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azelastine (Nasal route)

Pronunciation

ay-ze-LAS-teen

Commonly used brand name(s)

In the U.S.

  • Astelin
  • Astelin Ready-Spray
  • Astepro

Available Dosage Forms:

  • Spray

Therapeutic Class: Nasal Agent

Pharmacologic Class: Antihistamine

Uses For azelastine

Azelastine nasal spray is used to help relieve symptoms (eg, stuffy or runny nose, itching, sneezing) of seasonal (short-term) or perennial (year-round) allergic rhinitis (hay fever), and vasomotor rhinitis.

Slideshow: Top Prevention Tips - Seasonal Allergies

Azelastine is an antihistamine. It works by preventing the effects of a substance called histamine, which is produced by the body. Histamine can cause itching, sneezing, runny nose, and watery eyes.

azelastine is available only with your doctor's prescription.

Before Using azelastine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For azelastine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to azelastine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of azelastine nasal spray in children 6 to 17 years of age. However, safety and efficacy have not been established in children younger than 6 years of age.

Geriatric

Although appropriate studies on the relationship of age to the effects of azelastine nasal spray have not been performed in the geriatric population, no geriatric-specific problems have been documented to date. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving azelastine nasal spray.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking azelastine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using azelastine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Cimetidine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of azelastine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of azelastine

Use azelastine only as directed by your doctor. Do not use more of it and do not use it more often than your doctor ordered. To do so may increase the chance of side effects.

azelastine usually comes with patient information insert. Read and follow the instructions carefully. Ask your doctor if you have any questions.

azelastine is for use only in the nose. Do not get any of it in your eyes or on your mouth. If it does get on these areas, rinse it off with water and call your doctor right away.

Do not use azelastine for any other nose problem without checking with your doctor first.

To use the spray:

  • When you use the azelastine nasal spray for the first time, you must prime the spray. Press down fully the top of the pump 6 times or until a fine spray comes out. Prime again with 2 sprays if it has not been used for 3 or more days.
  • Gently blow your nose before using the spray. Tilt your head back slightly and insert the tip of the nose piece into your nostril.
  • Close the opposite nostril with a finger. Release 1 spray and at the same time, breathe in gently through the nostril.
  • Hold your breath for a few seconds then breathe out slowly through your mouth.
  • Spray the opposite nostril using the same steps.
  • Do not blow your nose or tip your head back after using the spray.
  • Wipe the tip of the outside of the nose piece with a clean, dry tissue or cloth and put the cap back on.
  • Throw azelastine away after you use 200 sprays.

Dosing

The dose of azelastine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of azelastine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For nasal dosage form (spray):
    • For treatment of perennial allergic rhinitis:
      • Adults, teenagers, and children 12 years of age—2 sprays in each nostril two times a day. Each spray contains 137 micrograms (mcg) of azelastine.
      • Children 6 to 11 years of age—1 spray in each nostril two times a day.
      • Children younger than 6 years of age—Use and dose must be determined by your doctor.
    • For treatment of seasonal allergic rhinitis:
      • Adults, teenagers, and children 12 years of age—1 or 2 sprays in each nostril two times a day, or 2 sprays in each nostril once a day. Each spray contains 137 micrograms (mcg) of azelastine.
      • Children 6 to 11 years of age—1 spray in each nostril two times a day.
      • Children younger than 6 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of azelastine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Store the bottle upright with the pump tightly closed.

Precautions While Using azelastine

Your doctor should check you or your child at regular visits for any problems or unwanted effects that may be caused by azelastine. If your symptoms do not improve within a few days or if they become worse, check with your doctor.

azelastine will add to the effects of alcohol and other CNS depressants (medicines that makes you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures, muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using azelastine.

azelastine may cause some people to become dizzy, drowsy, or less alert than they are normally. Even if used at bedtime, it may cause some people to feel drowsy or less alert on arising. Make sure you know how you react to azelastine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert.

Keep the spray away from the eyes because azelastine may cause irritation or blurred vision. Closing your eyes while you are using azelastine may help keep it out of your eyes.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

azelastine Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare
  • Blood in the urine
  • blurred vision or other change in vision
  • cough
  • eye pain
  • eye redness
  • hives
  • itching
  • rapid heartbeat
  • skin rash
  • sores in the mouth or on the lips
  • tightness in the chest
  • troubled breathing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Bitter taste in the mouth
  • drowsiness or sleepiness
Less common
  • Bloody mucus or unexplained nosebleeds
  • burning inside the nose
  • dizziness
  • dryness of the mouth
  • headache
  • muscle aches or pain
  • nausea
  • sore throat
  • sudden outbursts of sneezing
  • unusual tiredness or weakness
  • weight gain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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