Allegra vs. Astelin
See how Allegra and Astelin compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Allegra is a pill taken once or twice daily, while Astelin is a nasal spray used in each nostril twice daily.
Allegra also treats chronic hives, a use Astelin does not have, while Astelin also treats vasomotor rhinitis, a use Allegra does not have.
Astelin can cause drowsiness and a bitter taste, while Allegra is non-sedating and does not require a spray.
Allegra vs. Astelin Drug Summary
Allegra
Allegra (fexofenadine) is a second-generation H1 antihistamine used to relieve seasonal allergic rhinitis symptoms and chronic idiopathic urticaria. It comes as a tablet, orally disintegrating tablet, or liquid, taken once or twice daily depending on the dose.
Astelin
Astelin (azelastine) is an H1-antihistamine nasal spray used for seasonal allergic rhinitis and vasomotor rhinitis. It's sprayed into each nostril once or twice daily depending on the dose and symptoms.
Allegra vs. Astelin Side Effects
Allegra
Astelin
Allegra vs. Astelin Dosage
Allegra
Astelin
| STAGE | DOSE | WHEN |
| Starting dose | 30 mg twice daily | At the start |
| Maximum dose | 60 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 1 spray/nostril twice daily | At the start |
| Maximum dose | 2 sprays/nostril twice daily | If needed |
| Dose changes | 1 increase | As tolerated |
Allegra
| STAGE | DOSE | WHEN |
| Starting dose | 30 mg twice daily | At the start |
| Maximum dose | 60 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Astelin
| STAGE | DOSE | WHEN |
| Starting dose | 1 spray/nostril twice daily | At the start |
| Maximum dose | 2 sprays/nostril twice daily | If needed |
| Dose changes | 1 increase | As tolerated |
Allegra vs. Astelin Indications
Allegra
Allegra relieves seasonal allergic rhinitis symptoms like sneezing, runny nose, and itchy eyes, and also treats chronic idiopathic urticaria (hives). It is approved for children as young as 6 years and adults, with dosing based on age and kidney function.
Seasonal allergic rhinitis symptom relief
Chronic idiopathic urticaria (hives) treatment
Approved for ages 6 and older
Available as tablet, ODT, or liquid
Astelin
Astelin treats seasonal allergic rhinitis in patients 5 and older and vasomotor (nonallergic) rhinitis in those 12 and older. It is sprayed directly into the nose, targeting local nasal symptoms rather than hives or full-body allergic reactions.
Seasonal allergic rhinitis in ages 5 and up
Vasomotor (nonallergic) rhinitis in ages 12+
Not approved for allergic rhinitis under age 5
Nasal spray targets local nasal symptoms
Allegra vs. Astelin Pros and Cons
Allegra
Allegra is a non-sedating oral antihistamine taken as a tablet, orally disintegrating tablet, or liquid to relieve seasonal allergic rhinitis and chronic hives. It works throughout the body rather than targeting the nose directly, so it does not treat vasomotor rhinitis.
Pros
Non-sedating, no drowsiness warning
Oral tablet, ODT, or liquid, no spray needed
Also treats chronic idiopathic urticaria (hives)
Roughly $6 to $20 per month, less than Astelin
Cons
Not approved for vasomotor (nonallergic) rhinitis
ODT form contains phenylalanine, avoid with PKU
Does not directly target nasal congestion
Twice-daily dosing unless using 180 mg once-daily
Astelin
Astelin is an intranasal antihistamine spray used for seasonal allergic rhinitis and, unlike Allegra, for vasomotor (nonallergic) rhinitis. It delivers medication directly to nasal tissue but carries a sedation risk and a bitter taste some patients notice.
Pros
Also approved for vasomotor (nonallergic) rhinitis
Delivers medicine directly to nasal tissue
Approved down to age 5 for allergic rhinitis
No boxed warning despite sedation risk
Cons
Can cause drowsiness, avoid driving until known
Bitter taste reported by many users
Must avoid alcohol due to additive sedation
Roughly $21.60 to $70.38 per month, more than Allegra
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