Comparative Pharmacology
Head-to-head clinical analysis: AZELASTINE HYDROCHLORIDE CHILDREN S ALLERGY versus VISTARIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AZELASTINE HYDROCHLORIDE CHILDREN S ALLERGY versus VISTARIL.
AZELASTINE HYDROCHLORIDE CHILDREN'S ALLERGY vs VISTARIL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Azelastine hydrochloride is a phthalazinone derivative that acts as a selective histamine H1-receptor antagonist. It inhibits the release of histamine and other mediators from mast cells, reduces chemotaxis, and decreases eosinophil activation. It also suppresses leukotriene and cytokine production.
Hydroxyzine is a piperazine derivative antihistamine that acts as a competitive antagonist of histamine H1 receptors, thereby suppressing histamine activity in the subcortical area of the central nervous system. It also has anxiolytic, sedative, antiemetic, and antispasmodic effects.
Azelastine hydrochloride nasal spray: 1 spray (137 mcg) per nostril twice daily; maximum 2 sprays per nostril twice daily.
Oral: 50-100 mg 4 times daily; IM: 25-100 mg every 4-6 hours as needed.
None Documented
None Documented
Terminal elimination half-life is 22–25 hours in adults; steady state achieved in 3–5 days. In children (6–11 years), half-life is similar (mean 22 hours).
Terminal elimination half-life: 20-25 hours in adults; prolonged in hepatic impairment or elderly; steady-state achieved in ~4-5 days.
Primarily renal (approximately 75%), with about 50% as unchanged drug and 25% as metabolites via CYP3A4 and CYP2D6. Fecal excretion accounts for ~20%.
Primarily hepatic metabolism; <1% excreted unchanged in urine; biliary/fecal elimination of metabolites accounts for approximately 50-60% of total clearance.
Category C
Category C
Antihistamine
Antihistamine