Azelastine HCl

Azelastine HCl is FDA-approved for the treatment of symptoms associated with seasonal allergic rhinitis (SAR) and perennial allergic rhinitis (PAR) in adults and children aged 6 years and older (for the nasal spray). It is also approved for the treatment of allergic conjunctivitis in adults and children aged 3 years and older (for the ophthalmic solution).

Azelastine HCl is contraindicated in patients with a known hypersensitivity to azelastine hydrochloride or any of the other components of the formulation. Caution is advised in patients with a history of nasal surgery, trauma, or ulcers when using the nasal spray, as it may slow wound healing. Patients with contact lenses should remove them before using the ophthalmic solution and wait at least 15 minutes before reinserting them.

Patients using Azelastine HCl nasal spray should be advised to prime the spray before first use and if it hasn’t been used for more than a few days. To prime, the spray, they should release a few sprays into the air until a fine mist is visible. The nasal spray should be used consistently as prescribed, even if symptoms improve, to maintain symptom relief. Patients using the ophthalmic solution should be instructed to avoid touching the dropper tip to any surface, including the eye, to avoid contamination. If using other eye drops, patients should wait at least 10 minutes between applications. It’s important to inform patients that Azelastine HCl can cause drowsiness or dizziness, so they should avoid driving or operating heavy machinery until they know how the medication affects them.

Common side effects of Azelastine HCl nasal spray include a bitter taste, drowsiness, headache, nasal discomfort, and nosebleeds. For the ophthalmic solution, common side effects include burning or stinging in the eyes, dry eyes, and temporary blurred vision.

Serious side effects, though rare, can include severe allergic reactions, such as rash, itching, swelling, dizziness, or trouble breathing. Patients should seek medical attention if they experience any severe or persistent side effects.

Azelastine HCl may cause drowsiness or dizziness, particularly when first starting the medication or when increasing the dose. Patients should be cautioned about engaging in activities that require alertness, such as driving or operating heavy machinery, until they know how the medication affects them. Long-term use of the nasal spray may increase the risk of nasal septal perforation, though this is rare. Patients using the nasal spray for an extended period should be monitored for nasal mucosal changes.

Azelastine HCl may interact with other central nervous system depressants, such as alcohol, sedatives, and tranquilizers, increasing the risk of drowsiness and dizziness. Patients should inform their healthcare provider of all medications and supplements they are taking to avoid potential interactions. The ophthalmic solution should not be used concurrently with other eye medications unless instructed by a healthcare provider.

Alternative treatments for allergic rhinitis include other antihistamine nasal sprays, such as fluticasone (Flonase) or mometasone (Nasonex), as well as oral antihistamines like loratadine (Claritin) or cetirizine (Zyrtec). For allergic conjunctivitis, alternatives include other antihistamine eye drops, such as olopatadine (Patanol) or ketotifen (Zaditor). The choice of treatment depends on the severity of symptoms, patient preference, and response to previous treatments.