Dosing & Uses
Dosage Forms & Strengths
nasal spray
- 0.1% (137mcg/spray) (Astelin Nasal Spray [Rx]; Astepro [Rx], generic [Rx])
- 0.15% (205.5mcg/spray) (Astepro Allergy [OTC]; generic [Rx])
Seasonal Allergic Rhinitis
Astelin 0.1%: 1-2 sprays per nostril q12hr, OR
Astepro 0.15%: 2 sprays per nostril qDay
Perennial Allergic Rhinitis
Astepro 0.15%: 2 sprays per nostril q12hr
Vasomotor Rhinitis
Astelin 0.1%: 2 sprays per nostril q12hr
Dosage Forms & Strengths
nasal spray
- 0.1% (137mcg/spray) (Astelin Nasal Spray [Rx]; Astepro [Rx], generic [Rx])
- 0.15% (205.5mcg/spray) (Astepro Allergy [OTC]; Children’s Astepro Allergy [OTC]; generic [Rx])
Seasonal Allergic Rhinitis
Astelin
- <5 years: Safety and efficacy not established
- 5 to <12 years: 1 spray per nostril q12hr
- ≥12 years: 1-2 sprays per nostril q12hr
Astepro
- <2 years: Safety and efficacy not established
- 2 to <6 years: 0.1%; 1 spray per nostril q12hr
- 6-12 years: 0.1% or 0.15%; 1 spray per nostril q12hr
-
≥12 years
- 0.1% or 0.15%: 1 or 2 sprays per nostril q12hr, or
- 0.15%: 2 sprays per nostril qDay
Perennial Allergic Rhinitis
Astepro
- <6 months: Safety and efficacy not established
- 6 months to <6 years: 0.1%; 1 spray per nostril q12hr
- 6 to <12 years: 0.1% or 0.15%; 1 spray per nostril q12hr
- ≥12 years: 0.15%; 2 sprays per nostril q12hr
Vasomotor Rhinitis
Astelin
- <12 years: Safety and efficacy not established
- ≥12 years: 2 sprays per nostril q12hr
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (2)
- calcium/magnesium/potassium/sodium oxybates
azelastine, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Coadministration with alcohol or sedative hypnotics are contraindicated because of additive CNS depression.
- sodium oxybate
azelastine, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Coadministration with alcohol or sedative hypnotics are contraindicated because of additive CNS depression.
Serious - Use Alternative (4)
- clonidine
clonidine, azelastine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Enhanced CNS depressant effects.
- fedratinib
azelastine will increase the level or effect of fedratinib by Other (see comment). Avoid or Use Alternate Drug. Avoid coadministration of fedratinib (a CYP3A4 and CYP2C19 substrate) with dual CYP3A4 and CYP2C19 inhibitor. Effect of coadministration of a dual CYP3A4 and CYP2C19 inhibitor with fedratinib has not been studied.
- lonafarnib
azelastine will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.
- stiripentol
stiripentol, azelastine. Either increases effects of the other by sedation. Avoid or Use Alternate Drug. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.
Monitor Closely (186)
- albuterol
azelastine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- alfentanil
azelastine and alfentanil both increase sedation. Use Caution/Monitor.
- alprazolam
azelastine and alprazolam both increase sedation. Use Caution/Monitor.
- amitriptyline
azelastine and amitriptyline both increase sedation. Use Caution/Monitor.
- amobarbital
azelastine and amobarbital both increase sedation. Use Caution/Monitor.
- amoxapine
azelastine and amoxapine both increase sedation. Use Caution/Monitor.
- apomorphine
azelastine and apomorphine both increase sedation. Use Caution/Monitor.
- arformoterol
azelastine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- aripiprazole
azelastine and aripiprazole both increase sedation. Use Caution/Monitor.
- armodafinil
azelastine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- atogepant
azelastine will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- avapritinib
azelastine will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- axitinib
azelastine increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- baclofen
azelastine and baclofen both increase sedation. Use Caution/Monitor.
- belladonna and opium
azelastine and belladonna and opium both increase sedation. Use Caution/Monitor.
- benperidol
azelastine and benperidol both increase sedation. Use Caution/Monitor.
- benzphetamine
azelastine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- brompheniramine
azelastine and brompheniramine both increase sedation. Use Caution/Monitor.
- buprenorphine
azelastine and buprenorphine both increase sedation. Use Caution/Monitor.
- buprenorphine buccal
azelastine and buprenorphine buccal both increase sedation. Use Caution/Monitor.
- butabarbital
azelastine and butabarbital both increase sedation. Use Caution/Monitor.
- butalbital
azelastine and butalbital both increase sedation. Use Caution/Monitor.
- butorphanol
azelastine and butorphanol both increase sedation. Use Caution/Monitor.
- caffeine
azelastine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbinoxamine
azelastine and carbinoxamine both increase sedation. Use Caution/Monitor.
- carisoprodol
azelastine and carisoprodol both increase sedation. Use Caution/Monitor.
- chloral hydrate
azelastine and chloral hydrate both increase sedation. Use Caution/Monitor.
- chlordiazepoxide
azelastine and chlordiazepoxide both increase sedation. Use Caution/Monitor.
- chlorpheniramine
azelastine and chlorpheniramine both increase sedation. Use Caution/Monitor.
- chlorpromazine
azelastine and chlorpromazine both increase sedation. Use Caution/Monitor.
- chlorzoxazone
azelastine and chlorzoxazone both increase sedation. Use Caution/Monitor.
- cimetidine
cimetidine increases effects of azelastine by decreasing metabolism. Use Caution/Monitor.
- cinnarizine
azelastine and cinnarizine both increase sedation. Use Caution/Monitor.
- clemastine
azelastine and clemastine both increase sedation. Use Caution/Monitor.
- clobazam
azelastine, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).
- clomipramine
azelastine and clomipramine both increase sedation. Use Caution/Monitor.
- clonazepam
azelastine and clonazepam both increase sedation. Use Caution/Monitor.
- clorazepate
azelastine and clorazepate both increase sedation. Use Caution/Monitor.
- clozapine
azelastine and clozapine both increase sedation. Use Caution/Monitor.
- codeine
azelastine and codeine both increase sedation. Use Caution/Monitor.
- cyclizine
azelastine and cyclizine both increase sedation. Use Caution/Monitor.
- cyclobenzaprine
azelastine and cyclobenzaprine both increase sedation. Use Caution/Monitor.
- cyproheptadine
azelastine and cyproheptadine both increase sedation. Use Caution/Monitor.
- dantrolene
azelastine and dantrolene both increase sedation. Use Caution/Monitor.
- desipramine
azelastine and desipramine both increase sedation. Use Caution/Monitor.
- dexchlorpheniramine
azelastine and dexchlorpheniramine both increase sedation. Use Caution/Monitor.
- dexfenfluramine
azelastine increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dexmedetomidine
azelastine and dexmedetomidine both increase sedation. Use Caution/Monitor.
- dexmethylphenidate
azelastine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextroamphetamine
azelastine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextromoramide
azelastine and dextromoramide both increase sedation. Use Caution/Monitor.
- diamorphine
azelastine and diamorphine both increase sedation. Use Caution/Monitor.
- diazepam
azelastine and diazepam both increase sedation. Use Caution/Monitor.
- diethylpropion
azelastine increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- difenoxin hcl
azelastine and difenoxin hcl both increase sedation. Use Caution/Monitor.
- dimenhydrinate
azelastine and dimenhydrinate both increase sedation. Use Caution/Monitor.
- diphenhydramine
azelastine and diphenhydramine both increase sedation. Use Caution/Monitor.
- diphenoxylate hcl
azelastine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- dipipanone
azelastine and dipipanone both increase sedation. Use Caution/Monitor.
- dobutamine
azelastine increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dopamine
azelastine increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dopexamine
azelastine increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dosulepin
azelastine and dosulepin both increase sedation. Use Caution/Monitor.
- doxepin
azelastine and doxepin both increase sedation. Use Caution/Monitor.
- doxylamine
azelastine and doxylamine both increase sedation. Use Caution/Monitor.
- droperidol
azelastine and droperidol both increase sedation. Use Caution/Monitor.
- ephedrine
azelastine increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine
azelastine increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine racemic
azelastine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- estazolam
azelastine and estazolam both increase sedation. Use Caution/Monitor.
- ethanol
azelastine and ethanol both increase sedation. Use Caution/Monitor.
- etomidate
etomidate and azelastine both increase sedation. Use Caution/Monitor.
- fenfluramine
azelastine increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- finerenone
azelastine will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or weak CYP3A4 inhibitors. Adjust finererone dosage as needed.
- flibanserin
azelastine will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.
- fluphenazine
azelastine and fluphenazine both increase sedation. Use Caution/Monitor.
- flurazepam
azelastine and flurazepam both increase sedation. Use Caution/Monitor.
- formoterol
azelastine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- gotu kola
gotu kola increases effects of azelastine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- haloperidol
azelastine and haloperidol both increase sedation. Use Caution/Monitor.
- hawthorn
hawthorn increases effects of azelastine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- hops
hops increases effects of azelastine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- hyaluronidase
azelastine decreases effects of hyaluronidase by Other (see comment). Use Caution/Monitor. Comment: Antihistamines, when given in large systemic doses, may render tissues partially resistant to the action of hyaluronidase. Patients may require larger amounts of hyaluronidase for equivalent dispersing effect.
- hydromorphone
azelastine and hydromorphone both increase sedation. Use Caution/Monitor.
- hydroxyzine
azelastine and hydroxyzine both increase sedation. Use Caution/Monitor.
- iloperidone
azelastine and iloperidone both increase sedation. Use Caution/Monitor.
- imipramine
azelastine and imipramine both increase sedation. Use Caution/Monitor.
- isavuconazonium sulfate
azelastine will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- isoproterenol
azelastine increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ivacaftor
azelastine increases levels of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor when coadministered with weak CYP3A4 inhibitors .
- kava
kava increases effects of azelastine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- ketotifen, ophthalmic
azelastine and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.
- lemborexant
azelastine will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.
- levalbuterol
azelastine increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- levorphanol
azelastine and levorphanol both increase sedation. Use Caution/Monitor.
- lisdexamfetamine
azelastine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lofepramine
azelastine and lofepramine both increase sedation. Use Caution/Monitor.
- lofexidine
azelastine and lofexidine both increase sedation. Use Caution/Monitor.
- lomitapide
azelastine increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.
- loprazolam
azelastine and loprazolam both increase sedation. Use Caution/Monitor.
- lorazepam
azelastine and lorazepam both increase sedation. Use Caution/Monitor.
- lormetazepam
azelastine and lormetazepam both increase sedation. Use Caution/Monitor.
- loxapine
azelastine and loxapine both increase sedation. Use Caution/Monitor.
- loxapine inhaled
azelastine and loxapine inhaled both increase sedation. Use Caution/Monitor.
- lurasidone
lurasidone, azelastine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.
- maprotiline
azelastine and maprotiline both increase sedation. Use Caution/Monitor.
- marijuana
azelastine and marijuana both increase sedation. Use Caution/Monitor.
- mavacamten
azelastine will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose.
- melatonin
azelastine and melatonin both increase sedation. Use Caution/Monitor.
- meperidine
azelastine and meperidine both increase sedation. Use Caution/Monitor.
- meprobamate
azelastine and meprobamate both increase sedation. Use Caution/Monitor.
- metaproterenol
azelastine increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metaxalone
azelastine and metaxalone both increase sedation. Use Caution/Monitor.
- methadone
azelastine and methadone both increase sedation. Use Caution/Monitor.
- methamphetamine
azelastine increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methocarbamol
azelastine and methocarbamol both increase sedation. Use Caution/Monitor.
- methylenedioxymethamphetamine
azelastine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- midazolam
azelastine and midazolam both increase sedation. Use Caution/Monitor.
- midazolam intranasal
azelastine will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.
- midodrine
azelastine increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mirtazapine
azelastine and mirtazapine both increase sedation. Use Caution/Monitor.
- modafinil
azelastine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- morphine
azelastine and morphine both increase sedation. Use Caution/Monitor.
- motherwort
azelastine and motherwort both increase sedation. Use Caution/Monitor.
- moxonidine
azelastine and moxonidine both increase sedation. Use Caution/Monitor.
- nabilone
azelastine and nabilone both increase sedation. Use Caution/Monitor.
- nalbuphine
azelastine and nalbuphine both increase sedation. Use Caution/Monitor.
- norepinephrine
azelastine increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nortriptyline
azelastine and nortriptyline both increase sedation. Use Caution/Monitor.
- olanzapine
azelastine and olanzapine both increase sedation. Use Caution/Monitor.
- opium tincture
azelastine and opium tincture both increase sedation. Use Caution/Monitor.
- orphenadrine
azelastine and orphenadrine both increase sedation. Use Caution/Monitor.
- oxazepam
azelastine and oxazepam both increase sedation. Use Caution/Monitor.
- oxycodone
azelastine and oxycodone both increase sedation. Use Caution/Monitor.
- oxymetazoline intranasal
oxymetazoline intranasal, azelastine. Other (see comment). Modify Therapy/Monitor Closely. Comment: Oxymetazoline has been known to slow the rate, but not affect the extent of absorption of concomitantly administered intranasal products. Do not administer other intranasal products with oxymetazoline intranasal.
- oxymorphone
azelastine and oxymorphone both increase sedation. Use Caution/Monitor.
- paliperidone
azelastine and paliperidone both increase sedation. Use Caution/Monitor.
- papaveretum
azelastine and papaveretum both increase sedation. Use Caution/Monitor.
- papaverine
azelastine and papaverine both increase sedation. Use Caution/Monitor.
- passion flower
passion flower increases effects of azelastine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- pentazocine
azelastine and pentazocine both increase sedation. Use Caution/Monitor.
- pentobarbital
azelastine and pentobarbital both increase sedation. Use Caution/Monitor.
- perphenazine
azelastine and perphenazine both increase sedation. Use Caution/Monitor.
- phendimetrazine
azelastine increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenobarbital
azelastine and phenobarbital both increase sedation. Use Caution/Monitor.
- phentermine
azelastine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine
azelastine increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine PO
azelastine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- pholcodine
azelastine and pholcodine both increase sedation. Use Caution/Monitor.
- pimozide
azelastine and pimozide both increase sedation. Use Caution/Monitor.
- pirbuterol
azelastine increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- primidone
azelastine and primidone both increase sedation. Use Caution/Monitor.
- prochlorperazine
azelastine and prochlorperazine both increase sedation. Use Caution/Monitor.
- promethazine
azelastine and promethazine both increase sedation. Use Caution/Monitor.
- propylhexedrine
azelastine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- protriptyline
azelastine and protriptyline both increase sedation. Use Caution/Monitor.
- quazepam
azelastine and quazepam both increase sedation. Use Caution/Monitor.
- quetiapine
azelastine and quetiapine both increase sedation. Use Caution/Monitor.
- ramelteon
azelastine and ramelteon both increase sedation. Use Caution/Monitor.
- risperidone
azelastine and risperidone both increase sedation. Use Caution/Monitor.
- salmeterol
azelastine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- scullcap
azelastine and scullcap both increase sedation. Use Caution/Monitor.
- secobarbital
azelastine and secobarbital both increase sedation. Use Caution/Monitor.
- shepherd's purse
azelastine and shepherd's purse both increase sedation. Use Caution/Monitor.
- sufentanil
azelastine and sufentanil both increase sedation. Use Caution/Monitor.
- tapentadol
azelastine and tapentadol both increase sedation. Use Caution/Monitor.
- tazemetostat
azelastine will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- temazepam
azelastine and temazepam both increase sedation. Use Caution/Monitor.
- terbutaline
azelastine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- thioridazine
azelastine and thioridazine both increase sedation. Use Caution/Monitor.
- thiothixene
azelastine and thiothixene both increase sedation. Use Caution/Monitor.
- tinidazole
azelastine will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- topiramate
azelastine and topiramate both increase sedation. Modify Therapy/Monitor Closely.
- tramadol
azelastine and tramadol both increase sedation. Use Caution/Monitor.
- trazodone
azelastine and trazodone both increase sedation. Use Caution/Monitor.
- triazolam
azelastine and triazolam both increase sedation. Use Caution/Monitor.
- triclofos
azelastine and triclofos both increase sedation. Use Caution/Monitor.
- trifluoperazine
azelastine and trifluoperazine both increase sedation. Use Caution/Monitor.
- trimipramine
azelastine and trimipramine both increase sedation. Use Caution/Monitor.
- triprolidine
azelastine and triprolidine both increase sedation. Use Caution/Monitor.
- valerian
valerian increases effects of azelastine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- xylometazoline
azelastine increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- yohimbine
azelastine increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ziconotide
azelastine and ziconotide both increase sedation. Use Caution/Monitor.
- ziprasidone
azelastine and ziprasidone both increase sedation. Use Caution/Monitor.
- zotepine
azelastine and zotepine both increase sedation. Use Caution/Monitor.
Minor (8)
- ashwagandha
ashwagandha increases effects of azelastine by pharmacodynamic synergism. Minor/Significance Unknown. May enhance CNS depression.
- brimonidine
brimonidine increases effects of azelastine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.
- eucalyptus
azelastine and eucalyptus both increase sedation. Minor/Significance Unknown.
- nettle
nettle increases effects of azelastine by pharmacodynamic synergism. Minor/Significance Unknown. (High dose nettle; theoretical interaction) May enhance CNS depression.
- ruxolitinib
azelastine will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- ruxolitinib topical
azelastine will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- sage
azelastine and sage both increase sedation. Minor/Significance Unknown.
- Siberian ginseng
Siberian ginseng increases effects of azelastine by pharmacodynamic synergism. Minor/Significance Unknown. May enhance CNS depression.
Adverse Effects
>10%
Bitter taste (8-19.7%)
Headache (8-14.8%)
Somnolence (1-11.5%)
Cold symptoms/rhinitis (2-17%)
Cough (11%)
1-10%
Nasal burning (4.1%)
Sneezing (3.1%)
Dry mouth (2.8%)
Nausea (2.8%)
Conjunctivitis (2-5%)
Asthma (5%)
Fatigue (2.3%)
Rhinitis (2.3%)
Pharyngitis (4%)
Dizziness (2%)
Weight increase (2%)
Myalgia (<2%)
<1%
Amenorrhea
Breast pain
Constipation
Contact dermatitis
Eczema
Flushing
Glossitis
Hyperkinesia
Hypertension
Tachycardia
Vertigo
Vomiting
Postmarketing Reports
Anaphylactoid reaction
Application site irritation
Atrial fibrillation
Chest pain
Confusion
Dyspnea
Facial edema
Involuntary muscle contractions
Nasal sores
Palpitations
Paresthesia
Parosmia
Pruritus
Rash
Disturbance or loss of sense of smell and/or taste
Tolerance
Urinary retention
Vision abnormal
Xerophthalmia
Warnings
Contraindications
Documented hypersensitivity
Cautions
May cause CNS depression/drowsiness; use caution when performing tasks requiring mental alertness eg, operating heavy machinery
Avoid administering concurrent CNS depressants that may add to somnolence
Caution in premature newborns and neonates
Pregnancy & Lactation
Pregnancy
Limited data from postmarketing experience over decades of use in pregnant women have not identified any drug associated risks of miscarriage, birth defects, or other adverse maternal or fetal outcomes
Animal data
- In animal reproduction studies, there was no evidence of fetal harm at oral doses approximately 5 times the clinical daily dose; oral administration to pregnant mice, rats, and rabbits, during the period of organogenesis, produced developmental toxicity that included structural abnormalities, decreased embryo-fetal survival, and decreased fetal body weights at doses 270 times and higher than maximum recommended human daily intranasal dose of 1.096 mg; relevance of these findings in animals to pregnant women considered questionable based upon high animal to human dose multiple
Lactation
There are no data on presence in human milk, effects on breastfed infant, or on milk production; breastfed infants should be monitored for signs of milk rejection during use by lactating women; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from drug or from underlying maternal condition
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
H1-receptor antagonist; inhibits release of histamine and other mediators involved in allergic response; may reduce hyperactivity of airways if used intranasally
Absorption
Bioavailability: 40%
Onset: 1-3 hr
Duration: 12 hr
Peak serum time: 2-4 hr
Distribution
Protein bound: 88%
Vd: 14.5 L/kg
Metabolism
Metabolized by hepatic P450
Metabolites: Desmethylazelastine
Elimination
Half-life: 22 hr
Clearance: 0.5 L/hr/kg
Excretion: Feces (75%)
Administration
Intranasal Preparation
Prime with 4 sprays before initial use to obtain fine mist when sprayed; if idle for 3 days, reprime with 2 sprays
Intranasal Administration
For intranasal administration only
Avoid spraying into eyes
Keep head tilted downward when spraying into nostril
Breathe gently and do not tip head back after spraying avoid medicine from running down into throat
May experience bitter taste in mouth after administration
Storage
Store at controlled room temperature 20-25ºC (68-77ºF)
Protect from freezing
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| azelastine nasal - | 205.5 mcg (0.15 %) aerosol |  | |
| azelastine nasal - | 137 mcg (0.1 %) aerosol |  | |
| azelastine nasal - | 137 mcg (0.1 %) aerosol |  | |
| azelastine nasal - | 205.5 mcg (0.15 %) aerosol |  | |
| azelastine nasal - | 205.5 mcg (0.15 %) aerosol |  | |
| azelastine nasal - | 137 mcg (0.1 %) aerosol |  | |
| azelastine nasal - | 137 mcg (0.1 %) aerosol |  | |
| azelastine nasal - | 137 mcg (0.1 %) aerosol |  | |
| azelastine nasal - | 205.5 mcg (0.15 %) aerosol |  | |
| azelastine nasal - | 137 mcg (0.1 %) aerosol |  | |
| azelastine nasal - | 205.5 mcg (0.15 %) aerosol |  | |
| azelastine nasal - | 137 mcg (0.1 %) aerosol |  | |
| azelastine ophthalmic (eye) - | 0.05 % drops |  | |
| azelastine ophthalmic (eye) - | 0.05 % drops |  | |
| azelastine ophthalmic (eye) - | 0.05 % drops |  | |
| azelastine ophthalmic (eye) - | 0.05 % drops |  | |
| azelastine ophthalmic (eye) - | 0.05 % drops |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
azelastine nasal
AZELASTINE SPRAY - NASAL
(AY-ze-LAS-teen)
COMMON BRAND NAME(S): Astelin, Astepro
USES: This medication is used to relieve nasal symptoms such as runny/itching/stuffy nose, sneezing, and post-nasal drip caused by allergies or other conditions. Azelastine belongs to a class of drugs known as antihistamines. It works by blocking certain natural substances called histamines that are responsible for nasal symptoms.
HOW TO USE: Read the Patient Information Leaflet provided by your pharmacist before you start using this medication and each time you get a refill. Follow the illustrated directions for the proper use of this medication. If you have any questions, consult your doctor or pharmacist.Follow the instructions for test sprays in the air if you are using the spray pump for the first time or if you have not used it for 3 days or more. A fine mist is a sign that the spray pump is working properly.Gently blow your nose before using this medication. Use this medication in the nose as directed by your doctor, usually once or twice a day in both nostrils. Do not spray it in your eyes or mouth. The dosage is based on your medical condition, age, and response to treatment.To prevent a bitter taste in your mouth, breathe in gently and do not tilt your head back after using this medication.Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time(s) each day.Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.Keep track of the number of sprays used from the spray pump. Discard the pump after you have used the number of sprays specified on the manufacturer's package.This medication usually begins to work within 3 hours of use.Tell your doctor if you do not get better or if you get worse.
SIDE EFFECTS: A bitter taste in the mouth, drowsiness, tiredness, nasal discomfort, sneezing fits, cough, nose bleeds, runny nose, dry mouth, headache, or red eyes may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that your doctor has prescribed this medication because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before using azelastine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney problems.This drug may make you drowsy. Alcohol or marijuana (cannabis) can make you more drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or other antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: Do not share this medication with others.Ask your doctor for ways to reduce your exposure to substances (such as pollen, pet dander, dust mites, mold, smoke) that can worsen allergy symptoms.
MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Keep the bottle upright with the pump tightly closed. Store at room temperature away from light and moisture. Do not freeze. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised July 2021. Copyright(c) 2022 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
