Azelastine Azelastine Azelastine is a potent, second-generation, selective, histamine antagonist (histamine-H-receptor antagonist) used as a first line therapy of mild intermittent, moderate/severe intermittent and mild persistent rhinitis (new classification system for rhinitis). Azelastine has been formulated both as a nasal spray and as eye drops and are available worldwide under many brand names. Azelastine nasal spray is indicated for the local treatment of the symptoms of seasonal allergic rhinitis and perennial allergic rhinitis, such as rhinorrhea, sneezing and nasal pruritus in adults and children 5 years of age and older. In some countries, it is also indicated for the treatment of
Allergic rhinitis of prolonged steroid therapy. Other measures that may be used second line include: decongestants, cromolyn, leukotriene receptor antagonists, and nonpharmacologic therapies such as nasal irrigation. Topical decongestants may also be helpful in reducing symptoms such as nasal congestion, but should not be used for long periods, as stopping them after protracted use can lead to a rebound nasal congestion called rhinitis medicamentosa. For nocturnal symptoms, intranasal corticosteroids can be combined with nightly oxymetazoline, an adrenergic alpha-agonist, or an antihistamine nasal spray without risk of rhinitis medicamentosa. Nasal saline irrigation (a practice where salt water is poured into the nostrils), may