azelastine hydrochloride + fluticasone propionate at a glance
Medicine class
Combined intranasal antihistamine and corticosteroid
Licensed use
Moderate to severe seasonal or perennial allergic rhinitis inadequately controlled by either component alone
Licensed age
Adults and adolescents aged 12 years and over
Administration
Shake before use and keep the head tilted down while spraying
What is azelastine hydrochloride + fluticasone propionate used for?
The product is licensed for:
Moderate to severe seasonal allergic rhinitis, including pollen-related hay fever, when an intranasal antihistamine or corticosteroid alone is not considered sufficient.
Moderate to severe perennial allergic rhinitis, including allergy associated with house dust mites, mould or pets, when either component alone is not considered sufficient.
How does azelastine hydrochloride + fluticasone propionate work?
Azelastine blocks histamine H1 receptors and has mast-cell-stabilising and anti-inflammatory activity. Fluticasone activates glucocorticoid receptors to suppress inflammation in the nasal lining. Together they target congestion, sneezing, itching and a runny nose.
azelastine hydrochloride + fluticasone propionate preparations and strengths
Nasal preparation
Route: Nasal
Strengths: 137 micrograms + 50 micrograms/actuation
How to take azelastine hydrochloride + fluticasone propionate
Use only in the nose and follow the supplied device instructions.
Shake the bottle gently and prime the pump as directed when first opened or after it has not been used for several days.
Blow your nose, keep your head tilted down, hold the bottle upright and sniff gently while spraying.
Avoid contact with the eyes.
Wipe the spray tip and replace the cap. Clean a blocked actuator with water rather than piercing it.
azelastine hydrochloride + fluticasone propionate side effects
Common or expected effects
- Nosebleed
- Headache
- Bitter or unpleasant taste, particularly if the head is tilted backwards
- Unpleasant smell
Get urgent medical advice
- Severe allergic reaction, including facial or tongue swelling, breathing difficulty or bronchospasm
- Blurred vision, loss of vision, or a red and painful eye
- Nasal ulceration or damage to the nasal septum
- Systemic corticosteroid effects, particularly with excessive or prolonged exposure
azelastine hydrochloride + fluticasone propionate in pregnancy
Combination-specific pregnancy data are limited. Use is advised only when the expected benefit justifies potential fetal risk. Nasal fluticasone alone has low systemic absorption and UK pregnancy sources consider topical corticosteroids usable in pregnancy, but a prescriber must still assess the azelastine-containing combination.
azelastine hydrochloride + fluticasone propionate while breastfeeding
Direct product data are limited, and an individual benefit–risk assessment is recommended. UK specialist guidance considers intranasal fluticasone compatible with breastfeeding and identifies no additional risk from combining it with azelastine. This applies to healthy, full-term infants; seek specialist advice for a premature or unwell infant.
azelastine hydrochloride + fluticasone propionate interactions
Tell the prescriber or pharmacist about all medicines, particularly other corticosteroids and the following:
Ritonavir
Can greatly increase fluticasone exposure and cause systemic corticosteroid effects; concurrent use should generally be avoided unless benefits outweigh risks.
Cobicistat-containing medicines
May increase systemic fluticasone effects; avoid unless clinically justified and monitor carefully if used.
Potent CYP3A4 inhibitors, including ketoconazole
May increase fluticasone exposure, requiring additional caution and clinical review.
Common questions about azelastine hydrochloride + fluticasone propionate
Answers are fully visible for fast scanning and source review.
Is it an antihistamine or a steroid?
It contains both: azelastine is an antihistamine and fluticasone is a corticosteroid.
Why can it leave a bitter taste?
Spray can run towards the throat if the head is tilted backwards. Keeping the head down and sniffing gently reduces this problem.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.