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Antihistamine nasal spray used to relieve sneezing, runny nose, and itchy nose caused by seasonal or year-round allergies (and, for some strengths, non-allergic/vasomotor rhinitis).
Reviewed by:
Dr. Steve Malen, PharmD
Dr. Steven Blikstein, PharmD
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Azelastine nasal spray is an antihistamine used to relieve nasal allergy symptoms such as sneezing, runny nose, itchy nose, and nasal congestion. It is available generically as Astelin (0.1%) and Astepro (0.1% and 0.15%), and is used for seasonal and year-round (perennial) allergic rhinitis; the 0.15% strength is also approved for non-allergic (vasomotor) rhinitis. The typical dose for Astelin 0.1% is 1-2 sprays per nostril twice daily. For Astepro 0.15%, dosing may be 1-2 sprays per nostril twice daily for allergic rhinitis or 2 sprays per nostril twice daily for vasomotor rhinitis, depending on age and indication. Shake the bottle gently and prime the pump before first use or after several days without use. The most common side effect is a bitter taste in the mouth after spraying; azelastine can also cause drowsiness, so caution is advised with alcohol, other sedating medications, and activities like driving until you know how it affects you. Other possible side effects include nasal discomfort, headache, and nosebleeds. Azelastine nasal spray is available both by prescription (Astelin, and Astepro Rx strengths) and, for the 0.15% strength in adults and children 6 and older, over the counter.
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Shake the bottle gently before each use, and prime the pump before the first use or if the spray has not been used for several days. Tilt your head slightly forward and spray into each nostril, aiming away from the nasal septum (the wall between the nostrils) to reduce irritation.
If you are using the 0.15% strength for non-allergic (vasomotor) rhinitis, follow your prescriber's specific dosing instructions, since dosing can differ from the allergy-symptom regimen. Tell your prescriber if your symptoms do not improve, or if you develop signs of a nasal infection, prolonged bleeding, or a hole or sore inside the nose.