Astepro OTC has now been approved by the FDA without a prescription. The generic name for Astepro is Azelastine. Azelastine comes in 2 different strengths, 0.1% and 0.15%. The 0.15% is the one that is going OTC. Astepro OTC is a nasal antihistamine similar to Claritin, Allegra, Benadryl or Zyrtec, but it is in the nasal topical form, so it does not have to be ingested. Astepro OTC is indicated for the temporary relief of nasal congestion, runny nose, sneezing and itchy nose due to hay fever or other upper respiratory allergies. It is steroid free and indicated for ages 6 and up.
First line medications for seasonal and perennial allergies are nasal steroid sprays like Flonase, Nasonex and Nasocort. All of these medications used to be only available with a prescription, but eventually became over the counter like Astepro OTC.
Astelin also comes in a combination form in Dymista, where it is combined with a nasal steroid Flonase, but in that medication it is the 0.1% strength.
Bayer expects the medication to be available sometime early in 2022.
Although nasal antihistamines such as Astepro are not first line treatment for those who have allergies, Astepro OTC could be used as an add-on treatment in addition to oral antihistamines. Over the years all allergy medications have become over the counter likely because of their safety data. The most common side effect seen with Astelin nasal spray is a bitter taste in the mouth, drowsiness and dizziness. A complete list of side effects are here.
Interestingly, Astelin in the 0.1% has not been approved yet for OTC use even though it is in the weaker strength.