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Overview: Nasal azelastine is an antihistamine nasal spray used to treat symptoms, including stuffy nose, runny nose, and sneezing, from allergic rhinitis and nonallergic rhinitis. The most common side effects of nasal azelastine are drowsiness, a bitter taste, and headaches. Do not drive or do other activities that require alertness or coordination until you know how nasal azelastine affects you.

Uses

What is nasal azelastine used for?

Nasal azelastine is commonly used to treat symptoms, including stuffy nose, runny nose, and sneezing, from following conditions.

Nasal azelastine may also be used for other conditions as determined by your health care provider.

How does nasal azelastine work (mechanism of action)?

Nasal azelastine is an antihistamine, which blocks a chemical in your body called histamine. This reduces symptoms like stuffy nose, runny nose, and sneezing.

How is nasal azelastine supplied (dosage forms)?

Brands and other names

  • Astelin
  • Astepro Allergy
  • Children’s Astepro Allergy

Dosage forms and strengths

  • 137 mcg, 205.5 mcg per nasal spray

How should I store nasal azelastine?

Nasal azelastine should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store it upright in a cool, dry place. Do not freeze it.

Side Effects

What are the most common side effects of nasal azelastine?

The most common side effects of nasal azelastine are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Bitter taste
  • Headache
  • Drowsiness or tiredness
  • Unusual touch sensations, such as tingling or burning
  • Runny nose or stuffy nose, sneezing, or sore throat
  • Burning, discomfort, swelling, or inflammation in your nose or sinuses
  • Nosebleeds
  • Nausea
  • Dry mouth
  • Dizziness
  • Weight gain

There may be other side effects of nasal azelastine that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of nasal azelastine?

While less common, the most serious side effects of nasal azelastine are described below, along with what to do if they happen.

Severe Allergic Reactions. Nasal azelastine may cause allergic reactions, which can be serious. Stop using nasal azelastine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Sleepiness. Nasal azelastine can make you sleepy. Do not drive or do other activities that require alertness or coordination until you know how nasal azelastine affects you.

Warnings & Precautions

Who should not use nasal azelastine?

Allergies to Ingredients. People who are allergic to any of the following should not use nasal azelastine.

  • Azelastine
  • Astelin
  • Astepro Allergy
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific nasal azelastine products they stock.

What should I know about nasal azelastine before using it?

If nasal azelastine was prescribed to you by a health care provider, use it as prescribed. If you are using over-the-counter nasal azelastine, follow the instructions that come with the product.

Do not share nasal azelastine that was prescribed for you by a health care provider with other people, even if they have the same condition as you. It may harm them.

Ask your pharmacist or other health care provider to show you how to correctly use, prime, and clean nasal azelastine. Follow the “Instructions for Use” that come with it.

Do not share nasal azelastine with other people, even if they have the same condition as you. Sharing a nasal spray can spread germs or harm other people.

Keep nasal azelastine out of the reach of children. If a young child is prescribed nasal azelastine, an adult should help them use it.

Nasal azelastine is only for use in your nose. Do not spray it into your eyes or mouth.

Tilt your head down when using nasal azelastine. This may make you less likely to have a bitter taste in your mouth after using it. Try not to tilt your head back right after using it. This will help keep the medicine from running down the back of your throat.

Nosebleeds can happen while you use nasal azelastine. Stop using it if you have frequent nosebleeds or nosebleeds that are difficult to stop.

What should I tell my health care provider before using nasal azelastine?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if nasal azelastine is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Recent nose surgery or ulcers
  • A nose injury that is not fully healed

Other Medicines and Supplements. Nasal azelastine may interact with other medicines and supplements. Before using nasal azelastine, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how nasal azelastine could affect pregnancy or harm an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should use nasal azelastine while you are pregnant or trying to get pregnant.

Breastfeeding. It is not known if nasal azelastine passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should use nasal azelastine while breastfeeding.

Interactions

Does nasal azelastine interact with foods or drinks?

There are no known interactions between nasal azelastine and foods or drinks.

Do not drink alcohol while using nasal azelastine. The risk of sleepiness may be increased if you drink alcohol while using it.

Does nasal azelastine interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are taking any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, or medicines for anxiety.

This may not be a complete list of medicines that can interact with nasal azelastine. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much nasal azelastine?

If you or someone else has used too much nasal azelastine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of nasal azelastine?

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses.