From the Guidelines
Azelastine 0.1% nasal spray is generally more effective than over-the-counter medications for treating allergic rhinitis symptoms, and its efficacy is comparable to other intranasal antihistamines like olopatadine, but with a faster onset of action and more targeted delivery to the nasal tissues. Azelastine is a prescription-strength antihistamine nasal spray that works directly in the nasal passages, providing faster relief of nasal congestion, sneezing, and runny nose compared to oral or eye drop antihistamines. The typical dosage is 1-2 sprays per nostril twice daily.
- Azelastine works by blocking histamine receptors in the nasal passages, reducing the inflammatory response to allergens.
- Some patients report a bitter taste with Azelastine, but this side effect often diminishes with continued use.
- For severe or persistent allergies, combining Azelastine with a nasal corticosteroid like fluticasone provides enhanced symptom relief, as shown in studies such as 1.
- The combination of an intranasal corticosteroid and an intranasal antihistamine, such as Azelastine, may be recommended for initial treatment of moderate to severe seasonal allergic rhinitis in persons aged 12 years or older, as suggested by the 2017 joint task force on practice parameters 1.
- Intranasal antihistamines like Azelastine have a rapid onset of action, making them suitable for episodic use, and are effective for all symptoms of seasonal allergic rhinitis, including nasal congestion, as reported in studies such as 1 and 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Comparison of Azelastine 0.1% and Ateopro
- Azelastine 0.1% is a fast-acting, efficacious, and well-tolerated H1-receptor antagonist for the treatment of rhinitis, with mast-cell stabilizing and anti-inflammatory properties 2.
- There is no direct comparison between azelastine 0.1% and ateopro in the provided studies.
- Azelastine nasal spray has been compared to other agents, such as intranasal corticosteroids, oral antihistamines, and other intranasal antihistamines, and has shown superior efficacy and a better safety profile in some cases 2, 3.
- Azelastine nasal spray has a rapid onset of action, improving nasal symptoms associated with rhinitis, including congestion and postnasal drip, and can be used on an as-needed basis without compromising clinical efficacy 2, 4.
Efficacy and Safety of Azelastine 0.1%
- Azelastine nasal spray has demonstrated greater efficacy when used in combination with fluticasone propionate nasal spray compared to either agent alone, and this combination may provide benefit for patients with moderate-to-severe rhinitis 2, 4.
- The most common side effect associated with azelastine nasal spray is bitter taste, which can be mitigated by the dosing technique recommended by the manufacturer 2, 4.
- Azelastine is an effective, rapid-acting, and well-tolerated second-generation antihistamine that improves nasal symptoms associated with seasonal allergic rhinitis and nonallergic vasomotor rhinitis 4.
Mechanism of Action
- Azelastine has demonstrated a wide range of pharmacologic effects on chemical mediators of inflammation, including leukotrienes, kinins, and platelet activating factor, and has been shown to downregulate intercellular adhesion molecule-1 expression and reduce inflammatory cell migration in patients with rhinitis 2, 4.
- Azelastine intranasal spray reduces substance P release into nasal lavage fluid of perennial nonallergic rhinitis patients, which may be an important aspect of its clinical efficacy 5.