Azelastine

Azelastine is a type of medication known as a second-generation antihistamine. Antihistamine medications block the action of histamine, an inflammatory chemical the body releases during an allergic reaction. The release of histamine leads to a number of symptoms including watery eyes, runny nose, sneezing, and itchy skin. Azelastine helps stop these symptoms from happening.

Azelastine is the generic form of the brand name medication, Astelin. The two medications are considered equivalent. The U.S. Food and Drug Administration requires that generic drugs demonstrate bioequivalence to the brand name drug, which means they act the same way in the body and are expected to produce the same effects as the original brand name drug.

Azelastine works by blocking the H1 receptors on cells, which are receptors that are normally activated by the chemical histamine. When the body is exposed to an allergen, immune cells (called mast cells and basophils) release histamine. Since azelastine blocks histamine from activating the H1 receptors, the symptoms that are typically caused by histamine are lessened. Azelastine also has anti-inflammatory effects and reduces congestion.

Azelastine comes as a nasal spray that delivers the medication directly to the inside of the nose. It is used two times per day, once in the morning and once in the evening. If possible, try to take the medication at the same time each day. To properly use the nasal spray, follow the directions for use that accompany the medication. You may also find these steps helpful:

1. Before first use, pump the bottle about 5 times until a mist appears. Also do this if the product hasn’t been used in 3+ days.

2. Shake the bottle gently.

3. Blow your nose to clear it before each use.

4. Slightly tilt your head forward and insert the applicator tip into your nostril.

5. Hold the applicator tip inside your nose and point the tip towards the outer corner of your eye. It’s helpful to use the opposite hand with each nostril to ensure that the tip is facing the outer corner of your eye. The goal is NOT to spray the medication straight back. You also do not want to point the tip towards the midline of the nose (where the septum is) because that can cause nosebleeds.

6. Close off the other nostril with a finger. Breathe in, and press the pump to release the spray while inhaling.

7. Hold your breath for a few seconds, and breathe out slowly through your mouth after each spray.

8. Alternate nostrils after each pump (e.g. right-left-right-left)

9. After using the spray, gently sniff.

10. Wipe the tip of the applicator with a clean tissue after each use.

What if you miss a dose?

If you accidentally miss a dose, take it when you remember. However, if your next dose is supposed to be within a couple of hours, skip the missed dose and resume your normal schedule. Do not take a double dose.

What if you take more than you are prescribed?

Using too much azelastine is generally not considered dangerous. However, it may cause drowsiness and frequent spraying of the medication into your nose could cause trauma to the lining inside of your nose, which could lead to nosebleeds. If you have sprayed too much azelastine and are experiencing symptoms, contact a healthcare provider immediately.

The most common side effects of azelastine hydrochloride nasal spray include:

Unusual bitter taste Headace Headache Sleepiness Nose burning, pain or discomfort Runny nose Scratchy or sore throat Nosebleeds Inflammation or swelling of the sinuses Sneezing Nausea Dry mouth Fatigue Dizziness Weight increase

Azelastine hydrochloride nasal spray is for use in your nose only. It may cause sleepiness.

• Do not drive, operate machinery, or do other dangerous activities until you know how azelastine hydrochloride nasal spray affects you.

• Do not drink alcohol or take other medicines that may cause you to feel sleepy while using azelastine hydrochloride nasal spray. It may make your sleepiness worse.

• Keep azelastine hydrochloride nasal spray out of reach of children.

Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all of the possible side effects of azelastine hydrochloride nasal spray. For more information, ask your healthcare provider or pharmacist.

You are encouraged to report negative side effects of prescription products to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.