Reported Reactions

Drugs › Histamine-1 receptor antagonist

Generic name

Azelastine: adverse event reports filed with FDA

1,548 reports list it as a suspect or interacting product, 2011–2026. Class: Histamine-1 receptor antagonist. Also reported as Azelastine Nasal Spray.

1,548
reports as suspect product
0% of all reports · about 102 a year
40
reports, 12 months to June 2026
36 in the 12 months before
11.6%
marked serious by the reporter
57.7% across the class
0.7%
record death among outcomes, as reported
11 reports · not verified by FDA

Between May 2011 and June 2026, 1,548 adverse event reports received by FDA list azelastine, a generic name as a suspect or interacting product. Reports that mention it only as a concomitant medication (8,904) are left out of every figure here.

In the 12 months to June 2026, 40 reports listed it, up 11% from 36 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 102 reports a year and 0% of the 20,646,523 reports in the database, and 1.1% 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 reactions recorded most often are treatment failure (70.2%), drug ineffective (7%) and product dose omission issue (2.3%). A report can list several reactions, so shares add to more than 100%; 210 different terms appear across these reports. Treatment failure is recorded in 70.2% of these reports, a larger share than in the median histamine-1 receptor antagonist drug (0.4%).

11.6% of the reports are marked serious by the reporter (57.7% across the class); 0.7% record death among the outcomes and 2.9% record hospitalisation, as reported. 74.2% of the reports came from consumers, and the largest patient age group is 45 to 64 (3.7%). 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

01121Jul 2021: 5Aug 2021: 3Sep 2021: 4Oct 2021: 21Nov 2021: 4Dec 2021: 22022Jan 2022: 1Feb 2022: 3Mar 2022: 3Apr 2022: 3May 2022: 3Jun 2022: 3Jul 2022: 9Aug 2022: 4Sep 2022: 6Oct 2022: 2Nov 2022: 3Dec 2022: 22023Jan 2023: 6Feb 2023: 9Mar 2023: 4Apr 2023: 1May 2023: 8Jun 2023: 8Jul 2023: 5Aug 2023: 8Sep 2023: 4Oct 2023: 1Nov 2023: 1Dec 2023: 02024Jan 2024: 1Feb 2024: 1Mar 2024: 8Apr 2024: 2May 2024: 6Jun 2024: 0Jul 2024: 2Aug 2024: 4Sep 2024: 1Oct 2024: 1Nov 2024: 2Dec 2024: 12025Jan 2025: 3Feb 2025: 3Mar 2025: 4Apr 2025: 6May 2025: 9Jun 2025: 0Jul 2025: 2Aug 2025: 1Sep 2025: 2Oct 2025: 3Nov 2025: 3Dec 2025: 42026Jan 2026: 4Feb 2026: 5Mar 2026: 0Apr 2026: 11May 2026: 2Jun 2026: 3

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

05451,0902011: 520112012: 102013: 820132014: 72015: 1320152016: 222017: 1720172018: 252019: 3120192020: 1,0902021: 12920212022: 422023: 5520232024: 292025: 4020252026: 25

2026 covers reports received through June 2026 only.

Reactions recorded in the reports

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

  1. Treatment failurethe treatment did not work70.2%1,086
  2. Drug ineffectivethe medicine did not work as expected7%108
  3. Product dose omission issuea dose was missed2.3%35
  4. Hypersensitivityan allergic-type reaction1.3%20
  5. Headachehead pain1.1%17
  6. Diarrhoealoose or frequent stools1%15
  7. Dyspnoeashortness of breath1%15
  8. Product delivery mechanism issue1%15
  9. Dizzinesslight-headedness or unsteadiness0.9%14
  10. Painpain, site not specified0.9%14
  11. Product use in unapproved indicationused for a purpose not on the label0.9%14
  12. Somnolencedrowsiness0.9%14
  13. Coughcough0.8%13
  14. Pruritusitching0.8%13
  15. Nauseafeeling sick0.8%12
  16. Condition aggravatedthe condition being treated got worse0.7%11
  17. Drug hypersensitivityan allergic-type reaction to a medicine0.7%11
  18. Epistaxisnosebleed0.7%11
  19. Eye irritationeye irritation0.6%9
  20. Psoriasispsoriasis, a skin condition0.6%9
  21. Arthralgiajoint pain0.5%8
  22. Asthmaasthma0.5%8
  23. Fatiguetiredness0.5%8
  24. Rhinorrhoeaa runny nose0.5%8
  25. Dehydrationdehydration0.5%7
  26. Hepatic failureliver failure0.5%7
  27. Anxietyanxiety0.4%6

Top 30 of 210 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

Death0.7%11
Life-threatening0.6%9
Hospitalisation (initial or prolonged)2.9%45
Disability0.3%4
Congenital anomaly0.1%1
Other serious9.8%152
Not serious88.4%1,368

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 20.1%1
2 to 110.3%4
12 to 170.3%4
18 to 442.3%35
45 to 643.7%58
65 to 741.9%29
75 and over2.5%38
Age not given89.1%1,379

Patient sex

Female66.5%1,030
Male29.8%461
Not given3.7%57

Who reported

Physician7.9%123
Pharmacist2%31
Other health professional14.1%219
Lawyer0%0
Consumer or non-health professional74.2%1,148
Not given1.7%27

Age and sex as stated in the report; the reporter's qualification is the primary source recorded by FDA. 93.7% of reports give the United States as the country of the event or reporter.

Reason for use recorded

Indication as recorded (MedDRA)ReportsShare
Hypersensitivity332.1%
Asthma80.5%
Rhinitis70.5%
Nasal congestion60.4%
Seasonal allergy50.3%
Psoriasis40.3%

The indication field is filled in by the reporter and is often blank; shares are of all 1,548 reports.

Drugs most often listed in the same reports

Drug (any role in the report)ReportsShare of Azelastine reports
Zaditor59438.4%
Pataday49431.9%
Olopatadine hydrochloride40426.1%
Ketotifen38624.9%
Patanol38324.7%
Ketorolac1157.4%
Ketotifen fumarate412.6%
Fluticasone312%
Montelukast251.6%
Fluticasone propionate201.3%

Other products listed in reports where Azelastine 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

MeasureAzelastineHistamine-1 receptor antagonistAll reports
Reports as suspect product1,548135,66620,646,523
Share of that pool—1.1%0%
Reports, latest 12 months40—1,332,454
Marked serious11.6%57.7%57.4%
Death recorded among outcomes, per 1,000 reports719091
Hospitalisation recorded, per 1,000 reports29203213
Consumer-filed share74.2%50.8%45.8%
Top term, share of reportsTreatment failure 70.2%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%
Azelastine hydrochloridegeneric2,5021515.7%
Aleve PMbrand1,877136.4%

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 reports

How many adverse event reports has FDA received for Azelastine?

1,548 reports list Azelastine as a suspect or interacting product in the openFDA FAERS release of 28 Sep 2026, covering reports received through June 2026. 40 of them arrived in the latest 12 months. Another 8,904 list it only as a concomitant medication.

What reactions are recorded in Azelastine reports?

treatment failure (70.2%), drug ineffective (7%), product dose omission issue (2.3%), hypersensitivity (1.3%) and headache (1.1%). 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 was responsible.

How serious are the reports?

11.6% are marked serious by the reporter. Among the outcomes recorded, 0.7% of reports include death and 2.9% 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 (74.2%), other health professional (14.1%) and physician (7.9%). Most reports reach FDA through the manufacturer, which must forward reports it receives.

Are reports for Azelastine rising?

40 reports in the 12 months to June 2026, up 11% from 36 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 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?

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 as a suspect or interacting product; reports listing it only as a concomitant medication (8,904) 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.