Azelastine nasal spray interactions: A detailed guide

Key takeaways

• Azelastine nasal spray, used to treat allergy symptoms, can interact with certain drugs like opioids, some antidepressants, benzodiazepines, and muscle relaxants, potentially causing excessive sleepiness.
• While azelastine nasal spray doesn’t have known interactions with Sudafed or ibuprofen, it’s important to consult your doctor before combining these medications.
• Using azelastine nasal spray with alcohol or cannabis may intensify sleepiness and reduce alertness, so discussing the safety of combining these substances with your doctor is recommended.

Overview

This article describes possible interactions with azelastine nasal spray. Interactions can cause a drug to have a different effect on the body than expected. Interactions can occur due to medications, alcohol, or certain health conditions.

Azelastine comes as a nasal spray that you’ll spray into your nose. It’s also available as an eye drop that you’ll instill in your eye. Interactions and uses of azelastine may vary depending on the form of azelastine you’re prescribed.

For more information about azelastine, including details on its uses and side effects, see this overview article.

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Other drugs and azelastine

Before using the azelastine nasal, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Doing so may help prevent possible interactions. If you’re concerned about possible interactions, talk with your doctor or pharmacist.

The drugs in the list below may interact with azelastine nasal spray. This article doesn’t include all drugs that may interact with azelastine.

Drug classes or drugs that may interact with azelastine nasal spray include:

• certain anticonvulsants:
  • drug examples: gabapentin (Neurontin) and pregabalin (Lyrica)
  • what might happen: can cause excessive sleepiness
• certain antidepressants:
  • drug examples: amitriptyline and doxepin (Silenor)
  • what might happen: can cause excessive sleepiness
• benzodiazepines:
  • drug examples: lorazepam (Ativan) and clonazepam (Klonopin)
  • what might happen: can cause excessive sleepiness
• muscle relaxants:
  • drug examples: cyclobenzaprine and baclofen
  • what might happen: can cause excessive sleepiness
• opioids:
  • drug examples: codeine and hydrocodone
  • what might happen: can cause excessive sleepiness
• sedating antihistamines:
  • example drugs: diphenhydramine (Benadryl, others) and chlorpheniramine
  • what might happen: can cause excessive sleepiness

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Alcohol and azelastine

Azelastine nasal spray is known to interact with alcohol.

Using azelastine nasal spray and drinking alcohol may cause:

• excessive sleepiness
• decreased alertness
• problems thinking or reacting

If you drink alcohol, talk with your doctor about whether it’s safe to consume it while using azelastine nasal spray.

Other interactions and azelastine

Interactions can occur with supplements, foods, vaccines, and some lab tests. Below you can learn whether azelastine nasal spray has these interactions. 

The information below doesn’t include all other possible interactions with azelastine.

Azelastine and supplements

Before using azelastine nasal spray, tell your doctor and pharmacist about any herbs you take, as well as vitamins and supplements. Doing so may help you avoid interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Azelastine interactions with herbs

Azelastine nasal spray isn’t known to interact with any herbs. But this doesn’t mean interactions with herbs can’t happen or won’t be identified later.

Because of this, ask your doctor or pharmacist before taking any of these products while using azelastine nasal spray.

Azelastine interactions with vitamins

Azelastine nasal spray isn’t known to interact with any vitamins. But this doesn’t mean interactions with vitamins can’t happen or won’t be identified later.

Because of this, ask your doctor or pharmacist before taking any of these products while using azelastine nasal spray.

Azelastine and food

Azelastine nasal spray isn’t known to interact with foods. But this doesn’t mean interactions with foods can’t happen or won’t be identified later.

Because of this, talk with your doctor or pharmacist about what foods you should avoid while using azelastine nasal spray.

Azelastine and vaccines

Azelastine nasal spray isn’t known to interact with any vaccines. But this doesn’t mean interactions with vaccines can’t happen or won’t be identified later.

Because of this, talk with your doctor or pharmacist before receiving any vaccines while using azelastine nasal spray.

Azelastine and lab tests

Azelastine nasal spray isn’t known to interact with lab tests. But this doesn’t mean interactions with lab tests can’t happen or won’t be identified later.

Because of this, talk with your doctor or pharmacist before having any tests while using azelastine nasal spray.

Azelastine and cannabis or CBD

Reports have shown cannabis (commonly called marijuana) and cannabis products may interact with azelastine. Cannabidiol (CBD) is an example of a cannabis product.

Using azelastine and cannabis or CBD may lead to excessive sleepiness and decreased alertness.

Before you using azelastine nasal spray, tell your doctor and pharmacist if you use cannabis. Doing so may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Health factors and azelastine

Certain medical conditions or other health factors may increase the risk of interactions with azelastine nasal spray. Keep in mind that interactions could lead to side effects or affect how well the drug works. Before using azelastine, tell your doctor about your health history. They’ll determine whether azelastine is right for you.

These health conditions or other factors might interact with azelastine nasal spray:

• pregnancy or breastfeeding
• past allergic reaction to azelastine

Questions about azelastine and interactions

Here you’ll find answers to some common questions about azelastine and possible interactions.

Are there any azelastine contraindications?

No, the drugmaker of azelastine nasal spray hasn’t reported any contraindications for this drug. Contraindications are health conditions or other factors that could increase risks with the use of a medication.

If you have concerns about the risks of azelastine treatment, talk with your doctor. They can recommend whether this nasal spray is a suitable treatment option for you.

Can I use Sudafed and azelastine together?

Yes, if your doctor recommends it. Azelastine nasal spray isn’t known to interact with pseudoephedrine, the active ingredient in Sudafed. (An active ingredient is what makes a drug work.) So, it may be okay to use these medications together to manage your symptoms. But be sure to ask your doctor if that suits your condition.

Are there any known azelastine and ibuprofen interactions?

No, there’s not a known interaction between azelastine nasal spray and ibuprofen (Advil, Motrin). If your doctor recommends it, you can take ibuprofen and use azelastine nasal spray together. Check with your doctor to learn whether this treatment combination will be helpful for your condition.

Preventing azelastine interactions

You may be able to help avoid certain interactions with azelastine nasal spray. Before using this drug, you may want to discuss possible interactions with your doctor and pharmacist.

Things to consider include:

• Whether you drink alcohol or use cannabis.
• Other medications and herbs you take, as well as vitamins and supplements. Your doctor or pharmacist can help you fill out a medication list.
• What to do if you’re prescribed a new drug while using azelastine nasal spray.

Using azelastine nasal spray exactly as prescribed can also help prevent interactions.

Related articles

• Azelastine vs. fluticasone
• Azelastine nasal spray dosage

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.