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Adverse experience information for Azelastine hydrochloride nasal solution (nasal spray) at a dose of one spray per nostril twice daily is derived from two placebo-controlled 2-week clinical studies which included 276 patients 12 years of age and older with seasonal allergic rhinitis.
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In the situations, nasal corticosteroids or second-generation antihistamines have been of use.
Response to treatment with antihistamines supports the diagnosis of allergic rhinitis, although sneezing, itching, and rhinorrhea associated with nonallergic rhinitis can also improve with antihistamines.
Table 1 contains adverse reactions reported with frequencies greater than or equal to 2% and more frequently than placebo in patients treated with DYMISTA in the seasonal allergic rhinitis controlled clinical trials.
They conclude that the delivery system should be tailored according to the desired effect, be that consistent delivery of medication to certain sinuses or larger volume irrigation for debridement purposes.
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Many of the patients (56%) were also taking an imidazole compound or a macrolide antibiotic, which could inhibit the P450 CYP3A4 isoenzyme that metabolises cisapride and results in increased serum concentrations.
If such changes occur, the dosage of azelastine hydrochloride and fluticasone propionate nasal spray should be discontinued slowly, consistent with accepted procedures for discontinuing oral corticosteroid therapy.
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Certainly in stroke patients the risk of aspiration has been related to the extent of laryngopharyngeal hyposensitivity.
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Thus, vasomotor rhinitis in older patients may represent a decline in control of neurological responses that affect nasal physiology.
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Azelastine hydrochloride ophthalmic solution should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Lieberman P: Treatment update: nonallergic rhinitis.
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In this article the authors describe classification systems, review existing empirical evidence and evaluate the major classification system against five criteria.
Indeed, recommends that for most patients with rhinitis, improving patient well-being and QoL should be the primary goal of treatment.
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The authors ended up with 34 studies with about 2500 patients.
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