Astelin vs. Patanase
See how Astelin and Patanase compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Astelin is approved for both seasonal allergic rhinitis and vasomotor (nonallergic) rhinitis, while Patanase covers only seasonal allergic rhinitis.
Both are twice-daily nasal antihistamine sprays, but Patanase's trials reported notably higher rates of bitter taste, headache, and epistaxis.
Astelin's typical monthly list price is far lower than Patanase's, though insurance coverage can change out-of-pocket cost for either drug.
Astelin vs. Patanase Drug Summary
Astelin
Astelin (azelastine) is an intranasal antihistamine that treats seasonal allergic rhinitis and vasomotor rhinitis by blocking H1 receptors in the nasal lining. It comes as a metered spray used one to two sprays per nostril, twice daily, and has been available since 1996.
Patanase
Patanase (olopatadine) is an intranasal antihistamine that treats seasonal allergic rhinitis by blocking H1 receptors in the nasal lining. It is delivered through a metered-dose pump used one to two sprays per nostril, twice daily, and has been available since 2008.
Astelin vs. Patanase Side Effects
Astelin
Patanase
Astelin vs. Patanase Dosage
Astelin
Patanase
| 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 |
| 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 |
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 |
Patanase
| 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 |
Astelin vs. Patanase Indications
Astelin
Astelin is FDA-approved for seasonal allergic rhinitis in patients 5 and older and for vasomotor rhinitis, a nonallergic form of chronic nasal inflammation, in those 12 and older. This dual approval sets it apart from many other nasal antihistamines that only cover allergic triggers.
Seasonal allergic rhinitis in adults and children 5 and older
Vasomotor rhinitis in adults and adolescents 12 and older
Not approved for seasonal allergic rhinitis in children under 5
Not approved for vasomotor rhinitis in children under 12
Patanase
Patanase is FDA-approved only for seasonal allergic rhinitis, in patients 6 years and older. It has not been studied or approved for perennial allergic rhinitis in children under 12 or for nonallergic forms of rhinitis.
Seasonal allergic rhinitis in adults and children 6 and older
Not approved for perennial allergic rhinitis in children under 12
Not approved for use in children under 6
Not approved for vasomotor (nonallergic) rhinitis
Astelin vs. Patanase Pros and Cons
Astelin
Astelin has a broader FDA approval that includes vasomotor rhinitis, plus a lower typical monthly cost than Patanase. Insurance coverage and formulary tiers can still shift out-of-pocket cost in either direction.
Pros
FDA-approved for vasomotor (nonallergic) rhinitis, a use Patanase lacks
Approved for children as young as 5, a year younger than Patanase
Lower reported rates of bitter taste, headache, and epistaxis in trials
Cons
Not approved for use in children under 5
Somnolence is listed among its common side effects
Simple spray design without a specialized metering pump
Patanase
Patanase carries a narrower FDA approval limited to seasonal allergic rhinitis but has an established safety record in children as young as 6. Its metered-dose pump requires priming, and its typical list price is substantially higher than Astelin's.
Pros
Approved for children as young as 6, with established pediatric dosing
Delivered via a metered-dose pump some patients find easier to use consistently
Newer drug (2008) with a large controlled trial dataset supporting approval
Cons
Roughly $314 to $350 per month, far more than Astelin's typical price
Higher reported rates of bitter taste, headache, and epistaxis in trials
Added warning about nasal septal perforation and ulceration risk
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