What is azelastine, and how does it work (mechanism of action)?

Azelastine is an antihistamine, a chemical that blocks the effects of histamine, another chemical that is responsible for some of the symptoms in allergic reactions. Azelastine is chemically different from other antihistamines and is used only as a nasal inhaler for the treatment of symptoms of seasonal allergic rhinitis, such as runny nose, sneezing, and nasal itching in adults and children 12 years of age and older. Azelastine was approved by the FDA in 1996.

What brand names are available for azelastine?

Astelin, Astepro

Is azelastine available as a generic drug?


Do I need a prescription for azelastine?


What are the side effects of azelastine?

The most common side effect noted with azelastine is a bitter taste that develops in 1 of 5 persons using it. Tiredness occurs in 1 of 9. Weight gain has been reported in 1 of 50 and muscle pain in 1 of 75. Other reported side effects include:

What is the dosage for azelastine?

Azelastine generally is used as 2 sprays in each nostril twice daily.

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Is azelastine safe to take if I’m pregnant or breastfeeding?

Abnormalities in bones of the skeleton have been noted in animals receiving more than 240 times the human dose of azelastine. There are no adequate studies in pregnant women. Azelastine should be used during pregnancy only if the physician feels that the benefit justifies the potential risk to the fetus.

It is not known whether azelastine is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when azelastine is used by a nursing woman.

What else should I know about azelastine?

What preparations of azelastine are available?

Nasal spray: 137 mcg per spray.

How should I keep azelastine stored?

The nasal spray should be stored at room temperature, between 15 C and 30 C (59 F – 86 F).

Medically Reviewed on 3/12/2019


Medically reviewed by John P. Cunha, DO, FACOEP; Board Certified Emergency Medicine


FDA Prescribing Information