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Azelastine nasal Side Effects

Medically reviewed by Last updated on Aug 7, 2022.


Commonly reported side effects of azelastine nasal include: drowsiness, bitter taste, and dysgeusia. Other side effects include: epistaxis. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to azelastine nasal: nasal spray

Side effects requiring immediate medical attention

Along with its needed effects, azelastine nasal 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 while taking azelastine nasal:

More common

Less common

  • Burning or discomfort inside the nose
  • ear congestion
  • chills
  • cough
  • fever
  • sore throat
  • body aches or pain
  • headache
  • loss of voice
  • trouble breathing
  • unusual tiredness or weakness


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

Side effects not requiring immediate medical attention

Some side effects of azelastine nasal 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
  • dizziness
  • dryness of the mouth
  • muscle aches or pain
  • nausea
  • sudden outbursts of sneezing
  • weight gain

For Healthcare Professionals

Applies to azelastine nasal: nasal spray


The most commonly reported adverse reactions were headache, bitter taste, sinusitis, and epistaxis.[Ref]


Common (1% to 10%): Epistaxis, nasal discomfort, upper respiratory infection, sneezing, nasal mucosal ulceration, sinusitis

Postmarketing reports: Nasal burning, throat irritation, dyspnea, paroxysmal sneezing[Ref]


Postmarketing reports: Anaphylactoid reaction[Ref]


Postmarketing reports: Application site irritation[Ref]

Nervous system

Very common (10% or more): Bitter taste (10%)

Common (1% to 10%): Headache, somnolence, dysgeusia

Postmarketing reports: Sweet taste, confusion, dizziness, nervousness, paraesthesia, parosmia, involuntary muscle contractions, disturbance or loss of sense of smell and/or taste[Ref]


Postmarketing reports: Atrial fibrillation, chest pain, hypertension, palpitations, tachycardia[Ref]


Very rare (less than 0.01%): Urticaria, pruritus, rash[Ref]


Postmarketing reports: Abdominal pain, nausea[Ref]


Common (1% to 10%): Fatigue

Postmarketing reports: Facial edema, tolerance[Ref]


Postmarketing reports: Blurred vision, xerophthalmia[Ref]


Postmarketing reports: Urinary retention[Ref]


1. "Product Information. Astelin (azelastine)." Carter Products, Cranbury, NJ.

2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

3. "Product Information. Astepro (azelastine nasal)." Meda Pharmaceuticals (2009):

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.