What is an alternative to Optilast eye drops?: Choosing the Right Allergy Relief

October 8, 2025 •

4 min read

According to the American College of Allergy, Asthma & Immunology, allergic conjunctivitis affects millions, causing itchy, red, and watery eyes. For those seeking relief after using or discontinuing Optilast, understanding what is an alternative to Optilast eye drops? is crucial for managing these uncomfortable symptoms.

Quick Summary

This guide provides an overview of alternatives for allergic eye relief, including over-the-counter and prescription options that address symptoms like itching, redness, and swelling, while considering potential side effects and contact lens compatibility.

Key Points

Optilast (azelastine) alternatives: Many OTC options like ketotifen and olopatadine provide similar dual-action relief for allergic eye symptoms.
Consider dosage and duration: Ketotifen and olopatadine offer different relief durations (up to 12 or 24 hours), influencing dosing frequency.
Beware of rebound redness: Decongestant eye drops (e.g., Naphcon-A) reduce redness quickly but are not for long-term use due to the risk of worsening redness after discontinuation.
Prescription options are available: For severe allergies, prescription drops like alcaftadine or supervised corticosteroid drops may be necessary.
Non-medication remedies help: Simple steps like applying a cold compress, rinsing with saline solution, and avoiding allergens can offer significant relief.
Check contact lens compatibility: Some eye drops require removing contact lenses before use, while others, like olopatadine and alcaftadine, are compatible after a short waiting period.
Consult a professional for guidance: Choosing the right alternative depends on individual symptoms and needs, making a healthcare provider's consultation crucial for safety and efficacy.

What is Optilast and Why Seek Alternatives?

Optilast is a brand name for azelastine, an antihistamine eye drop designed to relieve the itching associated with allergic conjunctivitis. While effective, the brand name for the ophthalmic solution (Optivar) has been discontinued in the U.S., though generic azelastine may still be available. Other reasons for seeking an alternative include experiencing side effects such as a bitter taste in the mouth or temporary eye stinging, or simply desiring a different dosing schedule. Fortunately, the market offers numerous effective alternatives, available both over-the-counter (OTC) and by prescription, that can provide fast and long-lasting relief from eye allergies.

Over-the-Counter (OTC) Alternatives

For many, non-prescription eye drops are a convenient and effective starting point for managing allergic eye symptoms. These products can be found in most pharmacies and offer a variety of benefits depending on the active ingredients.

Dual-Action Antihistamine and Mast Cell Stabilizers

These popular eye drops work in two ways: they block the histamine that causes an immediate allergic reaction and prevent mast cells from releasing inflammatory chemicals, providing both rapid and longer-term relief.

Ketotifen (e.g., Alaway, Zaditor): This is a widely available OTC option that provides up to 12 hours of relief from itchy eyes. It is generally well-tolerated and is approved for children as young as three years old. However, some formulations are not compatible with contact lenses and require waiting at least 10 minutes before reinserting them.
Olopatadine (e.g., Pataday Once Daily Relief, Pataday Twice Daily Relief): Olopatadine is a potent option, with different strengths available over-the-counter. The once-daily formulation offers 24-hour relief, while the twice-daily version provides 12-hour relief. It is known for its efficacy and, unlike some alternatives, is safe for contact lens wearers after a 10-minute waiting period.

Decongestant Combination Eye Drops

Some OTC eye drops combine an antihistamine with a decongestant to reduce both itching and redness. While they offer quick relief from redness, they are not recommended for long-term use due to the risk of “rebound redness”.

Naphazoline/Pheniramine (e.g., Naphcon-A, Opcon-A): This combination provides relief for multiple symptoms, including itchy and red eyes. Due to the decongestant component, usage should be limited to 72 hours at a time.

Lubricating Eye Drops

For those with dry or sensitive eyes exacerbated by allergies, or for general symptom relief, artificial tears are an excellent option. They work by lubricating the eyes and helping to flush out allergens.

Systane Ultra, Refresh Tears, etc.: These products are primarily for moisturizing but can offer symptom relief by removing irritants from the eye's surface. Using preservative-free options can minimize further irritation, especially for sensitive eyes.

Prescription-Only Alternatives

If OTC options don't provide sufficient relief, an eye doctor may prescribe stronger medications.

Potent Dual-Action Drops

Prescription versions of dual-action drops offer higher concentrations or unique formulations for more severe cases.

Alcaftadine (Lastacaft): This is a prescription-strength antihistamine and mast cell stabilizer that offers long-lasting relief, typically for 16 hours or more with once-daily dosing. It is also suitable for contact lens wearers after a brief wait.

Corticosteroid Eye Drops

For severe, chronic, or inflammatory allergic conjunctivitis, a doctor might prescribe steroid eye drops to reduce swelling and inflammation. These are typically used for short-term, supervised treatment due to potential side effects like increased eye pressure and cataracts. Examples include loteprednol (Alrex, Lotemax).

Mast Cell Stabilizers

Unlike dual-action drops, pure mast cell stabilizers work preventatively by inhibiting the release of histamines. They need to be used regularly before allergen exposure to be effective and do not provide immediate relief. Cromolyn (Crolom) is an example, often used as ongoing therapy.

Non-Pharmacological Strategies

Medication is not the only way to manage eye allergies. Lifestyle adjustments and home remedies can significantly reduce symptoms.

Cold Compresses: Applying a cold compress to closed eyes for 10-15 minutes can constrict blood vessels, reduce swelling, and soothe itching.
Saline Rinses: Gently rinsing the eyes with a sterile saline solution can flush out allergens and provide immediate relief.
Allergen Avoidance: Minimizing exposure to triggers is key. This can include keeping windows closed during high pollen seasons, using air purifiers, and avoiding rubbing your eyes. If you wear contacts, consider using a fresh pair daily or switching to glasses during peak allergy season.

Comparison of Common Allergy Eye Drops

This table provides a quick reference for some of the most common OTC and prescription eye drops used as an alternative to azelastine.


Feature	Ketotifen (Alaway, Zaditor)	Olopatadine (Pataday)	Naphazoline/Pheniramine (Naphcon-A)	Alcaftadine (Lastacaft)
Availability	Over-the-Counter (OTC)	OTC (Rx-strength available OTC)	Over-the-Counter (OTC)	Prescription-Only
Active Ingredients	Ketotifen	Olopatadine	Naphazoline & Pheniramine	Alcaftadine
Mechanism	Antihistamine + Mast Cell Stabilizer	Antihistamine + Mast Cell Stabilizer	Antihistamine + Decongestant	Antihistamine + Mast Cell Stabilizer
Dosing Frequency	Typically twice daily	Once or twice daily (depends on strength)	Up to 4 times daily (max 72 hours)	Once daily
Duration of Relief	Up to 12 hours	12-24 hours	Short-term	16+ hours
Redness Relief	Yes (via anti-inflammatory action)	Yes	Yes (directly via decongestant)	Yes
Contact Lens Safe	No (wait 10 mins)	Yes (wait 10 mins)	No (wait 10-15 mins)	Yes (wait 10 mins)
Best For	Fast, reliable itch relief	Once-daily convenience	Fast, short-term redness relief	Longest-lasting prescription relief

Conclusion

While Optilast (azelastine) eye drops were a reliable option for allergic conjunctivitis, several strong alternatives exist for those seeking a different treatment. Over-the-counter options like ketotifen (Alaway, Zaditor) and olopatadine (Pataday) offer effective dual-action relief with varying durations and contact lens compatibility. For more severe symptoms, prescription drops like alcaftadine (Lastacaft) or steroid drops can be highly effective under professional guidance. It is important to consider individual needs, such as symptom severity, frequency of dosing, and contact lens usage, when choosing an alternative. As always, consulting with a healthcare provider or eye care specialist can help determine the most suitable option for your specific situation. This ensures a personalized approach to managing eye allergies safely and effectively. For more information on allergy medication classifications, visit authoritative health resources like MedlinePlus.

Frequently Asked Questions

Optilast is a brand name for azelastine ophthalmic solution. While the specific brand Optivar has been discontinued in the U.S., generic azelastine eye drops may be available with a prescription.

Over-the-counter dual-action drops containing ingredients like ketotifen (Alaway, Zaditor) and olopatadine (Pataday) are often very effective for treating allergic eye itchiness and inflammation, and can be sufficient for many people. The best choice depends on the severity of your symptoms and desired dosing schedule.

For long-lasting relief, olopatadine (Pataday) is a strong candidate, with a once-daily formula providing up to 24-hour relief. Prescription alcaftadine (Lastacaft) is another option known for providing 16+ hours of relief with a once-daily dose.

Decongestant eye drops (e.g., Naphcon-A) can relieve redness, but they are not recommended for long-term use. Frequent use can lead to 'rebound redness,' where the eyes become even redder after you stop using the drops. For ongoing allergy management, dual-action antihistamines are a better choice.

Yes, natural strategies like applying a cold compress, using sterile saline rinses to flush out allergens, and consciously avoiding allergens can provide significant relief without medication.

Over-the-counter options like ketotifen (Zaditor) are approved for children as young as three years old. However, you should always consult with a pediatrician or eye doctor before giving any new medication to a child.

It's best to see a doctor if OTC drops are not providing sufficient relief, if you experience severe side effects, or if your symptoms are severe, persistent, or affecting your vision. A doctor can evaluate your condition and prescribe a stronger option like corticosteroid drops if necessary.