Azelastine
ASTELIN
Pronunciation: a-ZEL-as-teen
“A zealous teen a’ stealin”
What it isIntranasal H1 antihistamine; allergic rhinitis.
Why this oneFixed combination with fluticasone provides broader nasal relief than either component alone.
What limits itBitter taste is the main reason for stopping. Some systemic absorption causes mild sedation.
Azelastine prescription history
Animated chart of estimated U.S. prescriptions per year, H1 antihistamines (1944–2026). Azelastine enters in 1996 (estimated).
FDA-approved for
- allergic rhinitis (1996)
Principal riskBitter taste, which drives non-adherence
Classes and tags
Clinical profile
Legacy pregnancy categoryUnknown / historical label unavailable
Defining liabilityLocal irritation, sensitization or administration-site injury; negligible systemic toxicity at usual use.
FDA label
Read the full label on DailyMed ↗
NO BOXED WARNINGS
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Allergic rhinitis (nasal allergy symptoms) | Adults & children ≥12 y | 2 sprays/nostril QD, OR 1–2 sprays/nostril q12h (BID) | 1–2 sprays/nostril BID | 4 sprays/nostril per 24 h |
| Allergic rhinitis (nasal allergy symptoms) | Children 6–11 y | 1 spray/nostril q12h (BID) | 1 spray/nostril BID | 2 sprays/nostril per 24 h |
Renal Undefined
Hepatic Undefined
Do not exceed 4 sprays/nostril (adults & ≥12 y) or 2 sprays/nostril (6–11 y) in 24 hours
Instructions
- Prime the bottle before first use, and again if not used for 3 or more days
- Do not use in children under 6 years
- Clean the spray nozzle if it becomes clogged
Available strengths
- nasal spray 137, 205.5 mcg/spray
- drops 0.05 %
Pregnancy Undefined
Lactation Undefined
Cost
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 137 mcg/spray | nasal spray | per unit | $0.27/mL | offered |
| 205.5 mcg/spray | nasal spray | per unit | not offered |
Generic entry2009
Open Azelastine in the interactive console ↗
Self-check
- Which nasal combination broadens azelastine relief?
Fluticasone plus azelastine. - What commonly causes azelastine discontinuation?
Bitter taste.