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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