Reported Reactions

Drugs › Histamine-1 receptor antagonist

Generic name

Azelastine hydrochloride: adverse event reports filed with FDA

2,502 reports list it as a suspect or interacting product, 2011–2026. Class: Histamine-1 receptor antagonist. Also reported as Azelastine Hydrochloride Nasal Solution, Azelastine Hcl Nasal Solution, Azelastine Hydrochloride Nasal Spray.

2,502
reports as suspect product
0% of all reports · about 169 a year
151
reports, 12 months to June 2026
209 in the 12 months before
5.7%
marked serious by the reporter
57.7% across the class
0.2%
record death among outcomes, as reported
5 reports · not verified by FDA

2,502 adverse event reports received by FDA list azelastine hydrochloride, a generic name as a suspect or interacting product, from September 2011 to May 2026. A further 4,144 reports list it only as a concomitant medication, and those are not counted in the figures on this page.

In the 12 months to June 2026, 151 reports listed it, down 28% from 209 in the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Over its reporting history that is about 169 reports a year and 0% of the 20,646,523 reports in the database, and 1.8% of the reports for the histamine-1 receptor antagonist class. How many people take it is not in the data, so a count is not a rate of occurrence.

The MedDRA terms listed most often are treatment failure (31.1%), drug ineffective (16.1%) and no adverse event (13.8%). A report can list several reactions, so shares add to more than 100%; 270 different terms appear across these reports. Treatment failure is recorded in 31.1% of these reports, a larger share than in the median histamine-1 receptor antagonist drug (0.4%).

5.7% of the reports are marked serious by the reporter (57.7% across the class); 0.2% record death among the outcomes and 1.7% record hospitalisation, as reported. 83.7% of the reports came from consumers, and the largest patient age group is 75 and over (5.7%). FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event."

Reports by month, five years

057114Jul 2021: 2Aug 2021: 4Sep 2021: 5Oct 2021: 33Nov 2021: 6Dec 2021: 42022Jan 2022: 1Feb 2022: 8Mar 2022: 10Apr 2022: 3May 2022: 16Jun 2022: 2Jul 2022: 7Aug 2022: 24Sep 2022: 4Oct 2022: 60Nov 2022: 14Dec 2022: 52023Jan 2023: 4Feb 2023: 14Mar 2023: 17Apr 2023: 2May 2023: 47Jun 2023: 4Jul 2023: 3Aug 2023: 20Sep 2023: 1Oct 2023: 98Nov 2023: 3Dec 2023: 32024Jan 2024: 0Feb 2024: 18Mar 2024: 1Apr 2024: 7May 2024: 21Jun 2024: 114Jul 2024: 5Aug 2024: 7Sep 2024: 6Oct 2024: 77Nov 2024: 3Dec 2024: 32025Jan 2025: 13Feb 2025: 6Mar 2025: 6Apr 2025: 5May 2025: 10Jun 2025: 68Jul 2025: 4Aug 2025: 10Sep 2025: 6Oct 2025: 105Nov 2025: 1Dec 2025: 42026Jan 2026: 3Feb 2026: 6Mar 2026: 3Apr 2026: 7May 2026: 2Jun 2026: 0

Reports by the month FDA received them. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases.

By year received

04529042011: 320112012: 72013: 620132014: 62015: 5920152016: 2722017: 6720172018: 472019: 14620192020: 9042021: 9420212022: 1542023: 21620232024: 2622025: 23820252026: 21

2026 covers reports received through June 2026 only.

Reactions recorded in the reports

share of Azelastine hydrochloride reports recording the termmedian drug in histamine-1 receptor antagonist

  1. Treatment failurethe treatment did not work31.1%779
  2. Drug ineffectivethe medicine did not work as expected16.1%403
  3. No adverse eventno adverse event was reported13.8%346
  4. Product delivery mechanism issue12.5%313
  5. Product dose omission issuea dose was missed10.1%253
  6. Device breakagethe device broke3.2%79
  7. Device issuea problem with the device2.9%72
  8. Device malfunctionthe device did not work properly2.3%58
  9. Dysgeusiaaltered taste2.1%52
  10. Headachehead pain2%50
  11. Dizzinesslight-headedness or unsteadiness2%49
  12. Dyspnoeashortness of breath1.6%41
  13. Product odour abnormalthe product smelt odd1.4%36
  14. Device leakagethe device leaked1.4%35
  15. Nauseafeeling sick1.4%34
  16. Product taste abnormalthe product tasted odd1.3%33
  17. Fatiguetiredness1.3%32
  18. Nasal congestiona blocked nose1.2%29
  19. Somnolencedrowsiness1.2%29
  20. Wrong technique in product usage processthe product was used in the wrong way1.2%29
  21. Epistaxisnosebleed1.1%27
  22. Hypersensitivityan allergic-type reaction1.1%27
  23. Eye irritationeye irritation1%24
  24. Coughcough0.8%21

Top 30 of 270 MedDRA preferred terms recorded across these reports, with a plain-language gloss where one is available. One report can record several terms. The hollow bar is the median share across the 34 drugs in the histamine-1 receptor antagonist class; it describes the reports, not the patients. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."

Outcomes recorded

Death0.2%5
Life-threatening0.1%2
Hospitalisation (initial or prolonged)1.7%43
Disability0.6%15
Congenital anomaly0%0
Other serious4.7%117
Not serious94.3%2,360

Outcome flags as the reporter set them; a report can carry several, and "other serious" is FDA's own category for serious reports outside the named outcomes. Grey bar: all 135,666 reports in the class. FDA has not verified any outcome and states that the reports "cannot be used to estimate the incidence of these events."

Patients and reporters

Patient age

Under 20%0
2 to 110.2%6
12 to 170.2%5
18 to 441.4%35
45 to 644.9%123
65 to 745.3%133
75 and over5.7%143
Age not given82.2%2,057

Patient sex

Female59.8%1,496
Male27.2%680
Not given13%326

Who reported

Physician2.9%72
Pharmacist5.6%140
Other health professional7.1%177
Lawyer0%1
Consumer or non-health professional83.7%2,093
Not given0.8%19

Age and sex as stated in the report; the reporter's qualification is the primary source recorded by FDA. 97.7% of reports give the United States as the country of the event or reporter.

Reason for use recorded

Indication as recorded (MedDRA)ReportsShare
Hypersensitivity1184.7%
Conjunctivitis allergic933.7%
Rhinitis allergic502%
Nasal congestion371.5%
Eye pruritus241%
Upper-airway cough syndrome230.9%

The indication field is filled in by the reporter and is often blank; shares are of all 2,502 reports.

Drugs most often listed in the same reports

Drug (any role in the report)ReportsShare of Azelastine hydrochloride reports
Zaditor45818.3%
Pataday39015.6%
Ketotifen30112%
Patanol30012%
Olopatadine hydrochloride25610.2%
Ketorolac tromethamine692.8%
Ketorolac401.6%
Ketotifen fumarate401.6%
Flonase331.3%
Aspirin241%

Other products listed in reports where Azelastine hydrochloride is a suspect product, whatever their own role. Co-listing means the two were recorded together; it says nothing about either product's part in the event. Only the 2,500 most-reported names are counted here.

In context

MeasureAzelastine hydrochlorideHistamine-1 receptor antagonistAll reports
Reports as suspect product2,502135,66620,646,523
Share of that pool—1.8%0%
Reports, latest 12 months151—1,332,454
Marked serious5.7%57.7%57.4%
Death recorded among outcomes, per 1,000 reports219091
Hospitalisation recorded, per 1,000 reports17203213
Consumer-filed share83.7%50.8%45.8%
Top term, share of reportsTreatment failure 31.1%median 0.4%0.4%

Shares are of reports, not of patients treated. The number of people taking a product is not in the data, so none of these figures is a rate, and differences between columns reflect who takes a product, who reports and how long it has been sold. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."

Other drugs in the histamine-1 receptor antagonist class

DrugName typeReportsLatest 12 monthsMarked serious
Zyrtecbrand20,34292916.7%
Cetirizine hydrochloridegeneric19,0922,04377.5%
Diphenhydraminegeneric15,3391,15796%
Cetirizinegeneric12,5221,54891.7%
Benadrylbrand9,61243266.6%
Allegra Allergybrand7,8683043.6%
Diphenhydramine hydrochloridegeneric5,55653894.6%
Xyzal Allergy 24HRbrand5,3021473.3%
Cetirizine hydrochloride, pseudoephedrine hydrochloridegeneric4,91490999.3%
Xyzalbrand3,82418144.6%
Fexofenadinegeneric3,14233562.5%
Diphenhydramine hclgeneric2,741091%
Desloratadinegeneric2,69919093.6%
Aleve PMbrand1,877136.4%
Azelastinegeneric1,5484011.6%

Ordered by report count for navigation only. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic." A brand and its generic are separate rows because reporters name them separately.

Questions about Azelastine hydrochloride reports

How many adverse event reports has FDA received for Azelastine hydrochloride?

2,502 reports list Azelastine hydrochloride as a suspect or interacting product in the openFDA FAERS release of 28 Sep 2026, covering reports received through June 2026. 151 of them arrived in the latest 12 months. Another 4,144 list it only as a concomitant medication.

What reactions are recorded in Azelastine hydrochloride reports?

treatment failure (31.1%), drug ineffective (16.1%), no adverse event (13.8%), product delivery mechanism issue (12.5%) and product dose omission issue (10.1%). These are MedDRA preferred terms coded from what the reporter described; a report can list several, and a term's presence is not a finding that Azelastine hydrochloride was responsible.

How serious are the reports?

5.7% are marked serious by the reporter. Among the outcomes recorded, 0.2% of reports include death and 1.7% include hospitalisation. FDA has not verified these outcomes and states that the reports "cannot be used to estimate the incidence" of the events.

Who files these reports?

consumer or non-health professional (83.7%), other health professional (7.1%) and pharmacist (5.6%). Most reports reach FDA through the manufacturer, which must forward reports it receives.

Are reports for Azelastine hydrochloride rising?

151 reports in the 12 months to June 2026, down 28% from 209 in the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Counts also move with how many people take a product, its time on the market and publicity.

Do these reports show that Azelastine hydrochloride was responsible for these reactions?

No. FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event." The reaction may relate to the condition being treated, to other medicines, or to something else.

Is this a list of the side effects of Azelastine hydrochloride?

No. It is a count of what was reported to FDA. The adverse reactions observed in clinical studies are printed on the FDA-approved label, which a pharmacist or clinician can go through with you.

How do I report an adverse event?

Consumers and health professionals can report to FDA through MedWatch (Form FDA 3500 online, or 1-800-FDA-1088), or to the manufacturer, which must pass reports on. See the guide on how to report.

Where this comes from. Counts are built from the openFDA Drug Adverse Event (FAERS) bulk export released 28 Sep 2026, which holds reports FDA received through 30 Jun 2026. Drug names are as reported, resolved to the brand or generic name on the FDA label where openFDA's harmonisation matched them; classes are the pharmacologic class (EPC) from the label and the National Drug Code Directory of 17 Sep 2026. A report counts here when it lists Azelastine hydrochloride as a suspect or interacting product; reports listing it only as a concomitant medication (4,144) are excluded. No report narrative, lot number, patient detail or reporter identity is published. See the methodology and sources; FDA's record is authoritative, and corrections are handled within five working days.

Drug data (FAERS) through 30 Jun 2026; device data (MAUDE) through 31 Aug 2026. Not medical advice.