Worst Pills, Best Pills

An expert, independent second opinion on more than 1,800 prescription drugs, over-the-counter medications, and supplements

Drug Profile

Do NOT stop taking this or any drug without the advice of your physician. Some drugs can cause severe adverse effects when they are stopped suddenly.

Do Not Use [what does this mean?]
Generic drug name: azelastine (a ZEL as teen)
Brand name(s): ASTELIN, ASTEPRO, OPTIVAR
GENERIC: not available FAMILY: Antihistamines
Find the drug label by searching at DailyMed.

Alternative Treatment [top]

Facts About This Drug [top]

Azelastine (ASTELIN) is an antihistamine nasal spray.

Side effects

About 40 percent of each dose of the drug is absorbed into the bloodstream. This may explain why 11.5 percent of patients using azelastine experienced drowsiness (compared to 5.4 percent of those using a placebo) in clinical trials.[1]

Between 9 and 12 percent of azelastine users complain of a bitter taste in the mouth.[2]

There has been a small number of cases of hypertension reported following the use of nasally...

Azelastine (ASTELIN) is an antihistamine nasal spray.

Side effects

About 40 percent of each dose of the drug is absorbed into the bloodstream. This may explain why 11.5 percent of patients using azelastine experienced drowsiness (compared to 5.4 percent of those using a placebo) in clinical trials.[1]

Between 9 and 12 percent of azelastine users complain of a bitter taste in the mouth.[2]

There has been a small number of cases of hypertension reported following the use of nasally inhaled azelastine.[3]

Studies say...

In their review of azelastine, the Medical Letter on Drugs and Therapeutics concluded by saying that oral antihistamines or corticosteroid nasal sprays are preferred to azelastine.[2]

Watch out for your wallet!

Azelastine is expensive: a 30mL bottle costs $85.99 at an Internet pharmacy. There is no reason to take a prescription antihistamine nasal spray when there is no evidence that it is any safer or more effective than oral nonprescription antihistamines.

Regulatory actions surrounding azelastine

2007: In 2007, the Food and Drug Administration (FDA) revised the adverse events section of the package label to include palpitations and atrial fibrillation (irregular heartbeat) in the post marketing section.[4]

last reviewed August 31, 2023