Histamine skin test reactivity following single and multiple doses of azelastine nasal sprayin patients with seasonal allergic rhinitis

The diagnosis and management of rhinitis: An updated practice parameter

“…[336][337][338]340 Because intranasal antihistamines are absorbed via the gastrointestinal tract, they can suppress skin test response for at least 48 hours in the case of azelastine. 657 Oral and topical decongestants 70. Oral decongestants, such as pseudoephedrine and phenylephrine, are a-adrenergic agonists that can reduce nasal congestion but can result in side effects such as insomnia, irritability, and palpitations.…”

Effect of Azelastine Nasal Spray on Histamine-and Allergen-Induced Skin Wheal Response in Patients with Allergic Rhinitis

“…However, 5 hours after discontinuing 14 days' treatment with azelastine nasal spray (2 sprays per nostril twice daily; 1.1 mg/day), skin test response to histamine was suppressed in many patients. It was only 48 hours after discontinuing the treatment that the skin wheal response returned within 20% of baseline values in all the patients (18). In our study, we used azelastine nasal spray in pediatric dosage of 1 spray in each nostril twice daily (0.28 mg/dose) in adults as against the recommended dose of 2 sprays per nostril twice daily.…”

“…Skin tests were performed at 2 different sites of the forearm of each patient to ensure reproducibility of the results. Pearlman et al (2003) reported that a single dose of azelastine nasal spray (2 sprays per nostril; 0.55 mg) did not significantly alter wheal and flare response to histamine. However, 5 hours after discontinuing 14 days' treatment with azelastine nasal spray (2 sprays per nostril twice daily; 1.1 mg/day), skin test response to histamine was suppressed in many patients.…”

Azelastine hydrochloride:a review of pharmacology, pharmacokinetics, clinical efficacy and tolerability

“…In an onset-of-action study conducted in an environmental exposure chamber, significant relief of nasal symptoms of SAR with azelastine nasal spray was shown at 15 min compared to placebo 24 , while in a study designed to determine the effect of azelastine nasal spray on the wheal and flare response to histamine, rhinitis symptom scores were improved while wheal and flare responses were not attenuated after singledose administration 25 . Taken together, these studies indicate that significant clinical activity occurs before any meaningful level of systemic absorption.…”