Astelin (azelastine hydrochloride) is a prescription antihistamine nasal spray clinically proven to provide rapid relief from seasonal and perennial allergic rhinitis symptoms. As a second-generation antihistamine with anti-inflammatory properties, it targets the root cause of allergic reactions by blocking histamine receptors in nasal passages. Its unique formulation begins working within 15 minutes, offering patients a non-sedating alternative to oral antihistamines. Approved by the FDA, Astelin represents a targeted approach to managing nasal allergy symptoms with a favorable safety profile for appropriate candidates.

Features

• Contains azelastine hydrochloride (137 mcg per spray) as active ingredient
• H1-receptor antagonist with additional anti-inflammatory properties
• Alcohol-free, aqueous suspension with minimal systemic absorption
• Metered-dose pump delivery system (200 sprays per 30 mL bottle)
• Prescription-only medication with demonstrated stability at room temperature
• Compatible with most other allergy medications when used as directed

Benefits

• Provides rapid symptom relief, often within 15 minutes of administration
• Reduces nasal congestion, sneezing, runny nose, and postnasal drip effectively
• Minimizes sedative effects commonly associated with oral antihistamines
• Offers localized treatment with minimal systemic side effects
• Convenient twice-daily dosing maintains 24-hour symptom control
• Improves quality of life by enabling normal breathing and sleep during allergy seasons

Common use

Astelin Nasal Spray is primarily indicated for the treatment of seasonal allergic rhinitis (hay fever) and perennial allergic rhinitis in adults and children 5 years of age and older. Seasonal allergic rhinitis involves symptoms triggered by outdoor allergens such as tree, grass, and weed pollens, typically occurring during specific seasons. Perennial allergic rhinitis involves year-round symptoms caused by indoor allergens including dust mites, pet dander, and mold spores. Healthcare providers may also prescribe Astelin off-label for vasomotor rhinitis and as adjunctive therapy for nasal polyps in certain cases.

Dosage and direction

For adults and children 12 years of age and older: Two sprays per nostril twice daily. For children 5 to 11 years of age: One spray per nostril twice daily. Prior to initial use, prime the pump by releasing 4 sprays until a fine mist appears. If unused for 3 or more days, reprime with 2 sprays. Gently shake the bottle before each use. Blow nose gently to clear nostrils before administration. Tilt head slightly forward and insert tip into nostril, pointing away from nasal septum. Spray while breathing in gently through the nose. Repeat in other nostril. Avoid blowing nose for 15 minutes after application.

Precautions

Patients should inform their healthcare provider about any history of nasal surgery, nasal ulcers, nasal trauma, or recurrent nosebleeds. Use with caution in patients with renal impairment as azelastine is excreted renally. Although Astelin has minimal sedative effects, patients should exercise caution when driving or operating machinery until they know how the medication affects them. The spray may cause temporary alterations in taste sensation; avoiding immediate food or drink consumption after administration may minimize this effect. Regular nasal examinations are recommended during prolonged use to monitor nasal mucosa health.

Contraindications

Astelin is contraindicated in patients with known hypersensitivity to azelastine hydrochloride or any component of the formulation. The product contains benzalkonium chloride as a preservative, which may cause allergic reactions in susceptible individuals. Not recommended for children under 5 years of age due to limited safety and efficacy data in this population. Should not be used by patients with severe hepatic impairment without medical supervision. Contraindicated in patients with narrow-angle glaucoma or urinary retention unless benefits outweigh risks under specialist supervision.

Possible side effects

Common side effects (occurring in >2% of patients) include bitter taste (19.7%), somnolence (11.5%), nasal burning (5.0%), headache (4.6%), pharyngitis (3.2%), and dry mouth (2.8%). Less frequent adverse reactions include dizziness, epistaxis, weight increase, nasal ulceration, and sneezing paroxysms. Rare but serious side effects requiring immediate medical attention include severe allergic reactions (hives, difficulty breathing, swelling), vision changes, irregular heartbeat, and severe drowsiness. Most side effects are mild to moderate and often diminish with continued use.

Drug interaction

Although azelastine has low potential for interactions due to minimal systemic absorption, caution is advised with CNS depressants including alcohol, barbiturates, and opioids which may enhance sedative effects. No clinically significant interactions have been observed with oral contraceptives, warfarin, or digoxin in clinical studies. Theoretical interactions exist with other anticholinergic drugs. Patients using multiple nasal sprays should administer Astelin last to ensure optimal absorption. Always inform healthcare providers of all medications, including over-the-counter products and supplements.

Missed dose

If a dose is missed, administer it as soon as remembered unless it is nearly time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed administration. Consistent use provides optimal symptom control, so patients should try to maintain regular dosing intervals. Setting reminder alarms or associating dosing with routine activities (morning and evening teeth brushing) can help maintain adherence.

Overdose

While systemic absorption is minimal, excessive use may lead to increased side effects including severe drowsiness, dizziness, nausea, vomiting, and anticholinergic effects. No specific antidote exists for azelastine overdose. Treatment should be supportive and symptomatic. Gastric lavage may be considered if ingestion occurs within 1-2 hours. Activated charcoal may be administered if appropriate. Monitor vital signs and provide symptomatic care for CNS depression. Hemodialysis is unlikely to be beneficial due to azelastine’s high protein binding and extensive tissue distribution.

Storage

Store upright at controlled room temperature (20-25°C or 68-77°F) with excursions permitted between 15-30°C (59-86°F). Protect from light and freezing. Keep bottle tightly closed and away from direct heat sources. Discard 30 days after opening, even if medication remains. Keep out of reach of children and pets. Do not transfer contents to another container. Properly dispose of unused or expired medication through medication take-back programs or according to FDA guidelines.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Individual results may vary. Always consult with a qualified healthcare professional before starting, changing, or stopping any medication. Only a licensed physician can determine if Astelin is appropriate for your specific condition. Follow your healthcare provider’s instructions regarding dosage and administration. Report any adverse effects to your doctor immediately.

Reviews

Clinical studies demonstrate Astelin’s efficacy, with one 2-week trial showing significant improvement in total symptom scores compared to placebo (p<0.001). Patients report satisfaction with rapid onset of action and reduced sedation compared to oral alternatives. Some users note the bitter taste as a temporary drawback that diminishes with continued use. Healthcare providers appreciate its targeted action and compatibility with other allergy treatments. Real-world evidence supports its effectiveness in managing moderate to severe allergic rhinitis symptoms when used as directed.