A Comprehensive Guide on How to use azelastine nasal spray correctly?

October 8, 2025 •

5 min read

According to research published in the Journal of Allergy and Clinical Immunology, azelastine nasal spray demonstrates superior efficacy compared to oral antihistamines for relieving nasal symptoms. To achieve these optimal results, understanding how to use azelastine nasal spray correctly? is crucial for effective and fast-acting symptom relief.

Quick Summary

A step-by-step guide to using azelastine nasal spray for maximum relief. Learn the correct priming, application technique, and important precautions for effective management of allergy symptoms.

Key Points

Priming is essential: Before the first use or after a 3-day lapse, prime the pump by spraying into the air until a fine mist appears.
Tilt your head forward: Look down at your toes during application to prevent the medication from dripping down your throat, which causes a bitter taste.
Aim away from the center: Insert the nozzle and point it towards the outer side of your nostril, aiming toward the back of the nose to avoid the nasal septum.
Breathe in gently: Administer the spray while gently sniffing, rather than a deep, sharp inhalation.
Avoid alcohol and driving initially: Azelastine can cause drowsiness, so avoid alcohol and hazardous activities until you know how it affects you.
Use as directed: Follow the dosage instructions precisely, and do not use more or less than prescribed to ensure effectiveness.

Azelastine nasal spray, available by prescription (Astelin) and over-the-counter (Astepro Allergy), is an antihistamine medication used to treat seasonal and perennial allergic rhinitis. For some, it can also help with nonallergic (vasomotor) rhinitis. Unlike oral antihistamines that affect the entire body, azelastine works locally within the nose for faster relief. Its effectiveness, however, is heavily dependent on proper administration. A poor technique can lead to less effective symptom control and an unpleasant bitter taste.

Preparing the Spray for First Use

Before you use your azelastine nasal spray for the first time, or if it has been left unused for a few days, you must prime it to ensure you receive a full, fine mist with each spray. Follow these steps carefully:

Unpack and inspect: Take the spray bottle out of its packaging and remove the protective cap and safety clip.
Prepare the pump: Hold the bottle upright, away from your face, with your index and middle fingers on the applicator and your thumb on the bottom.
Prime the device: Press down firmly and release the pump several times (usually 4 to 6 times, depending on the manufacturer's instructions) until a fine, uniform mist appears.
Re-priming: If the spray has not been used for more than three days, re-prime the pump by spraying two times or until a fine mist is released.

Step-by-Step Guide for Correct Application

Following the right technique is essential for the medication to reach the nasal passages effectively and avoid side effects like a bitter taste.

Clear your nasal passages: Gently blow your nose into a tissue to clear out any mucus. This ensures the medicine can be absorbed properly.
Position your head correctly: Tilt your head slightly forward, looking down towards your feet. This helps prevent the medicine from draining down the back of your throat.
Insert the nozzle: Close one nostril by pressing a finger against it. Keeping the bottle upright, insert the nozzle about 1/4 to 1/2 inch into your other nostril. Aim the tip away from the nasal septum (the center wall of the nose) and towards the back of your nose, or toward the ear on the same side.
Administer the spray: Press the pump once firmly and quickly. At the same time, breathe in gently through your nose. Do not sniff forcefully, as this can cause the medicine to go down your throat.
Exhale and repeat: Exhale through your mouth. If you need a second spray in the same nostril, repeat the process. Then, switch nostrils and repeat steps 3 and 4.
Wipe and cap: Wipe the nozzle with a clean, dry tissue after each use and replace the cap.

How to Clean and Maintain Your Nasal Spray

Proper maintenance prevents the nozzle from getting clogged and helps ensure you get a consistent dose every time.

Daily cleaning: After each use, wipe the nozzle with a clean, dry tissue.
Deep cleaning: If the nozzle becomes clogged, do not use a pin or sharp object to clear it. Instead, remove the cap and rinse the nozzle under warm water for a few minutes. Dry it thoroughly before reassembling. You may need to re-prime the bottle after cleaning.
Track your dosage: Keep track of the number of sprays you use. Once you have reached the total number of sprays specified by the manufacturer, discard the bottle, even if there is still some liquid left. This ensures the medication remains effective.

Comparing Azelastine to Other Nasal Sprays

Different types of nasal sprays work in different ways to treat allergy symptoms. Here's a comparison of azelastine with some other common options.


Feature	Azelastine (e.g., Astepro)	Fluticasone (e.g., Flonase)	Oxymetazoline (e.g., Afrin)
Drug Class	Antihistamine	Corticosteroid	Alpha adrenergic receptor agonist
Mechanism	Blocks histamine to relieve symptoms	Reduces inflammation in the nasal passages	Narrows blood vessels to relieve congestion
Primary Uses	Allergic rhinitis and vasomotor rhinitis	Allergic rhinitis and seasonal allergies	Short-term relief for nasal and sinus congestion
Speed of Action	Fast-acting; provides relief quickly	Takes a few days to reach full effect	Works almost immediately
Duration of Use	Can be used long-term	Can be used long-term	Limited to 3 days due to rebound congestion risk
Side Effects	Bitter taste, drowsiness, nasal irritation	Nosebleeds, headache, nasal irritation	Burning/stinging in nose, rebound congestion
Availability	Prescription and OTC (Astepro Allergy)	OTC and Prescription	OTC only

What to Expect: Side Effects and Precautions

While azelastine is generally well-tolerated, be aware of potential side effects and necessary precautions.

Common Side Effects

Bitter taste: This is one of the most frequently reported side effects and can often be minimized by tilting your head forward during application. Eating or drinking something with a strong flavor afterward can also help.
Drowsiness: Though less common with nasal administration compared to oral antihistamines, some users may experience sleepiness or fatigue.
Nasal irritation: A stinging or burning sensation inside the nose may occur briefly after spraying.
Headache: Headaches are a possible, though uncommon, side effect.
Nosebleeds: Mild nosebleeds may occur. If they are frequent or severe, contact your doctor.

Important Precautions

Avoid alcohol: Alcohol can increase the sedative effects of azelastine, so it should be avoided while using the spray.
Operating machinery: Do not drive or operate heavy machinery until you know how the medication affects you, especially concerning drowsiness.
Age restrictions: Non-prescription azelastine (Astepro Allergy) is not for use in children younger than 6 years old. Prescription formulations may be used in younger children under a doctor's guidance.
Intranasal use only: The spray is only for use in the nose. Avoid spraying it into your eyes or mouth.
Medical conditions: If you have recent nasal surgery, injury, ulcers, or other nasal problems, consult your doctor before use.
Sharing: Do not share your nasal spray with others, as this can spread germs.

Conclusion

Using azelastine nasal spray correctly is vital for maximizing its therapeutic benefits and minimizing unwanted side effects. By following the proper priming and application techniques—such as tilting your head slightly forward and aiming away from the center of your nose—you can ensure the medication reaches the right area for effective relief. Being aware of common side effects and safety precautions, like avoiding alcohol and monitoring for drowsiness, will further enhance your experience. While azelastine is a powerful tool for managing allergic and nonallergic rhinitis, consulting your doctor or pharmacist is always recommended for personalized advice and to address any concerns. When used correctly, azelastine can be a rapid and effective solution for combating bothersome nasal symptoms. For more information, refer to official product inserts and medical resources from reputable organizations like MedlinePlus.

Frequently Asked Questions

A bitter taste is a common side effect that occurs when the medication drains from your nose down the back of your throat. To minimize this, tilt your head slightly forward while spraying and avoid sniffing too hard. Drinking a beverage afterward can also help.

For the first use, remove the cap and safety clip, hold the bottle upright, and press the pump 4 to 6 times until a fine mist appears. If you haven't used it for more than three days, re-prime with two sprays.

You should inform your doctor or pharmacist about all medications you are taking, including over-the-counter products. Combining azelastine with other sedatives or alcohol can increase drowsiness, so careful consultation is necessary.

Unlike some decongestant sprays that cause rebound congestion with long-term use, azelastine is an antihistamine and can be used safely for extended periods, as advised by your doctor.

If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed one and continue with your regular schedule. Do not double the dose to make up for a missed one.

Do not use a pin or sharp object to clear the clog, as this can damage the device. Instead, remove the nozzle and rinse it thoroughly under warm water. Dry it completely before reattaching and re-priming.

Common side effects include a bitter taste, nasal irritation, drowsiness, and headache. In rare cases, nosebleeds can occur. These effects are usually mild and may subside with proper technique and continued use.