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

Most common
Bitter taste (≥2%)
Headache (≥2%)
Epistaxis (≥2%)
Somnolence (≥2%)

Patanase

Most common
Bitter taste (up to 12.8%)
Headache (up to 4.4%)
Epistaxis (up to 3.2%)
Pharyngolaryngeal pain (up to 2.2%)

Astelin vs. Patanase Dosage

Astelin

Dosage
Dosage Table
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

Dosage
Dosage Table
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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