How does this medication work? What will it do for me?

This combination product contains two medications: fluticasone and azelastine. Together, they are used to treat the nasal and eye symptoms of moderate-to-severe seasonal allergies for adults and children more than 12 years of age. This product is used when treatment with either antihistamines or nasal corticosteroids alone have not worked well enough to control the allergy symptoms.

Fluticasone is a corticosteroid. It reduces the body’s response to the allergy triggers. Azelastine is an antihistamine. It works by blocking the effect of the chemicals produced in the body in response to an allergy trigger. For most people, relief of allergy symptoms occurs within 30-45 minutes after administration, however fluticasone–azelastine needs to be used regularly to get the best results.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each metered spray/actuation of white, homogeneous, redispersible suspension intended for intranasal administration delivers an average volume of 0.137 mL containing 137 mcg of azelastine hydrochloride and 50 mcg of fluticasone propionate. Nonmedicinal ingredients: disodium edetate, glycerol, microcrystalline cellulose, carmellose sodium, polysorbate 80, benzalkonium chloride, phenylethyl alcohol, and purified water.  

How should I use this medication?

The recommended dose of this medication is 1 actuation (spray) into each nostril two times a day – one in the morning and one in the evening.

If you are using this medication for the first time or you have not used it for more than 7 days, you will need to "prime" the pump by spraying the pump in the air (away from you) 6 times or until a fine mist is sprayed from the bottle.

Before each use, gently blow your nose to clear your nostrils.

With the cap on, shake the medication well. Then remove the cap and follow these 4 steps to use the medication:

  • Tilt your head forward slightly and place the nozzle in one of your nostrils. Point the end of the nozzle towards the side of your nose.
  • Press the button firmly one time to spray the medication while you are breathing in through your nose. Remove the nozzle from your nose and breathe out through your mouth.
  • Repeat steps 1 and 2 for the other nostril.
  • Replace the dust cap.

Avoid getting the spray in your eyes. If you do, thoroughly rinse your eyes with water. Always put the cap back on after use.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor.

If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children. 

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to fluticasone, azelastine or any ingredients of the medication
  • have an untreated infection of the respiratory tract (fungal, bacterial or tuberculosis infection)

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • change in sense of taste or smell
  • crusting in the nose
  • drowsiness
  • dry or soreness inside the nose
  • headache
  • nose bleeds
  • runny nose
  • symptoms of upper respiratory tract infection (e.g., sore throat, fever, cough, stuffy nose, chills, feeling tired)

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • bone or joint pain
  • signs of nasal ulcers (pain, burning or irritation)
  • signs of too much corticosteroid (e.g., rapid weight gain, sweating, thinning skin, dry skin, muscle weakness)
  • slowed growth (in adolescents)
  • symptoms of increased pressure in the eyes (e.g., decreased or blurred vision, eye pain, red eye, swelling of the eye)
  • symptoms of cataracts (e.g., visual glare, reduced vision)

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Drowsiness/reduced alertness: The antihistamine, azelastine, in this medication may affect the mental or physical abilities needed to drive or operate machinery. Avoid driving, operating machinery, or performing other hazardous tasks until you have determined how this medication affects you.

Growth in adolescents: Corticosteroids such as the fluticasone in this medication may slow down the growth of adolescents. Your doctor will monitor for this. Talk to your doctor if you have any concerns.

Infection: Corticosteroids such as the fluticasone in this medication can mask the signs of infection. You can also develop other infections such as a fungal throat infection or eye infection. Talk to your doctor as soon as possible if you develop any new symptoms.

Infections such as chickenpox and measles can be more serious in people taking medications such as fluticasone. If you are exposed to someone who has chickenpox or measles, contact your doctor.

Vision problems: Corticosteroids such as fluticasone may cause glaucoma or cataracts. Report any vision changes to your doctor immediately.

Wound healing: Corticosteroids such as fluticasone can impair the ability of wounds to heal. If you have ulcers in your nose, have had nasal surgery, or have had nasal trauma, talk to your doctor about how this medication will affect these conditions. Your doctor may recommend waiting until wounds have completely healed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: Fluticasone passes into breast milk. It is not known if azilastine passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children less than 12 years of age.

What other drugs could interact with this medication?

There may be an interaction between fluticasone-azelastine and any of the following:

  • aclidinium
  • alcohol
  • amphetamines (e.g., dextroamphetamine, lisdexamphetamine)
  • antihistamines (e.g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
  • antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
  • aripiprazole
  • atropine
  • azelastine
  • “azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
  • baclofen
  • barbiturates (e.g., butalbital, pentobarbital phenobarbital)
  • belladonna
  • benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
  • benztropine
  • betahistine
  • boceprevir
  • brimonidine
  • buspirone
  • ceritinib
  • chloral hydrate
  • clarithromycin
  • cobicistat
  • conivaptan
  • cyclobenzaprine
  • disopyramide
  • dofetilide
  • donepezil
  • dronabinol
  • flavoxate
  • galantamine
  • general anesthetics (medications used to put people to sleep before surgery)
  • glucagon
  • glycopyrrolate
  • HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delaviridine, efavirenz, etravirine, nevirapine)
  • HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
  • hyaluronidase
  • ipratropium
  • kava kava
  • ketotifen
  • lomitapide
  • magnesium sulfate
  • metoclopramide
  • metyrosine
  • mirabegron
  • mirtazapine
  • muscle relaxants (e.g., cyclobenzaprine, methocarbamol, orphenadrine)
  • nabilone
  • narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone)
  • nefazodone
  • nelfinavir
  • nicardipine
  • olopatadine
  • oxybutynin
  • pimozide
  • potassium chloride
  • pramipexole
  • rivastigmine
  • ropinirole
  • scopolamine
  • secretin
  • seizure medications (e.g., carbamazepine, clobazam, ethosuximide, felbamate, levetiracetam, phenobarbital, phenytoin, primidone, topiramate, valproic acid, zonisamide)
  • selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine, fluoxetine, paroxetine, sertraline)
  • tapentadol
  • telaprevir
  • thalidomide
  • thiazide diuretics (water pills; e.g., hydrochlorothiazide, indapamide, metolazone)
  • tiotropium
  • tolterodine
  • tranylcypromine
  • tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
  • tramadol
  • zolpidem
  • zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.