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(ep i NAS teen)

Index Terms

  • Epinastine Hydrochloride
  • Epinastrine HCl

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Ophthalmic, as hydrochloride:

Elestat: 0.05% (5 mL) [contains benzalkonium chloride]

Generic: 0.05% (5 mL)

Brand Names: U.S.

  • Elestat

Pharmacologic Category

  • Histamine H1 Antagonist
  • Histamine H1 Antagonist, Second Generation


Selective H1-receptor antagonist; inhibits release of histamine from the mast cell; also has affinity for the H2, alpha1, alpha2, and the 5-HT2 receptors


Low systemic absorption following topical application


Does not cross blood-brain barrier


<10% metabolized


IV: Urine (55%); feces (30%)

Onset of Action

3-5 minutes

Duration of Action

8 hours

Half-Life Elimination

12 hours

Protein Binding


Use: Labeled Indications

Treatment of allergic conjunctivitis


There are no contraindications listed in the manufacturer's labeling.

Dosing: Adult

Allergic conjunctivitis: Ophthalmic: Instill 1 drop into each eye twice daily. Continue throughout period of exposure, even in the absence of symptoms.

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Allergic conjunctivitis: Ophthalmic: Children ≥2 years: Refer to adult dosing.

Dosing: Renal Impairment

No dosage adjustment provided in manufacturer's labeling. However, dosage adjustment unlikely due to low systemic absorption.

Dosing: Hepatic Impairment

No dosage adjustment provided in manufacturer's labeling. However, dosage adjustment unlikely due to low systemic absorption.


For ophthalmic use only; avoid touching tip of applicator to eye or other surfaces. Contact lenses should be removed prior to application, may be reinserted after 10 minutes. Do not wear contact lenses if eyes are red.


Store at controlled room temperature of 15°C to 25°C (59°F to 77°F). Keep tightly closed.

Drug Interactions

There are no known significant interactions.

Adverse Reactions

Frequency not always defined.

1% to 10%:

Central nervous system: Headache (1% to 3%)

Infection: Infection (10%; defined as cold symptoms and upper respiratory tract infection)

Ophthalmic: Burning sensation of eyes, eye pruritus, follicular conjunctivitis, ocular hyperemia

Respiratory: Cough (1% to 3%), pharyngitis (1% to 3%), rhinitis (1% to 3%), sinusitis (1% to 3%)

<1% (Limited to important or life-threatening): Increased lacrimation


Concerns related to adverse effects:

• Bacterial keratitis: Inadvertent contamination of multiple-dose ophthalmic solutions has caused bacterial keratitis.

Special populations:

• Contact lens wearers: Contains benzalkonium chloride which may be absorbed by contact lenses; remove contact lenses prior to use and wait 10 minutes before reinserting.

Other warnings/precautions:

• Appropriate use: For topical ophthalmic use only. Not for the treatment of contact lens irritation; do not wear contact lenses if eye is red.

Pregnancy Risk Factor


Pregnancy Considerations

Teratogenic effects were not observed in animal studies. There are no adequate and well-controlled studies in pregnant women.

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience stinging, burning, cough, eye infection, or rhinorrhea. Have patient report immediately to prescriber vision changes, eye pain, or severe eye irritation (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.