effects with other anticholinergic agents. Use caution with monoamine oxidase inhibitors (MAOIs) due to potential enhanced anticholinergic effects. No known interactions with food. Always inform your healthcare provider of all medications, including over-the-counter products and supplements.

Missed dose

If a dose is missed, take it as soon as remembered unless it is nearly time for the next dose. Do not double the dose to make up for a missed one. Resume regular dosing schedule. If multiple doses are missed, contact your healthcare provider for guidance on resumption. Consistent use provides optimal symptom control, particularly during high pollen seasons.

Overdose

Symptoms may include drowsiness, dizziness, nausea, vomiting, and headache. In case of suspected overdose, contact poison control or emergency medical services immediately. Provide supportive care and symptomatic treatment. There is no specific antidote for azelastine overdose. Hemodialysis is unlikely to be effective due to high protein binding. Monitor vital signs and provide appropriate symptomatic management.

Storage

Store at controlled room temperature 20°C to 25°C (68°F to 77°F). Protect from light and freezing. Keep bottle tightly closed and upright. Discard 30 days after opening. Keep out of reach of children and pets. Do not store in bathroom where moisture could affect stability. Do not transfer to another container. Properly discard after expiration date or when empty.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting or changing any medication regimen. Individual results may vary. Proper diagnosis and treatment planning should be conducted by a licensed physician. Not all possible uses, warnings, or interactions are included here.

Reviews

Clinical studies demonstrate Astelin’s effectiveness with 60% of patients reporting significant symptom improvement within 15 minutes. Patient satisfaction surveys indicate high rates of continued use due to rapid action and minimal sedation. Many users report improved quality of life during allergy season. Some patients note the bitter taste diminishes with proper administration technique. Healthcare providers frequently prescribe it as first-line therapy for allergic rhinitis due to its favorable efficacy and safety profile.