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 additional mast cell stabilizing properties, Astelin offers a targeted approach to managing nasal congestion, sneezing, runny nose, and itchy nose that characterizes allergic responses. Its unique formulation works directly at the site of symptoms, providing localized relief without the systemic drowsiness often associated with oral antihistamines. Approved by the FDA, Astelin represents an advanced therapeutic option for patients seeking effective allergy management with a favorable safety profile.

Features

• Contains azelastine hydrochloride 137 mcg per spray
• H1-receptor antagonist with mast cell stabilizing properties
• Alcohol-free formulation
• Metered-dose pump delivery system
• Prescription strength medication
• Rapid onset of action (within 15-30 minutes)
• 12-hour duration of effect with twice daily dosing
• Compatible with other allergy medications
• Suitable for patients 5 years and older
• Non-habit forming formulation

Benefits

• Provides rapid relief from nasal allergy symptoms within minutes of administration
• Reduces nasal congestion, sneezing, runny nose, and post-nasal drip effectively
• Minimizes systemic side effects through localized nasal delivery
• Offers convenient twice-daily dosing for consistent symptom control
• Improves quality of life by enabling normal breathing and reducing allergy discomfort
• Allows for targeted therapy without significant sedation common with oral antihistamines

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 typically occurs in response to outdoor allergens such as tree, grass, and weed pollens, while perennial allergic rhinitis persists year-round due to 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. The medication is particularly valuable for patients who experience inadequate symptom control with oral antihistamines or who prefer localized treatment to minimize systemic exposure.

Dosage and direction

For adults and children 12 years and older: The recommended dosage is 1 or 2 sprays per nostril twice daily. For children 5 to 11 years: The recommended dosage is 1 spray per nostril twice daily. Prior to initial use, prime the pump by releasing 4 sprays until a fine mist appears. If the product hasn’t been used for 3 or more days, reprime with 2 sprays. Administer while gently breathing in through the nose. Avoid blowing the nose for 15 minutes after administration. Shake the bottle gently before each use. The therapeutic effect is typically maintained with regular use as prescribed.

Precautions

Patients should inform their healthcare provider about any pre-existing medical conditions, especially nasal septum ulcers, nasal surgery, or nasal trauma. Use with caution in patients with renal impairment as azelastine is excreted renally. Avoid contact with eyes; if contact occurs, rinse thoroughly with water. The medication may cause drowsiness in some patients; exercise caution when operating machinery or driving until response to the medication is known. Patients should avoid alcohol as it may enhance any sedative effects. Regular nasal examinations are recommended during prolonged use to monitor nasal mucosa integrity.

Contraindications

Astelin is contraindicated in patients with known hypersensitivity to azelastine hydrochloride or any component of the formulation. The product should not be used by patients who have experienced previous allergic reactions to other antihistamines. Contraindicated in children under 5 years of age due to insufficient safety and efficacy data. Not recommended for patients with severe renal impairment without appropriate dosage adjustment and monitoring. Avoid use in patients with active nasal infections until the infection has resolved.

Possible side effects

Common side effects (occurring in >2% of patients) include bitter taste (20.3%), somnolence (11.5%), nasal burning (5.0%), headache (4.6%), and pharyngitis (3.2%). Less frequent side effects may include nausea, dry mouth, dizziness, epistaxis, and weight gain. Transient nasal irritation or sneezing immediately after administration may occur. Rare but serious side effects include hypersensitivity reactions, bronchospasm, and paradoxical worsening of nasal symptoms. Most side effects are mild to moderate and tend to diminish with continued therapy. Patients should report persistent or severe side effects to their healthcare provider.

Drug interaction

Astelin may potentiate the sedative effects of CNS depressants including alcohol, barbiturates, benzodiazepines, and opioid analgesics. Concurrent use with other anticholinergic drugs may increase dry mouth and urinary retention. No clinically significant interactions have been observed with oral contraceptives, warfarin, or cimetidine. However, patients should inform their healthcare provider about all medications, including prescription drugs, over-the-counter medications, and herbal supplements, before starting Astelin therapy.

Missed dose

If a dose is missed, administer it as soon as remembered unless it is almost 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. Maintaining consistent dosing is important for optimal symptom control, but occasional missed doses are unlikely to significantly impact overall efficacy. Patients should establish a routine to minimize missed doses, such as associating administration with morning and evening activities.

Overdose

In case of accidental overdose, symptomatic and supportive treatment should be instituted. Due to the localized delivery system, systemic overdose is unlikely with proper nasal administration. However, excessive application may lead to increased side effects including severe drowsiness. If ingestion occurs, gastric lavage may be considered if performed soon after ingestion. There is no specific antidote for azelastine overdose. Patients experiencing suspected overdose should seek immediate medical attention or contact a poison control center. Hemodialysis is not expected to be effective due to high protein binding.

Storage

Store Astelin Nasal Spray at controlled room temperature between 20°C to 25°C (68°F to 77°F). Protect from light and freezing. Keep the bottle tightly closed and stored in an upright position. Discard 30 days after opening, even if medication remains. Keep out of reach of children and pets. Do not transfer the medication to another container. The product should be visually inspected for discoloration or particulate matter before use; discard if abnormalities are observed.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Astelin is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual results may vary. Patients should consult their healthcare provider for proper diagnosis and treatment recommendations. The complete prescribing information should be reviewed before initiating therapy. Never disregard professional medical advice or delay seeking treatment based on information contained in this document.

Reviews

Clinical studies demonstrate that Astelin provides significant improvement in total nasal symptom scores compared to placebo. In randomized controlled trials, 64% of patients reported marked improvement in allergy symptoms within the first week of treatment. Patient satisfaction surveys indicate high rates of continued use due to effective symptom control and convenient administration. Healthcare providers frequently report Astelin as a valuable option for patients who cannot tolerate oral antihistamines or require additional nasal-specific therapy. Real-world evidence supports the maintenance of efficacy with long-term use without development of tolerance.