AZELASTINE HYDROCHLORIDE

AZELASTINE HYDROCHLORIDe
(a-ze-las'teen)
Astelin, Optivar
Classifications: antihistamine; h1-receptor antagonist; ocular antihistamine;
Therapeutic: antihistamine

Prototype: Diphenhydramine
Pregnancy Category: C

Availability

137 mcg/spray nasal spray; 0.05% ophthalmic solution

Action

Potent histamine H1 receptor antagonist and inhibitor of mast cell release of histamine.

Therapeutic Effect

Effective in the symptomatic treatment of seasonal allergic rhinitis and as a nasal decongestant.

Uses

Seasonal allergic rhinitis, itching associated with allergic conjunctivitis.

Contraindications

Hypersensitivity to azelastine; concurrent use of CNS depressants; pregnancy (category C), lactation. Safety and efficacy in children <3 y for ophthalmic solution use, and <5 y for nasal spay use.

Cautious Use

Hepatic or renal disease; asthmatics.

Route & Dosage

Allergic Rhinitis
Adult: Intranasal 2 sprays per nostril b.i.d.
Child (5–11 y): Intranasal 1 spray per nostril b.i.d.

Allergic Conjunctivitis
See Appendix A-1.

Administration

Intranasal
  • Prime delivery unit before first use (see manufacturer's instructions).
  • Instruct patient to clear nasal passages prior to drug installation; then tilt head forward slightly and sniff gently when drug is sprayed into each nostril.
  • Store the bottle upright at room temperature, 15°–30° C (59°–86° F).

Adverse Effects (≥1%)

Body as a Whole: Fatigue, dizziness. GI: Dry mouth, nausea. Metabolic: Weight gain. CNS: Headache, somnolence. Respiratory: Pharyngitis, rhinitis, paroxysmal sneezing, cough, asthma. Special Senses: Bitter taste, nasal burning, epistaxis, conjunctivitis.

Interactions

Drug: Alcohol and cns depressants may cause reduced alertness.

Pharmacokinetics

Absorption: 40% from nasal inhalation. Peak: 2–3 h. Metabolism: Active metabolites. Elimination: Primarily in feces. Half-Life: 22 h.

Nursing Implications

Assessment & Drug Effects

  • Monitor level of alertness especially in older adults and with concurrent use of other CNS depressants.

Patient & Family Education

  • Follow manufacturer's directions for priming the metered dose spray unit before first use and after storage of >3 d.
  • Tilt head forward while instilling spray. Avoid getting spray in eyes.
  • Do not drive or engage in potentially hazardous activities until response to drug is known.
  • Avoid concurrent use of CNS depressants, such as alcohol, while taking this drug.
  • Discard spray unit and dispensing package bottle after 3 mo.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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