Azelastine hydrochloride or Astepro or Astelin is a chemical and drug in the phthalazinone family that has H1 antihistamine and bronchodilator properties. It is a molecule used in the treatment of allergy and asthma. It can be taken in the form of nasal spray and drop or solution. Normally, this drug is indicated to treat symptoms of asthma and seasonal (rhinorrhea, sneezing, nasal pruritus), perennial, and vasomotor (rhinorrhea, nasal congestion, postnasal drip) allergic rhinitis.
However, patients, especially pregnant or breastfeeding women, should use azelastine with caution if the benefits outweigh the risks. Because animal studies (mice) have shown developmental toxicity. By the same token, azelastine is contraindicated in patients with known hypersensitivity to azelastine hydrochloride or any of its components. It should be noted that azelastine has side effects. They include, but are not limited to, bitter taste, headache, cold symptoms, somnolence, pharyngitis, cough, and nasal burning.
When inhaled or absorbed into the human body, azelastine acts as a bronchodilator and antihistamine. To treat allergic rhinitis, azelastine (H1 receptor) antagonizes the actions of histamine. Thus, it inhibits the release of histamine and other mediators involved in allergic responses. Therefore, relief of allergic symptoms is observed within 15 minutes after intranasal administration.
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What are some side effects that I need to call my child’s doctor about right away?
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly possible side effects when taking a drug. Signs of an allergic reaction, like rash; hives; stuffy nose; tiredness/ sleepiness, skin rash, blistered or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
- Signs of infection like fever, chills, very bad sore throat, conjunctivitis,ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
- Signs of a weak adrenal gland like a very bad upset stomach or throwing up, very bad dizziness or passing out, muscle weakness, feeling very tired, mood changes, not hungry, or weight loss.
- Bad nose irritation.
- Crusting in the nose.
- Runny nose.
- Whistling sound when your child breathes.
- Change in eyesight, eye pain, or very bad eye irritation.
- Bad nosebleeds.
- Redness or white patches in mouth or throat.
- Feeling sleepy.
What are some other side effects of this drug?
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your child’s doctor or get medical help if any of these side effects or any other side effects bother your child or do not go away:
- Nose irritation.
- Change in taste.
These are not all of the side effects that may occur. If you have questions about side effects, call your child’s doctor. Call your child’s doctor for medical advice about side effects.
You may report side effects to your national health agency.
How is this drug best given?
Give this drug as ordered by your young child’s doctor. Read all information given to you. Follow all instructions closely.
- Do not give this drug by mouth. Use in your child’s nose only. Keep out of your child’s mouth and eyes (may burn).
- Shake well before use.
- Prime pump before first use by spraying it 6 times or until you see a fine mist.
- If you have not used the spray for more than 14 days, you will need to prime the pump with 1 spray or until you see a fine mist.
- Spray up your child’s nose only. Do not spray onto the wall joining your child’s nostrils.
- Put the cap back on after your child is done using a dose.
- If you get this drug in the eyes, flush right away with cool water and get medical help.
What do I do if my child misses a dose?
- Give a missed dose as soon as you think about it.
- If it is close to the time for your child’s next dose, skip the missed dose and go back to your child’s normal time.
- Do not give 2 doses at the same time or extra doses.
How do I store and/or throw out this drug?
- Store upright at room temperature. Do not freeze. Throw away any part not used after 120 sprays.
- Protect from light.
- Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
- Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of azelastine nasal spray in children. However, safety and efficacy of azelastine nasal have not been established to treat seasonal allergic rhinitis in children younger than 2 years of age and perennial allergic rhinitis in children younger than 6 months of age.
Although appropriate studies on the relationship of age to the effects of azelastine nasal spray have not been performed in the geriatric population, no geriatric-specific problems have been documented to date. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving azelastine nasal spray.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional knows if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.