H1 antihistamine (topical)
Azelastine hydrochloride
Brand names: Rhinolast, Optilast, Dymista (with fluticasone)
Adult dose
Dose: Nasal: 1 spray each nostril BD; Eye: 1 drop BD
Route: Intranasal / Ophthalmic
Frequency: BD
Clinical pearls
- BSACI / NICE CKS Allergic rhinitis: intranasal antihistamine option (with or without intranasal corticosteroid)
- RCOphth allergic conjunctivitis
- Dymista combination first-line for moderate-severe persistent rhinitis
Contraindications
- Hypersensitivity
Side effects
- Bitter taste
- Local irritation
- Headache
- Drowsiness (rare)
- Application-site burning
Interactions
- Minimal systemic
Monitoring
- Symptom relief
Reference: BNF; BSACI; NICE CKS Allergic rhinitis; RCOphth; https://bnf.nice.org.uk/drugs/azelastine-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Adult Upper Airway Obstruction (Stridor) · DAS 2015 unanticipated difficult airway; RCEM
- Epistaxis Management · ENT-UK / NICE
- Acute Otitis Media · NICE NG91 2018
- Tonsillitis and Sore Throat · NICE NG84 2018
- Benign Paroxysmal Positional Vertigo · NICE CG124 / AAO-HNS Guidelines
- Acute Rhinosinusitis · NICE NG79 2017 / EPOS 2020