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.” This drug is manufactured by Bayer which is one of the largest pharmaceutical companies in the world.
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.
In this article we’ll review medical studies on Astepro to provide our determination on whether it’s likely to be effective for treating allergy symptoms. We’ll highlight a few ingredients we consider to be questionable, and share an exposé detailing whether some ingredients in nasal spray may be addictive.
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 individual 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 clinical trial from 2007 was the most specific of any we reviewed: it 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 achieved over 50,000 views at the time of writing this article, and shares information on why one type of OTC nasal spray may be addictive:
Questionable Inactive Ingredients
Astepro contains two ingredients we would consider 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.
Astepro also contains sucralose which is an artificial sweetener shown to cause insulin dysregulation in a clinical trial in young, healthy adults. A very small amount of sucralose, if any, is likely to be absorbed when using a nasal spray, but again we question why this ingredient needs to be added to an allergy formulation.
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.
Astepro Real User Reviews
Astepro is available on Amazon, and has an average review rating of 4/5 stars.
The top positive review from a verified purchaser is written by a user named “Christopher” who claims the drug relieved their symptoms:
“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 claims Astepro worsened their 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.”
Where to Buy Astepro for 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 Nasal Allergy Sufferers
Patients that suffer from consistent nasal allergy symptoms may benefit from speaking with their regular 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 that treat symptoms, and it also may have a more favorable side effect profile. 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.