Azelastine nasal spray for the treatment of allergic and nonallergic rhinitis

Rhinitis affects millions of people around the world, places a huge burden on the economy and reduces patients' health-related quality of life. Azelastine nasal spray is a second-generation antihistamine, indicated for the treatment of allergic and nonallergic rhinitis in both adults and children. It offers a rapid onset of action (15 min) and flexibility of both dose (i.e., one or two sprays/nostril twice daily) as well as dosage (i.e., fixed or as needed). Compared with other agents used to treat allergic rhinitis, azelastine nasal spray exhibits superior efficacy to oral antihistamines (e.g., desloratadine and cetirizine), other intranasal antihistamines (e.g., levocabastine) and the intranasal corticosteroid mometasone furoate, and comparable efficacy to the potent intranasal corticosteroid fluticasone propionate (FP). Combination therapy with intranasal FP has the potential to enhance clinical benefit, as the combination of azelastine and FP nasal sprays reduce symptoms in allergic rhinitis patients more than either agent alone. Azelastine nasal spray has an excellent safety profile.