{"id":636828,"date":"2026-07-09T09:56:00","date_gmt":"2026-07-09T13:56:00","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=636828"},"modified":"2026-07-02T12:12:02","modified_gmt":"2026-07-02T16:12:02","slug":"is-azelastine-a-steroid","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/is-azelastine-a-steroid\/","title":{"rendered":"Is azelastine a steroid?"},"content":{"rendered":"

Azelastine<\/span><\/a> (sold under the brand name <\/span>Astepro<\/span><\/a>) is a second-generation antihistamine nasal spray (also available as eye drops). It\u2019s used to treat allergy symptoms like itching, sneezing, a runny nose, and watery eyes. Available both by prescription and over-the-counter for kids age 6 and older, plus adults, it’s often mistaken for a steroid nasal spray, but it works differently. Learn where the confusion comes from, how azelastine compares to steroid sprays like Flonase, and what you should know about using it for allergies.<\/span><\/p>\n

Allergy medicine coupons & resources<\/b><\/a><\/p>\n

Why do people think azelastine is a steroid?<\/span><\/h2>\n

We\u2019ve just established that azelastine is not a steroid, so why do people think it is? There are a few reasons. The first is because of who their neighbors are in the allergy treatment aisle. <\/span>Fraidy N. Maltz, Pharm.D.<\/span><\/a>, an associate professor of pharmacy practice at Touro College of Pharmacy in New York City, explains that people might assume azelastine is in the same class as steroid nasal sprays like <\/span>Flonase<\/span><\/a> (fluticasone), Rhinocort (budesonide), and <\/span>Nasonex<\/span><\/a> (mometasone) because they are all <\/span>available over the counter<\/span><\/a> and shelved together in the allergy section.\u00a0<\/span><\/p>\n

Likewise, both antihistamine and steroid nasal sprays were initially available only by prescription before OTC options became available in stores, further stoking confusion, says <\/span>Kara Wada, MD<\/span><\/a>, an allergist and immunologist and the founder of the Immune Confident Institute in Columbus, OH.<\/span><\/p>\n

Finally, there’s the fact that azelastine is available in a combination prescription product with fluticasone, sold as <\/span>Dymista (azelastine-fluticasone)<\/span><\/a>. This medication contains azelastine and would be considered a steroid nasal spray, but that\u2019s because of the fluticasone, not the azelastine.\u00a0<\/span><\/p>\n

Azelastine vs. Flonase: Which works better for allergies?<\/span><\/h2>\n

\u201cBoth sprays have their place in the treatment of nasal and eye allergy symptoms,\u201d Dr. Wada says. The one that\u2019s better for you may depend on your specific symptoms as well as their severity and how quickly you need relief. \u201cAzelastine may work better than steroid nasal sprays such as Flonase for eye symptoms, sneezing, itching, and runny nose,\u201d Dr. Maltz says. \u201cHowever, nasal steroids such as Flonase work better for congestion.\u201d Still, a <\/span>study<\/span><\/a> that compared the two sprays head-to-head found that they had comparable efficacy in controlling symptoms in patients with nasal allergies.<\/span><\/p>\n

The bigger difference is in the time it takes them to work. \u201cAzelastine works more quickly, kicking in within 15 to 30 minutes of use,\u201d Dr. Wada says. While Flonase may begin working within a few hours, \u201cit can take about two weeks of daily use to reach its full potential,\u201d Dr. Wada adds.\u00a0<\/span><\/p>\n

For these reasons, using both at the same time is not uncommon. \u201cI often recommend combining an intranasal antihistamine with an intranasal corticosteroid,\u201d Dr. Wada says. \u201c<\/span>Double-blind, placebo-controlled trials<\/span><\/a> have demonstrated that the combination is more effective and has a faster onset of action than either spray separately.\u201d Combining the two treatments is generally recommended when your symptoms are not responding to a single medication on its own. Dr. Maltz notes that you can either get a prescription for Dymista or buy both azelastine and Flonase separately over-the-counter and just use them at the same time.\u00a0<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n
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Azelastine vs. Flonase: Key differences<\/span><\/h2>\n<\/th>\n<\/tr>\n<\/thead>\n

Feature<\/span><\/td>\nAxelastine (generic Astepro)<\/span><\/td>\nFluticasone (generic Flonase)<\/span><\/td>\n<\/tr>\n
Drug class<\/span><\/td>\nAntihistamine<\/span><\/td>\nCorticosteroid<\/span><\/td>\n<\/tr>\n
How it works<\/span><\/td>\nBlocks histamine and reduces inflammation\u00a0<\/span><\/td>\nBlocks six substances, including histamine<\/span><\/td>\n<\/tr>\n
Onset of action<\/span><\/td>\nWithin 30 minutes<\/span><\/td>\n2 to 12 hours initial relief, 1-2 weeks for full effect<\/span><\/td>\n<\/tr>\n
Best for<\/span><\/td>\nEye symptoms, sneezing, itching, and runny nose<\/span><\/td>\nCongestion, also reduces sneezing, itching, and runny nose<\/span><\/td>\n<\/tr>\n
Contains a steroid?<\/span><\/td>\nNo<\/span><\/td>\nYes<\/span><\/td>\n<\/tr>\n
OTC availability?<\/span><\/td>\nYes<\/span><\/td>\nYes<\/span><\/td>\n<\/tr>\n
Average cost before discounts<\/span><\/td>\nPrice varies by pharmacy<\/span> per 30 mL bottle of nasal spray<\/span><\/td>\nPrice varies by pharmacy<\/span> per 16 gm bottle<\/span><\/td>\n<\/tr>\n
Average cost with SingleCare<\/span><\/td>\nPrice varies by pharmacy<\/span> per 30 mL bottle of nasal spray<\/span><\/td>\nPrice varies by pharmacy<\/span> per 16 gm bottle<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

What are the disadvantages of azelastine?<\/span><\/h2>\n

Azelastine is quite effective for treating nasal allergy symptoms. The <\/span>American Academy of Allergy, Asthma, and Immunology<\/span><\/a> considers it a first-line treatment for allergies, meaning it\u2019s among the <\/span>best allergy nasal sprays<\/span><\/a>. However, there are some notable drawbacks. Here are the ones our experts say you should know.<\/span><\/b><\/p>\n