Azelastine (Rhinolast nasal spray)

How does it work?

Rhinolast nasal spray contains the active ingredient azelastine hydrochloride, which is a type of medicine called an antihistamine. It works by preventing the actions of histamine.

Histamine is a substance produced by the body as part of its defence mechanisms. It is stored in cells called mast cells, in almost all tissues of the body. When the body reacts to a foreign substance (known as an allergen, eg flower pollen, pet fur, dust mites), the mast cells stimulated by the allergen release their stores of histamine.

The released histamine then binds to its receptors (H-1 receptors), causing a chain reaction that results in allergic symptoms. It causes an increase in blood flow to the area of the allergy, and the release of other chemicals that add to the allergic response.

All this results in the symptoms of an allergic reaction. In nasal allergies such as hayfever, histamine causes inflammation of the membranes in the nose. This results in symptoms such as a runny nose, sneezing and nasal congestion.

Azelastine is used as a nasal spray to allow it to act directly on the membranes in the nose. It works by blocking the histamine receptors in the nose. It doesn't prevent the actual release of histamine from mast cells, but prevents it binding to its receptors. This in turn prevents the release of other allergy chemicals and increased blood supply to the area.

The nasal spray can be used to both relieve and prevent the typical symptoms of nasal allergies.

What is it used for?

  • Relieving symptoms of hay fever (seasonal allergic rhinitis) in adults and children aged five years and over.
  • Relieving symptoms of nasal allergies such as pet allergies or dust mite allergies that occur throughout the year (perennial allergic rhinitis) in adults and children aged five years and over.

How do I use it?

  • Adults and children aged five years and over should use one spray in each nostril twice a day when needed to relieve symptoms.
  • Before using the spray for the first time, squeeze down the collar several times until an even spray emerges.
  • Follow this link for further instructions on how to use your nasal spray.


  • This medicine is for use in the nose only. It should not be taken by mouth. Take care to avoid getting the spray in the eyes.
  • Any remaining nasal spray should be thrown away six months after the spray is first opened. This is because it could be contaminated with dirt or germs. Write the date you open your nasal spray on the bottle so you know when to throw it away. Dispose of carefully, preferably by returning to your pharmacy.

Not to be used in

  • Children under five years of age.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

  • The safety of this medicine for use during pregnancy has not been established. Only minimal amounts of the medicine pass into the bloodstream after using the nasal spray, but the manufacturer states that it should be used with caution during pregnancy, and only if the benefits to the mother outweigh any potential risks to the developing baby. Seek medical advice from your doctor before using this medicine if you are pregnant.
  • Only very small amounts of this medicine may pass into breast milk after using the nasal spray. It should be used with caution by women who are breastfeeding and only if the benefits to the mother outweigh any potential risks to the nursing infant. Seek medical advice from your doctor before using this medicine if you are breastfeeding.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

  • Bitter taste and nausea (this is usually caused by tipping the head too far backwards when administering the spray into the nostrils).
  • Nasal irritation, eg stinging or itching.
  • Nosebleeds (epistaxis).
  • Sneezing.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

This medicine is only absorbed into the bloodstream in very small amounts after application into the nose. As such, it is unlikely to significantly affect other medicines that you are taking. However, as with all medicines, it is important to tell your pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while using this one, to make sure that the combination is safe.

Other medicines containing the same active ingredient

  • Optilast eye drops.
  • Rhinolast allergy nasal spray. This can be bought without a prescription from pharmacies.
  • Dymista nasal spray contains azelastine in combination with the corticosteroid fluticasone.