There are 2 nasal antihistamine sprays available for the treatment of nasal allergies -- Astelin (azelastine) and Patanase (olopatadine). While Astelin has been around for years, Patanase has only been available since May 2008. Both of these medications are appropriate for the treatment of allergic rhinitis. while Astelin is also appropriate for the treatment of non-allergic rhinitis.
Nasal antihistamine sprays do not appear to be as effective as nasal steroids for the treatment of allergies, although they do have some advantages. First, these medications start working within 30 minutes, while nasal steroids take hours to days to start working. Second, nasal antihistamines cause less side effects than nasal steroids, with no increased risk of glaucoma or cataracts. Lastly, nasal antihistamines work in various ways -- they have antihistamine effects and prevent mast cells from releasing chemicals that cause allergy symptoms. Astelin also has various anti-inflammatory effects.
Like nasal steroids, nasal antihistamines also seem to treat eye allergies. So, while nasal antihistamines may not be quite as good at treating allergy symptoms as nasal steroids, the combination of nasal antihistamines and nasal steroids has been shown to be more effective than either medication alone. Some of my patients find that using both medications together works much better for treating their allergy symptoms.
Want to keep learning? Find out more about other treatments for allergic rhinitis.
Sources:
Lieberman PL, Settipane RA. Azelastine Nasal Spray: A Review of Pharmacology and Clinical Efficacy in Allergic and Nonallergic Rhinitis. Allergy Asthma Proc. 2003, 24:95-105.
Ratner PH, Hampel FC, Amar NJ et al. Safety and Tolerability of Ololpatadine Hydrochloride Nasal Spray for the Treatment of Seasonal Allergic Rhinitis to Mountain Cedar. Ann Allergy Asthma Immunol. 2005, 95:474-9.
Ratner PH, Hampel F, Van Bavel J et al. Combination Therapy with Azelastine Hydrochloride Nasal Spray and Fluticasone Propionate Nasal Spray in the Treatment of Patients with Seasonal Allergic Rhinitis. Ann Allergy Asthma Immunol. 2008, 100:74-81.
Patel D, Garadi R, Brubaker M et al. Onset and Duration of Action of Nasal Sprays in Seasonal Allergic Rhinitis Patients: Olopatadine Hydrochloride Versus Mometasone Furoate Monohydrate. Allergy Asthma Proc. 2007, 28:592-9.
DISCLAIMER: The information contained in this site is for educational purposes only, and should not be used as a substitute for personal care by a licensed physician. Please see your physician for diagnosis and treatment of any concerning symptoms or medical condition.
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