"An estimated half a million epinephrine autoinjectors are coming off the market. The US Food and Drug Administration (FDA) is advising patients to call their doctor for an alternative, but some say there won't be enough supply to meet the demand."...
Azelastine hydrochloride is a relatively selective histamine H1 antagonist and an inhibitor of the release of histamine and other mediators from cells (e.g. mast cells) involved in the allergic response. Based on in-vitro studies using human cell lines, inhibition of other mediators involved in allergic reactions (e.g. leukotrienes and PAF) has been demonstrated with azelastine hydrochloride. Decreased chemotaxis and activation of eosinophils has also been demonstrated.
Pharmacokinetics and Metabolism
Absorption of azelastine following ocular administration was relatively low. A study in symptomatic patients receiving one drop of OPTIVAR (azelastine hydrochloride) ® in each eye two to four times a day (0.06 to 0.12 mg azelastine hydrochloride) demonstrated plasma concentrations of azelastine hydrochloride to generally be between 0.02 and 0.25 ng/mL after 56 days of treatment. Three of nineteen patients had quantifiable amounts of N-desmethylazelastine that ranged from 0.25-0.87 ng/mL at Day 56.
Based on intravenous and oral administration, the elimination half-life, steady-state volume of distribution and plasma clearance were 22 hours, 14.5 L/kg and 0.5 L/h/kg, respectively. Approximately 75% of an oral dose of radiolabeled azelastine hydrochloride was excreted in the feces with less than 10% as unchanged azelastine. Azelastine hydrochloride is oxidatively metabolized to the principal metabolite, N-desmethylazelastine, by the cytochrome P450 enzyme system. In-vitro studies in human plasma indicate that the plasma protein binding of azelastine and N-desmethylazelastine are approximately 88% and 97%, respectively.
In a conjunctival antigen challenge study, OPTIVAR (azelastine hydrochloride) ® was more effective than its vehicle in preventing itching associated with allergic conjunctivitis. OPTIVAR (azelastine hydrochloride) ® had a rapid (within 3 minutes) onset of effect and a duration of effect of approximately 8 hours for the prevention of itching.
In environmental studies, adult and pediatric patients with seasonal allergic conjunctivitis were treated with OPTIVAR (azelastine hydrochloride) ® for two to eight weeks. In these studies, OPTIVAR (azelastine hydrochloride) ® was more effective than its vehicle in relieving itching associated with allergic conjunctivitis.
Last reviewed on RxList: 8/5/2008
This monograph has been modified to include the generic and brand name in many instances.
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