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 research studies to work? Does the product have any side effects? Is nasal spray addictive? And are allergy shots a healthier long-term option?
In this article we'll answer all of these questions and more, as we analyze clinical 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 share our opinion on why allergy shots may be a healthier long-term option.
Key takeaways:
- Astepro is clinically proven to relieve nasal congestion
- Contains some inactive ingredients we consider unhealthy
- Allergy shots may be a better long-term option
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.
Are Allergy Shots Healthier?
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.
Astepro vs. Popular OTC Products
Here's how Astepro compares to other popular OTC allergy relief products in terms of potential effectiveness and healthiness, in our opinion:
SinuSonic
Uses pressure and acoustic vibrations to relief nasal allergy symptoms, and these methods are clinically shown to be effective, as we documented in our SinuSonic reviews article.
Free from any unhealthy additives.
Winner: SinuSonic
Navage
This nasal irrigation devices uses saline water to clear sinuses.
The underlying methodology is clinically shown to be effective, and no unhealthy additives are included.
Winner: Navage
Flonase
The active ingredient is a steroid, and nasal steroids were more likely to cause adverse effects than antihistamines like Astepro in a 2021 research review.
Winner: Astepro
Astepro Pros and Cons
Pros:
- Steroid-free
- FDA-approved
- Clinically proven to be effective
- Should relieve both allergic and non-allergic nasal symptoms
- Affordable
- Available OTC
Cons:
- Contains benzalkonium chloride
- Contains sucralose
- May not resolve root cause of allergies
