FDA-filed SPL labeling · retrieved through openFDA

Azelastine Ophthalmic

Azelastine ophthalmic is an antihistamine eye drop used to relieve eye itching caused by allergic conjunctivitis.

Brand names OptivarAstepro
Drug classes Histamine H1 Receptor Antagonists
Rx Form 1 Route Ophthalmic
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 3 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveJan 2, 2025
Clinical labels in scope 3
AvailabilityRx
Earliest approval/marketing year 1996
FDA-listed product records 6
Boxed warningNone found in compared labels
How we combine label and product data →
No current FDA shortage listed · checked Sep 22, 2026
Other forms & routes:
Azelastine Ophthalmic at a glance The quick version — the full detail is in the Patient Information Guide below.
💊
HelloPharmacist Editorial Team Bottom Line
Azelastine Hydrochloride Ophthalmic Solution 0.05% is a reliable antihistamine eye drop for relieving the itchy eyes of allergic conjunctivitis. It's applied twice daily and is generally well tolerated, with temporary stinging and bitter taste being the most common complaints. Use it only in the eye as directed, and check with your pharmacist or doctor if anything feels off.

📖 Azelastine Ophthalmic: Patient Information Guide

A plain-language walkthrough of Azelastine Ophthalmic — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for

Azelastine ophthalmic is an antihistamine eye drop approved for the following use:

  • Azelastine Hydrochloride Ophthalmic Solution 0.05% treats itching of the eye caused by allergic conjunctivitis (an allergic reaction affecting the eyes)
⚙️How it works

Azelastine is an antihistamine that works by blocking histamine H1 receptors in the eye. When you're exposed to an allergen, your body releases histamine — a chemical that binds to these receptors and triggers itching and irritation. By blocking those receptors, azelastine stops histamine from causing that reaction. Its main active breakdown product in the body, desmethylazelastine, also blocks H1 receptors, adding to the overall effect.

💊How it's taken

Azelastine Hydrochloride Ophthalmic Solution 0.05% is applied directly to the eye. The recommended dose is one drop instilled into each affected eye twice a day. Always follow your prescriber's specific instructions — if you miss a dose, apply it as soon as you remember, but skip it if it's nearly time for your next dose. Never double up.

🤒Side effects — in detail

Most side effects with azelastine eye drops are mild and happen right after you put in the drops. Common ones include:

  • Burning or stinging in the eye (affects about 1 in 3 people)
  • Headache (affects about 1 in 7 people)
  • Bitter taste (affects about 1 in 10 people)
  • Temporary blurred vision
  • Eye pain
  • Fatigue
  • Runny nose or nasal symptoms
  • Difficulty breathing or asthma symptoms

Call your doctor if you develop worsening eye pain, trouble breathing, or any signs of a reaction to the drops themselves.

⚠️Warnings & precautions
  • For the eye only: Azelastine Hydrochloride Ophthalmic Solution 0.05% must never be injected or swallowed — it is strictly an eye drop.
  • Allergy to ingredients: Do not use this product if you have a known or suspected allergy to azelastine or any other ingredient in the solution.
🔀What it interacts with

The FDA label for azelastine ophthalmic solution does not list specific drug, food, or supplement interactions for this eye drop formulation.

    This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

    📋Before taking it
    • Do not use if you are allergic to azelastine or any component of the solution
    • Tell your doctor or pharmacist about all other eye drops or medications you are currently using
    • This solution is for ocular (eye) use only — never take by mouth or inject
    📡Pharmacodynamics — effects in the body

    Azelastine blocks histamine H1 receptors, which are responsible for allergic itch and irritation. Studies with oral and nasal forms of azelastine have shown it does not meaningfully affect the heart's electrical rhythm (QTc interval) at recommended doses, suggesting a favorable cardiac safety profile at therapeutic levels.

    🔬Pharmacokinetics — how your body processes it

    Pharmacokinetic data in the label is primarily from intranasal and oral forms of azelastine. After intranasal use, about 40% of the dose reaches the bloodstream, with peak levels in 2 to 3 hours. The drug is broken down in the liver via the cytochrome P450 enzyme system into its active metabolite, desmethylazelastine. Azelastine has an elimination half-life of about 22 hours, meaning it takes roughly a day for half the drug to leave the body, and about 75% of an oral dose is eliminated through the feces.

    📦How to store it

    Azelastine hydrochloride ophthalmic solution, USP 0. Store UPRIGHT between 2° and 25°C (36° and 77°F).

    📄 Written from Azelastine Ophthalmic’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

    🩺 Pharmacist Counseling Corner

    Quick, plain-English answers to the questions patients ask most about Azelastine Ophthalmic — the kind of thing our pharmacy team would talk through with you at the counter.

    What is this eye drop actually for?
    These drops are used to relieve eye itching caused by allergic conjunctivitis — basically, itchy eyes from allergies. Azelastine is an antihistamine, so it works by blocking the chemical (histamine) that your body releases during an allergic reaction. It targets the itch directly in the eye.
    How do I use the drops correctly?
    You put one drop into each affected eye twice a day. Make sure you're only using these drops in your eye — they're not meant to be swallowed or injected. If you wear contact lenses, check with your doctor or pharmacist about timing, and always wash your hands before applying.
    My eyes burned after I put in the drops — is that normal?
    Yes, temporary burning or stinging right after applying the drops is actually the most commonly reported side effect — it happens in about 1 in 3 people. It usually passes quickly. You might also notice a bitter taste, which is also common. If the burning is severe or your eye pain gets worse instead of better, let your doctor know.
    Are there any side effects I should actually worry about?
    The most common side effects — stinging, headache, and bitter taste — are generally mild and brief. The ones worth calling your doctor about are significant worsening of eye pain, any difficulty breathing or asthma flare-up, or signs that you're reacting to the drops themselves, like increased swelling or redness that gets worse over time rather than better.
    Can I use these drops if I'm allergic to one of the ingredients?
    No — if you have a known or suspected allergy to azelastine or any ingredient in the solution, you should not use these drops. Let your doctor or pharmacist know so they can find a safe alternative for you.
    Can I use these drops with other eye medications?
    You should let your doctor or pharmacist know about any other eye drops or medications you're using before starting these. They can make sure everything is safe to use together and guide you on the right order and timing if you need more than one eye drop.
    Is Azelastine Ophthalmic available over the counter?
    Azelastine Ophthalmic is dispensed by prescription according to its FDA labeling, so it isn't sold over the counter. Your prescriber and pharmacist will determine if it's appropriate for you.
    When was Azelastine Ophthalmic first available?
    Azelastine Ophthalmic has been available in the United States since at least 1996, based on FDA approval history (Drugs@FDA) and product marketing records.
    Who makes Azelastine Ophthalmic?
    Azelastine Ophthalmic is supplied by 3 manufacturers listed in the FDA NDC Directory, including Somerset Therapeutics, LLC, Alembic Pharmaceuticals Inc., Alembic Pharmaceuticals Limited.

    💬 Answers drafted from Azelastine Ophthalmic’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

    🧰 Keep exploring

    💊 How Azelastine Ophthalmic comes

    Azelastine Ophthalmic is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

    Eye drops

    In the eye
    How this form is used
    What it may be used for
    • Azelastine Hydrochloride Ophthalmic Solution 0.05% is used to treat itching of the eye associated with allergic conjunctivitis
    Important instructions
    • Azelastine Hydrochloride Ophthalmic Solution 0.05%: instill one drop into each affected eye twice a day
    • Azelastine Hydrochloride Ophthalmic Solution 0.05% is for use in the eye only — do not inject or swallow
    • Follow your prescriber's directions and the label on your bottle for exact guidance
    Available strengths 1 strength
    6 FDA-listed product records

    📊 Azelastine Ophthalmic across the U.S. market

    How Azelastine Ophthalmic appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

    1
    Dose forms
    3
    Manufacturers
    2
    Brand names
    6
    FDA-listed product records
    1996
    First marketed
    Somerset Therapeutics, LLC50%
    Alembic Pharmaceuticals Inc.33%
    Alembic Pharmaceuticals Limited17%

    Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

    📈 How widely Azelastine Ophthalmic is used

    A general measure of how commonly Azelastine Ophthalmic is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.

    Think of this as a proxy for how widely Azelastine Ophthalmic is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.

    347,051
    Medicaid prescriptions filled (Q1–Q4 2025)
    $5.6M gross Medicaid reimbursement (before mandatory rebates — net cost is lower)

    How commonly is Azelastine Ophthalmic prescribed? Of the 1,596 medications we measure, Azelastine Ophthalmic ranks #304 by Medicaid prescriptions — more than 81% of them.

    Where Azelastine Ophthalmic ranks among the drugs we measure · Q1–Q4 2025 · neighbors ±5

    Utilization by Azelastine Ophthalmic product

    Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.

    azelastine hydrochloride 0.5 MG/ML Ophthalmic Solution

    347,051 Medicaid prescriptions (Q1–Q4 2025) 100% of Azelastine Ophthalmic prescriptions shown $5.6M gross reimbursement (before rebates) ≈ $16 per prescription (gross)

    Summed across the 6 of 9 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 860805

    Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.

    Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Azelastine Ophthalmic, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 6 of 9 listed Azelastine Ophthalmic NDCs with Medicaid activity.

    🔍 Compare Azelastine Ophthalmic products

    A representative set of FDA-listed product records for Azelastine Ophthalmic — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

    Strength Route Manufacturer / Labeler Category Details
    💊Eye drops
    0.5 mg/mL Ophthalmic Alembic Pharmaceuticals Inc. × 2 listings ANDA View NDC →
    0.5 mg/mL Ophthalmic Alembic Pharmaceuticals Limited ANDA View NDC →
    0.5 mg/mL Ophthalmic Somerset Therapeutics, LLC × 3 listings ANDA View NDC →

    Showing 6 of 6 products — FDA National Drug Code Directory. See every product, package size and price: browse all 6 Azelastine Ophthalmic NDCs →

    RxNorm Concept Web — From Ingredient to Every Form and Strength

    This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

    Ingredient (IN) Azelastine Ophthalmic RxCUI 18603 2 dose forms · 3 strengths
    1. Dose form (SCDF) Ophthalmic Solution RxCUI 636216 In current FDA listings
      Clinical drug / strength (SCD) hydrochloride 0.5 MG/ML RxCUI 860805

    Look up RxCUI 18603 in the RxCUI Atlas →

    RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

    🏷️ Sold under these brand names

    Optivar Astepro

    🏭 Manufacturers & labelers

    Somerset Therapeutics, LLC 3 Alembic Pharmaceuticals Inc. 2 Alembic Pharmaceuticals Limited 1

    RxNorm drug class

    Azelastine Ophthalmic belongs to the Histamine-1 Receptor Antagonist class.

    Pharmacologic class Histamine-1 Receptor Antagonist
    Drug family (ATC) Antiallergic agents, excl. corticosteroids, Other antihistamines for systemic use, Other antiallergics
    How it works Histamine H1 Receptor Antagonists

    Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

    🔬 Where this comes from

    Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

    📄
    FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Jan 2, 2025
    🏭
    Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Azelastine Ophthalmic.
    📈
    Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
    🚨
    Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
    🧾 Clinical label set — FDA-filed SPL labels retained for Azelastine Ophthalmic after exact ingredient or ingredient-combination matching and applicable route/form matching
    Clinical labels in scope
    3
    NDC products indexed
    6
    Distinct labelers/manufacturers represented
    3
    Linked representative label
    Alembic Pharmaceuticals Inc.
    Linked label effective
    Jan 2, 2025
    Composite sections available
    15
    Linked SPL Set ID
    7532ed82-5cfa-49da-83e5-c57ffdd3adbb
    Linked SPL Document ID
    0857a4e2-caec-4c87-9894-949a549144c3
    Open the linked representative label on DailyMed ↗

    How we combine label and product data

    HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 3 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

    Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Alembic Pharmaceuticals Inc. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

    This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.