Azelastine HCl (Astelin™) is an intranasal antihistamine indicated for use in patients with seasonal allergic rhinitis (SAR) and non-allergic vasomotor rhinitis (VMR). A side effect of this medication is bitter taste which many patients find aversive. To address the issue of bitter taste, azelastine has been reformulated to include sucralose and sorbitol. The new formulation (Astepro™ 0.1%) is approved for seasonal and perennial allergic rhinitis and has been demonstrated to have comparable pharmacokinetics, pharmacodynamics and therapeutic efficacy compared to Astelin. More recently, Astepro at a concentration 0.15% has been approved for once a day use. This review will provide an overview of the old and new formulations of Azelastine.