Nasallegra (Azelastine Hydrochloride, Fluticasone Propionate)

• Nasallegra, a combined antihistamine and corticosteroid nasal spray, is indicated for conditions affecting the nasal passages caused by allergic inflammation.
• Allergic rhinitis: reduces nasal congestion, sneezing, itching and rhinorrhea.
• Seasonal allergic rhinitis: controls symptoms triggered by pollen or seasonal allergens.
• Perennial allergic rhinitis: manages year‑round allergic nasal symptoms.

• Azelastine Hydrochloride selectively blocks H1 histamine receptors on mast cells and sensory nerves, preventing histamine‑mediated vasodilation and itching. Fluticasone Propionate binds to intracellular glucocorticoid receptors, modulating gene transcription to suppress pro‑inflammatory cytokines, reduce vascular permeability, and inhibit edema formation in nasal mucosa. The dual action provides both immediate antihistamine relief and longer‑term anti‑inflammatory control of allergic nasal symptoms.

Nasallegra may cause local and systemic adverse reactions, which are categorized by frequency.

Common Side Effects

• Nasopharyngeal irritation: mild burning or stinging sensation.
• Nosebleeds (epistaxis): occasional minor bleeding.
• Headache: transient mild headache.
• Unpleasant taste or smell: temporary alteration.
• Dry throat: mild dryness.

Serious or Rare Side Effects

• Severe allergic reaction (anaphylaxis): rare but may include swelling, hives, difficulty breathing.
• Cortisol suppression: prolonged high‑dose use may affect adrenal function.
• Glaucoma or cataract progression: rare ocular effects with long‑term corticosteroid exposure.
• Nasal septal perforation: very rare tissue damage.

• Before using Nasallegra, consider the following precautions to ensure safe and effective therapy.
• Pregnancy: consult a healthcare professional; safety data are limited.
• Breastfeeding: discuss risks with a physician as drug may pass into milk.
• Concomitant use of other nasal sprays: avoid overlapping corticosteroid therapy.
• Patients with severe liver disease: monitor for increased systemic exposure.
• Avoid use in individuals with known hypersensitivity to azelastine, fluticasone, or any formulation components.
• Store at below 25°C: keep in the original container, protect from moisture and heat.

Nasallegra can interact with other medicines; some combinations require avoidance while others need monitoring.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): may increase systemic fluticasone levels, raising risk of corticosteroid side effects.
• Central nervous system depressants (alcohol, benzodiazepines, opioids): may enhance drowsiness or sedation from azelastine.

Moderate Interactions (Monitor Closely)

• Moderate CYP3A4 inhibitors (e.g., erythromycin, ritonavir): may modestly raise fluticasone exposure; monitor for signs of adrenal suppression.
• Other antihistamines: additive anticholinergic effects may increase dryness or irritation.
• Antifungal agents (e.g., fluconazole): may affect fluticasone metabolism; observe for systemic effects.