What I Know about Astepro, including My Own Taste Test

I am going to summarize what I know about Astelin and Astepro, because I have been asked by patients and because their marketing department is pumping out lots of information, which can be confusing to all.

Astepro contains the same antihistamine, azalastine, as Astelin, in a new solution. Astelin, which is azalastine in the old solution, has been criticized because the post nasal drainage had a bitter taste (19.7%) (strong in my opinion) and sleepiness (11.5%), according to the package insert. These were significant adverse effects in my and my patients' experience. If shared nationally, this may have contributed lower sales and Meda's decision to develop a newer formulation. Astepro's package insert lists bitter taste as 7% (versus placebo 2%) and sleepiness 2% (versus placebo 0%). This is not as surprising, because Astepro's formulation uses sorbitol and sucralose (as in the artificial sweetener).

So I decided to try Astepro so I conducted my own taste test last week before I prescribed it for my patients. I had postnasal drip, but it was sweet, likely from the sucralose. I did not feel sleepy. Note, I don't have allergic rhinitis nor nonallergic rhinitis. I don't any feedback from my patients yet.

From calling around some local pharmacies, I found the average retail price of Astepro to be about $108. The average retail price for Astelin is about $113 per bottle. Both have coupons available on the Internet. If you decide to try Astepro, remember to ask at your doctor's office for a special coupon, that provides $100 credit to the first month, making it <$10. It's their introductory offer, not mine.

Tip: the way to distinguish them is to look the labels. Astelin is blue letters on a white background, whereas Astepro is white letters on a blue background - the reverse. Ignore the "New" label. From my readings, the label can only be used for 6 months and then it has to be removed. I couldn't find any accurate pictures in the 2009 Physician's Desk Reference or on the Internet. Note some pictures have an incorrect label. Here is the only correct product photo on the internet to date.

[Disclaimer: I have not received any payments for any reason from Meda. I do not own any Meda stock. I did not do any clinical trials with Meda. With a daughter in college, I am open for discussions.]