Astepro Review: The Best Nasal Allergy Spray?

Astepro Review: The Best Nasal Allergy Spray?

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Disclaimer: None of the information in this article constitutes medical advice. All statements are merely the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regard to allergy medication.

Astepro is a nasal allergy spray that was approved by the Food and Drug Administration (FDA) in 2021. It’s available over-the-counter (OTC), and the brand proudly claims that their spray is “fast, powerful and steroid-free.” 

The generic version of Astepro is called azelastine hydrochloride and we’ll use these terms interchangeably throughout this article as they refer to the same active drug ingredient.

But is Astepro proven in medical studies to work, or are these just marketing claims? Does the product have any side effects? Is nasal spray addictive? And which retailer sells Astepro for the best price?

In this article we'll answer all of these questions and more, as we analyze medical studies on Astepro to give our take on whether or not it's likely to be effective.

We'll feature a video suggesting that nasal sprays may be addictive, highlight some questionable inactive ingredients in Astepro and provide a cost comparison to show which retailer sells Astepro for the best price.

Does Astepro Work?

The active drug ingredient in Astepro has been around for decades, and has been studied in many clinical trials.

An extremely thorough medical review published in 2007 examined the effectiveness of Astepro.

The study authors reviewed data from many clinical trials, and found the drug to be effective for treating congestion and post-nasal drip. It was also documented that the drug has a “rapid onset of action” which means that it can provide quick relief.

A meta-study published in the Allergy & Asthma Proceedings journal found that Astepro was effective not only for allergic rhinitis (the medical term for nasal allergy symptoms), but also for non-allergic rhinitis.

A medical condition called vasomotor rhinitis can cause symptoms mimicking allergy like congestion and excessive mucus production, but the condition is not allergenic in nature.

This suggests that Astepro may be effective not only for treatment of allergy symptoms but for any common nasal symptoms such as congestion, runny nose and overproduction of mucus.

A 2007 clinical trial analyzed whether Astepro was effective when administered at one spray per nostril, twice daily. The drug was found to be effective. Nasal symptom scores dropped by around 50%.

We will conclude from the available research that Astepro is effective for reducing nasal symptoms of allergy. It doesn’t appear to treat the underlying cause of allergy, but can provide symptomatic relief.

Can Nasal Spray Be Addictive?

An exposé published by CBS New York titled “Warning About Over-The-Counter Nasal Sprays” has over 80,000 views, and suggests that one type of OTC nasal spray may be addictive:

Questionable Ingredients in Astepro

Astepro contains two inactive ingredients that may be questionable from a health perspective.

Benzalkonium chloride is a disinfectant compound.

A medical review of this ingredient states the following: “The available toxicity data of benzalkonium chloride (BKC) clearly shows that it is toxic; however, the weight of evidence favors the view that at doses encountered in nasally and orally inhaled pharmaceutical preparations it is well tolerated.”

With any toxin, the dose makes the poison, but we question whether directly spraying a compound “clearly proven” to be toxic into nasal airways is logical. It’s a question that patients may wish to discuss with their doctor.

Sucralose is an artificial sweetener that's clinically shown to cause insulin dysregulation, at least when consumed, as we documented in our review of Fiber One bars.

We can't find any evidence on systemic absorption of sucralose from nasal spray, but felt like this information was worth noting to potential consumers.

Suraclose is typically added to improve taste and overall experience, but since it has no medical function and questionable health effects, it may be logical to use nasal sprays without this ingredient.

Real People Try Astepro

Astepro is available on Amazon, which is a good resource for checking what real customers are saying about side effects.

The product has an average review rating of 4.3 out of 5 stars with over 1,200 total reviews at the time of updating this article.

The top positive review from a verified purchaser is written by a user named “Christopher” who gives the product a 5/5 star rating, and claims it provided effective symptom relief:

“This is almost so far as good as Afrin it works almost instantly after A couple sneezes and a tickling feeling almost feels like a baby Alka-Seltzer going off in my nose. Then all good”

The top negative review from a verified purchaser comes from a user named “Bryan Alfaro” who gives the product a 1/5 star rating and claims Astepro worsened nasal symptoms:

“I was really excited for this product and what it said it could do. I Followed all instructions as if it was my first time using a nose spray, waited for it to kick in, and boy did it. It felt as though my congestion got 10x worse and I couldn’t breathe through either nostril. I stood there with my head down for about 3 minutes waiting for it to get better… it did not. I stood up and my nose started running shortly after.”

Astepro currently has an average review rating of 4 out of 5 stars on Facebook.

A YouTube creator named "Reviews" had a negative experience with Astepro:

Where to Get the Best Price

Astepro is available in-store and online at various major retailers.

This product is sold in many different sizes, so we've standardized the below price comparison to the price-per-spray at the time of updating this article:

Walgreens: $0.22 (link)

Target: $0.20 (link)

Walmart: $0.20 (link)

Amazon: $0.16 (free shipping, link to official Amazon listing)

Astepro is currently around 20% cheaper on Amazon than at the second-cheapest retailer, and even moreso when factoring in shipping fees.

Our Recommendation for Allergy Sufferers

Patients that suffer from consistent nasal allergy symptoms may benefit from speaking with their doctor or allergist about allergy immunotherapy, commonly referred to as allergy shots.

Allergy shots are an extensively researched treatment modality that actually fixes the root problem rather than reduces symptoms.

Environmental allergies are caused by an overreaction by the immune system to substances such as dust or pollen. Allergy shots introduce low levels of those allergenic substances to the body in the form of injections which causes a sensitization reaction.

Over time, the patient experiences less severe reactions to environmental allergens and their allergies can be effectively “cured.”

In our opinion, this may be a more logical approach than nasal sprays which treat symptoms.

Allergy shots can cause severe reactions in some cases, but patients are required to wait in the allergy office for 30 minutes after their shot to ensure safety. 

There is no evidence of long-term side effects from allergy shots in the above-linked medical review.

Allergy shots are often fully or partially subsidized by health insurance in the U.S. because they treat a documented health condition.

Pros and Cons of Astepro

Here are the pros and cons of Astepro in our opinion:


  • Steroid-free
  • FDA-approved
  • Clinically proven to be effective
  • Should relieve both allergic and non-allergic nasal symptoms
  • Affordable
  • Available OTC
  • Contains benzalkonium chloride
  • Contains sucralose
  • May not resolve root cause of allergies
Stay up-to-date on our research reviews


Astepro is clinically proven to be effective for reducing symptoms of nasal allergy such as congestion and overproduction of mucus. It may be a safer alternative to steroid sprays.

This medication is approved by the FDA and available OTC without a prescription, so it may be a more convenient option for consumers than prescription steroid sprays.

Two of the inactive ingredients in Astepro may be questionable from a health perspective, and one in particular was described as toxic in a medical review linked in this article (but not at the doses currently used in nasal sprays).

Astepro has mostly positive reviews on Amazon, and is quite affordable for a pharmaceutical medication.

It may be worthwhile for patients with nasal allergy symptoms to speak with their doctor or allergist about allergy shots, which can reduce the immune system’s overreaction to airborne allergens and thus reduce the need for OTC nasal sprays which treat symptoms but fail to treat the root cause of the issue.