azelastine hydrochloride: clinical use

Prescribing considerations

• Confirm symptoms are consistent with allergic conjunctivitis; unilateral symptoms, pain or visual impairment require assessment for another cause.
• The licensed minimum age differs between seasonal and perennial allergic conjunctivitis.
• Consider benzalkonium chloride exposure in people with dry eye, corneal disease or soft contact-lens use.
• Systemic exposure after ocular application is very low.

Contraindications and cautions

• Hypersensitivity to azelastine hydrochloride or any excipient.
• Not indicated for treating eye infection.

Monitoring

• No routine laboratory monitoring is specified.
• Review diagnosis, administration technique, response and tolerability if symptoms worsen or fail to improve.
• Assess persistent irritation, corneal symptoms or visual disturbance.

Clinical pharmacology

Azelastine is a phthalazinone-derived selective H1-receptor antagonist with additional topical anti-inflammatory activity. It inhibits the synthesis or release of mediators including histamine, leukotrienes, platelet-activating factor and serotonin; plasma concentrations after ocular administration are very low.

Formulation and product differences

• The selected product is a clear, colourless, preserved multidose eye-drop solution.
• It contains benzalkonium chloride, which can irritate dry or diseased corneas and can be absorbed by or discolour soft contact lenses.
• The bottle should not be used more than 28 days after opening.

Eye drops

Route: Ophthalmic

Strengths: 0.5 mg/mL