Azelastine

Azelastine
Clinical data
Trade namesAstelin, others
AHFS/Drugs.comMonograph
MedlinePlusa603009
License data
Pregnancy
category
  • AU: B3
Routes of
administration		Eye drops, nasal spray, by mouth
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability40% (intranasal) [4]
Metabolitesdesmethylazelastine (active) [4]
Onset of actionWithin 1 hour [4]
Elimination half-life22 hours [4]
Duration of action12 hours [4]
Identifiers
  • (RS)-4-[(4-Chlorophenyl)methyl]-2-(1-methylazepan-4-yl)-phthalazin-1-one
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.133.278 Edit this at Wikidata
Chemical and physical data
FormulaC22H24ClN3O
Molar mass381.90 g·mol−1
3D model (JSmol)
  • Clc1ccc(cc1)CC\3=N\N(C(=O)c2ccccc2/3)C4CCCN(C)CC4
  • InChI=1S/C22H24ClN3O/c1-25-13-4-5-18(12-14-25)26-22(27)20-7-3-2-6-19(20)21(24-26)15-16-8-10-17(23)11-9-16/h2-3,6-11,18H,4-5,12-15H2,1H3 checkY
  • Key:MBUVEWMHONZEQD-UHFFFAOYSA-N checkY
  (verify)

Azelastine, sold under the brand name Astelin among others, is a H1 receptor-blocking medication primarily used as a nasal spray to treat allergic rhinitis (hay fever) and as eye drops for allergic conjunctivitis.[5][6] Other uses may include asthma and skin rashes for which it is taken by mouth.[7] Onset of effects is within minutes when used in the eyes and within an hour when used in the nose.[8] Effects last for up to 12 hours.[8]

Common side effects include headache, sleepiness, change in taste, and sore throat.[8] It is unclear if use is safe during pregnancy or breastfeeding.[9] It is a second-generation antihistamine and works by blocking the release of a number of inflammatory mediators including histamine.[7][8]

Azelastine was patented in 1971 and came into medical use in 1986.[10] It is available as a generic medication.[3][11] In 2022, it was the 124th most commonly prescribed medication in the United States, with more than 5 million prescriptions.[12][13]

Medical uses

Azelastine nasal spray is indicated for the local treatment of the symptoms of seasonal allergic rhinitis and perennial allergic rhinitis, such as rhinorrhea, sneezing and nasal pruritus in people five years of age and older.[14][15][1] In some countries, it is also indicated for the treatment of vasomotor rhinitis in adults and children ≥ 12 years old.[1] Azelastine eye drops are indicated for the local treatment of seasonal and perennial allergic conjunctivitis.[16][2]

Side effects

Azelastine is safe and well tolerated in both adults and children with allergic rhinitis.[17][18][19] Bitter taste, headache, nasal burning and somnolence are the most frequently reported adverse events. US prescribing recommendations warn against the concurrent use of alcohol and/or other central nervous system depressants, but to date there have been no studies to assess the effects of azelastine nasal spray on the CNS in humans[needs update?]. More recent studies[20][21] have shown similar degrees of somnolence (approx. 2%) compared with placebo treatment.

The most common side effect is a bitter taste (about 20% of people). Due to this, the manufacturer has produced another formulation of azelastine with sucralose.[22] The problem of bitter taste may also be reduced by correct application of the nasal spray (i.e. slightly tipping the head forward and not inhaling the medication too deeply), or alternatively using the azelastine/sucralose formulation.[23]

In addition, anosmia (loss in the ability to smell) can occur with nasal spray antihistamines (including both formulations of azelastine).[8]

Pharmacology

Pharmacodynamics

Azelastine has a triple mode of action:[24]

  1. Anti-histamine effect,
  2. Mast-cell stabilizing effect and
  3. Anti-inflammatory effect.

Pharmacokinetics

The systemic bioavailability of azelastine is approximately 40% when administered intranasally.[4] Maximum plasma concentrations (Cmax) are observed within 2–3 hours.[4] The elimination half life, steady-state volume of distribution and plasma clearance are 22 h, 14.5 L/kg and 0.5 L/h/kg respectively (based on intravenous and oral administration data). Approximately 75% of an oral dose is excreted in feces. Pharmacokinetics of orally administered azelastine is not affected by age, gender, or hepatic impairment.[24]

Metabolism

Azelastine is oxidatively metabolized by the cytochrome P450 family into its active metabolite, desmethylazelastine, and two inactive carboxylic acid metabolites.[24]

Chemical properties

The chemical nomenclature of azelastine is (±)-1-(2H)-phthalazinone, 4-[(4-chlorophenyl) methyl]-2-(hexahydro-1-methyl-1H-azepin-4-yl)-monohydrochloride. It is white, almost odorless with a bitter taste.[25]

References

  1. ^ a b c "Astelin- azelastine hydrochloride spray, metered".
  2. ^ a b "Optivar- azelastine hydrochloride solution/ drops".
  3. ^ a b "FDA Approves a Nasal Antihistamine for Nonprescription Use". U.S. Food and Drug Administration (FDA) (Press release). 17 June 2021. Retrieved 21 June 2021.
  4. ^ a b c d e f g Lieberman P, Hernandez-Trujillo V, Lieberman J, Frew AJ (2008). "Antihistamines". Clinical Immunology. Elsevier. pp. 1317–1329. doi:10.1016/b978-0-323-04404-2.10089-2. ISBN 9780323044042. After intranasal administration, its systemic bioavailability is approximately 40%. Azelastine has an onset of action within the first hour of administration and reaches peak activity at 1–3 hours after administration. Duration of activity is about 12 hours. Intranasal administration results in maximal plasma concentrations in 2–3 hours. ... The half-life of the parent compound is 22 hours ...
  5. ^ British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. p. 1169. ISBN 9780857113382.
  6. ^ Al-Ahmad M, Hassab M, Al Ansari A (21 December 2020). "Allergic and Non-allergic Rhinitis". Textbook of Clinical Otolaryngology. Cham: Springer International Publishing. pp. 241–252. doi:10.1007/978-3-030-54088-3_22. ISBN 978-3-030-54087-6. S2CID 234142758.
  7. ^ a b Aronson JK (2015). Meyler's Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions. Elsevier. p. 782. ISBN 9780444537164.
  8. ^ a b c d e "Azelastine Hydrochloride Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists.
  9. ^ "Azelastine ophthalmic (Optivar) Use During Pregnancy". Drugs.com. Retrieved 26 March 2019.
  10. ^ Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 548. ISBN 9783527607495.
  11. ^ "First Generic Drug Approvals". U.S. Food and Drug Administration (FDA). 8 July 2024. Retrieved 9 July 2024.
  12. ^ "The Top 300 of 2022". ClinCalc. Archived from the original on 30 August 2024. Retrieved 30 August 2024.
  13. ^ "Azelastine Drug Usage Statistics, United States, 2013 - 2022". ClinCalc. Retrieved 30 August 2024.
  14. ^ Bousquet J, Schünemann HJ, Togias A, Bachert C, Erhola M, Hellings PW, et al. (January 2020). "Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence". The Journal of Allergy and Clinical Immunology. 145 (1): 70–80.e3. doi:10.1016/j.jaci.2019.06.049. hdl:10400.17/3723. PMID 31627910.
  15. ^ "Rhinolast Nasal Spray Summary of Product Characteristics". October 2009. Retrieved 27 April 2010.
  16. ^ "Optilast Eye Drops Summary of Product Characteristics". January 2010. Retrieved 27 April 2010.
  17. ^ McNeely W, Wiseman LR (July 1998). "Intranasal azelastine. A review of its efficacy in the management of allergic rhinitis". Drugs. 56 (1): 91–114. doi:10.2165/00003495-199856010-00011. PMID 9664202. S2CID 46956783.
  18. ^ Ratner PH, Findlay SR, Hampel F, van Bavel J, Widlitz MD, Freitag JJ (November 1994). "A double-blind, controlled trial to assess the safety and efficacy of azelastine nasal spray in seasonal allergic rhinitis". The Journal of Allergy and Clinical Immunology. 94 (5): 818–25. doi:10.1016/0091-6749(94)90148-1. PMID 7963150.
  19. ^ LaForce C, Dockhorn RJ, Prenner BM, et al. (February 1996). "Safety and efficacy of azelastine nasal spray (Astelin NS) for seasonal allergic rhinitis: a 4-week comparative multicenter trial". Annals of Allergy, Asthma & Immunology. 76 (2): 181–8. doi:10.1016/S1081-1206(10)63420-5. PMID 8595539.
  20. ^ Corren J, Storms W, Bernstein J, Berger W, Nayak A, Sacks H (May 2005). "Effectiveness of azelastine nasal spray compared with oral cetirizine in patients with seasonal allergic rhinitis". Clinical Therapeutics. 27 (5): 543–53. doi:10.1016/j.clinthera.2005.04.012. PMID 15978303.
  21. ^ Berger W, Hampel F, Bernstein J, Shah S, Sacks H, Meltzer EO (September 2006). "Impact of azelastine nasal spray on symptoms and quality of life compared with cetirizine oral tablets in patients with seasonal allergic rhinitis". Annals of Allergy, Asthma & Immunology. 97 (3): 375–81. doi:10.1016/S1081-1206(10)60804-6. PMID 17042145.
  22. ^ Kalpaklioglu AF, Kavut AB (2010). "Comparison of azelastine versus triamcinolone nasal spray in allergic and nonallergic rhinitis". American Journal of Rhinology & Allergy. 24 (1): 29–33. doi:10.2500/ajra.2010.24.3423. PMID 20109317. S2CID 24449860.
  23. ^ Bernstein JA (October 2007). "Azelastine hydrochloride: a review of pharmacology, pharmacokinetics, clinical efficacy and tolerability". Current Medical Research and Opinion. 23 (10): 2441–52. doi:10.1185/030079907X226302. PMID 17723160. S2CID 25827650.
  24. ^ a b c Horak F, Zieglmayer UP (November 2009). "Azelastine nasal spray for the treatment of allergic and nonallergic rhinitis". Expert Review of Clinical Immunology. 5 (6): 659–669. doi:10.1586/eci.09.38. PMID 20477689. S2CID 32512061.
  25. ^ drugs.com Azelastine Page accessed 28 June 2015

Read other articles:

Hilton Worldwide

Hilton Worldwide Holdings Inc.JenisPublikIndustriPerhotelanDidirikan Cisco, Texas, ASKantorpusatTysons, Virginia, Amerika SerikatTokohkunciChristopher J. NassettaPresiden dan CEOPendapatanUS$8,162 miliar (2006)Karyawan105.000 (April 2007)Situs webHilton Hotels Corporation Hilton Worldwide Holdings Inc. adalah sebuah perusahaan perhotelan multinasional yang bermarkas di Tysons, Virginia, Amerika Serikat. Hingga April 2007, perusahaan ini terdiri dari 2.645 hotel dan 485.000 kamar dan beroperas...

 

 

USS William R. Rush (DD-714)

Gearing-class destroyer For other ships with the same name, see USS William R. Rush and ROKS Gangwon. USS William R. Rush on 4 May 1965 History United States NameWilliam R. Rush NamesakeWilliam R. Rush BuilderFederal Shipbuilding and Drydock Company Laid down19 October 1944 Launched8 July 1945 Commissioned21 September 1945 Decommissioned21 December 1951 Recommissioned3 September 1952 Decommissioned1 July 1978 Reclassified DDR-714, 18 July 1952 DD-714, 1 July 1964 Stricken1 July 1978 Identific...

 

 

KRI Teluk Palu (523)

Kapal pertama Kelas Teluk Bintuni Karier (ID) ProduksiPT DRU Mulai dibuat 2019 Diluncurkan Harga Unit - Dibeli2019 oleh TNI Angkatan Laut Status Pelabuhan utamaArmada Timur TNI-AL Karakteristik umum Berat benaman 5200 ton Panjang 120 meter (393,70 ft) Lebar 13 meter (42,65 ft) Draft3 meter (9,84 ft)Tenaga penggerakmesin diesel 2 x STX MAN 9L27 / 38 Kecepatan maksimum 16 knot Awak kapal 300 orang Persenjataan1× 40mm kanon Bofors1× 20mm kanon Oerlikon2× senapan berat(2×1) KR...

توغو

  لمعانٍ أخرى، طالع توغو (توضيح).   الجمهورية التوغولية République togolaise  (فرنسية) توغوعلم توغو توغوشعار توغو موقع توغو في غرب إفريقيا الشعار الوطنيالعمل - الحرية - الوطن[1] النشيد: نشيد توغو الوطني الأرض والسكان إحداثيات 8°15′00″N 1°11′00″E / 8.25°N 1.183333°E / ...

 

 

Paul Coble

American politician from North Carolina (born 1953) Paul CobleChair of the Wake County Board of CommissionersIn office2010–2012Preceded byTony GurleySucceeded byJoe BryanMember of the Wake County Board of Commissioners from the 7th districtIn office2006–2014Preceded byHerb CouncilSucceeded byJohn Burns36th Mayor of RaleighIn officeDecember 7, 1999 – December 2001Preceded byTom FetzerSucceeded byCharles MeekerMember of the Raleigh City CouncilIn office1993–1999 Personal detail...

 

 

Sofia Pride

This article uses bare URLs, which are uninformative and vulnerable to link rot. Please consider converting them to full citations to ensure the article remains verifiable and maintains a consistent citation style. Several templates and tools are available to assist in formatting, such as reFill (documentation) and Citation bot (documentation). (August 2022) (Learn how and when to remove this template message) Netta at Sofia Pride 2019 Sofia Pride Parade is a peaceful march of LGBT people and...

Holyoke Falcos

This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed.Find sources: Holyoke Falcos – news · newspapers · books · scholar · JSTOR (July 2023) (Learn how and when to remove this template message) Soccer clubFalco F.C.Full nameFalco A.A.F.C.Nickname(s)Holyoke FalcosFounded?Dissolved?GroundFarr Alpaca Field Holyoke, MassachusettsLe...

 

 

Cardboard

Heavy-duty paper of various strengths For other uses, see Cardboard (disambiguation). Example of cardboard Cardboard is a generic term for heavy paper-based products. The construction can range from a thick paper known as paperboard to corrugated fiberboard which is made of multiple plies of material. Natural cardboards can range from grey to light brown in color, depending on the specific product; dyes, pigments, printing, and coatings are available. The term cardboard has general use in Eng...

 

 

Bouleuterion

Assembly building of Ancient Greece Bouleuterion of Priene A bouleuterion (Greek: βουλευτήριον, bouleutērion), also translated as council house, assembly house, and senate house, was a building in ancient Greece which housed the council of citizens (βουλή, boulē) of a democratic city state. These representatives assembled at the bouleuterion to confer and decide about public affairs. There are several extant bouleuteria around Greece and its former colonies. It should not b...

Emily Menges

American professional soccer player (born 1992) Emily Menges Menges with the Thorns in September 2016Personal informationFull name Emily Townsend Menges[1]Date of birth (1992-07-28) July 28, 1992 (age 31)Place of birth Garden City, New York, United StatesHeight 5 ft 7 in (1.70 m)Position(s) DefenderTeam informationCurrent team Bay FCNumber 4Youth career Albertson Fury '91College careerYears Team Apps (Gls)2010–2013 Georgetown Hoyas 84 (0)Senior career*Years Team ...

 

 

Five Stories (short story collection)

Five Stories 1956 p/b editionAuthorWilla CatherCountryUnited StatesLanguageEnglishGenre(historical fiction)PublisherVintage BooksPublication date1956Pages214 Five Stories is a collection of stories, published in 1956[1] by the Estate of Willa Cather, after the author's death. Several of these stories had been previously published in other collections. Contents This collection contains the following stories:[2] The Enchanted Bluff Tom Outland's Story Neighbour Rosicky The Best ...

 

 

コルク

この記事は検証可能な参考文献や出典が全く示されていないか、不十分です。出典を追加して記事の信頼性向上にご協力ください。（このテンプレートの使い方）出典検索?: コルク – ニュース · 書籍 · スカラー · CiNii · J-STAGE · NDL · dlib.jp · ジャパンサーチ · TWL（2017年4月） コルクを打ち抜いて作った瓶の栓 コルク（木栓、�...

Carl Epting Mundy Jr.

United States Marine Corps general For his son, also a Marine Corps general officer, see Carl E. Mundy III. Carl E. Mundy Jr.30th Commandant of the Marine Corps (1991–1995)Born(1935-07-16)July 16, 1935Atlanta, Georgia, U.S.DiedApril 2, 2014(2014-04-02) (aged 78)Alexandria, Virginia, U.S.AllegianceUnited StatesService/branchUnited States Marine CorpsYears of service1953–1995RankGeneralCommands heldCommandant of the Marine CorpsMarine Forces AtlanticII Marine Expeditionary Force4t...

 

 

Новотитаровское сельское поселение

Сельское поселение России (МО 2-го уровня)Новотитаровское сельское поселение Флаг[d] Герб 45°14′09″ с. ш. 38°58′16″ в. д.HGЯO Страна  Россия Субъект РФ Краснодарский край Район Динской Включает 4 населённых пункта Адм. центр Новотитаровская Глава сельского пос�...

 

 

哈萨克斯坦总统

此条目序言章节没有充分总结全文内容要点。 (2019年3月21日)请考虑扩充序言，清晰概述条目所有重點。请在条目的讨论页讨论此问题。 哈萨克斯坦總統哈薩克總統旗現任Қасым-Жомарт Кемелұлы Тоқаев卡瑟姆若马尔特·托卡耶夫自2019年3月20日在任任期7年首任努尔苏丹·纳扎尔巴耶夫设立1990年4月24日（哈薩克蘇維埃社會主義共和國總統） 哈萨克斯坦 哈萨克斯坦政府...

Гари (Татарстан)

СелоГари 55°52′11″ с. ш. 52°01′04″ в. д.HGЯO Страна  Россия Субъект Федерации Татарстан Муниципальный район Елабужский Сельское поселение Бехтеревское История и география Первое упоминание 1678 Часовой пояс UTC+3:00 Население Население 342 человека (2010) Национальнос...

 

 

دي روفيغو

دي روفيغو الدوق دي روفيغو Anne Jean Marie René Savary آن جان ماري روني صافاري (دوق دي روفيغو) معلومات شخصية الميلاد 26 أفريل 1774ممارك، الأردين الوفاة 2 جوان 1833م (59 سنة)باريس مكان الدفن مقبرة بير لاشيز  الجنسية فرنسية اللقب بارون العشير مدام دو كايلا[1]  مناصب حاكم الجزائر   في ا�...

 

 

The Watchtower (Alberta)

Mountain in the country of Canada The WatchtowerThe WatchtowerHighest pointElevation2,791 m (9,157 ft)[1]Prominence651 m (2,136 ft)[1]Parent peakMount Kerkeslin (2984  m)[1]ListingMountains of AlbertaCoordinates52°49′00″N 117°50′00″W / 52.81667°N 117.83333°W / 52.81667; -117.83333[2]GeographyThe WatchtowerLocation of The Watchtower in AlbertaShow map of AlbertaThe WatchtowerThe Watchtower (Canada...

Muna Khalif

Somalian politician Muna Khalif منى خليفMP in the Federal Parliament of SomaliaIncumbentAssumed office November 2016 Personal detailsBorn1994-1995[1]SomaliaPolitical partyIndependent Muna Khalif (Somali: Muna Khalif Sheekh Abuu, Arabic: منى خليف), popularly known as Muna Kay,[2] is a Somali-American entrepreneur, fashion designer and legislator. She is the founder and CEO of the Muna Kay brand. Khalif also serves as an MP in the Federal Parliament of Somalia,...

 

 

Pride Microfinance Limited

Microfinance institution in Uganda Pride Microfinance Limited ugandaCompany typePrivateIndustryFinancial servicesFounded1995 (1995)HeadquartersVictoria Office Park6-9 Ben Kiwanuka Okot Close Bukoto, Kampala, UgandaKey peopleCharles Oleny OjokchairmanVeronicah Namagembemanaging directorProductsLoans, savingsRevenueAftertax:$4.5 million (UGX:11.7 billion) (2013)Total assetsUS$56.84 million (UGX:147.4 billion) (2013)Number of employees1585+ (2013)Websitewww.pridemicrofinance.co.ug Prid...