Overview:
This review article summarizes the mechanism, clinical efficacy, and safety of azelastine hydrochloride nasal spray in the treatment of seasonal and perennial allergic rhinitis. Azelastine, a second-generation intranasal antihistamine, works not only through H1-receptor antagonism but also by inhibiting inflammatory mediators like leukotrienes, free radicals, and cytokines.
The Takeaways:
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Azelastine provides rapid onset of action (benefit within ~2 hours) and a prolonged duration of effect (12–24 hours).
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It is effective in reducing major and total symptom complexes of allergic rhinitis and has demonstrated superiority over placebo.
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In comparison studies, azelastine performed similarly to other antihistamines (e.g., cetirizine, loratadine) and in some cases, showed benefit in nasal congestion, a domain typically better addressed by corticosteroids.
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Common side effects include drowsiness, headache, and bitter taste, though azelastine avoids the systemic sedation associated with oral antihistamines.
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While results vary when compared to intranasal corticosteroids like budesonide or beclomethasone, azelastine shows particular promise in congestion relief, which sets it apart from most other antihistamines.
Why It Matters:
Most antihistamines are excellent for treating sneezing, itching, and runny nose, but fail to relieve nasal congestion—a key symptom in allergic rhinitis. Azelastine stands out as one of the few antihistamines with meaningful decongestant effects. Its dual anti-histaminic and anti-inflammatory action offers broad symptom control with a fast onset and long duration, and it can be especially valuable for patients who cannot tolerate systemic antihistamines.
The Link to Allermi:
Azelastine is a cornerstone in Allermi’s science-backed nasal spray formulations. Its ability to relieve congestion, not just itching and sneezing, makes it uniquely powerful among antihistamines. Allermi combines azelastine with other low-dose components—including oxymetazoline and corticosteroids—for tailored relief of both allergic and non-allergic rhinitis, offering patients a targeted, non-sedating option that works quickly and lasts.
For more details, refer to the full study: Azelastine nasal spray: a review of pharmacology and clinical efficacy in allergic rhinitis and vasomotor rhinitis
