Compare Astepro vs. Afrin

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Astepro
(Azelastine)

Afrin
(Oxymetazoline)

Relieves nasal allergy symptoms. Astepro (Azelastine) is a prescription-only antihistamine nasal spray that can help with your allergy or nasal symptoms without exposing the rest of your body to the medicine.Clears your sinuses. Afrin (Oxymetazoline) clears stuffy noses well, but don't use it for more than 3 days in a row or your congestion could get worse.
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Reviews & ratings
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Reviews for Afrin (Oxymetazoline)
71%
29% vs. Astepro (Azelastine)
46%
54% vs. Astepro (Azelastine)
12%
12% vs. Astepro (Azelastine)
Side effects
AsteproAfrin
  • Bitter taste 19%
  • Inflammation inside the nose 7%
  • Drowsiness 7%
  • Nosebleed 4%
  • Pink eye 3%
  • Cough 3%
  • Nasal burning 2%
  • Sneezing 2%
  • Nausea 2%
  • Paroxysmal sneezing 2%
More Astepro side effects »

We haven’t found good data for Afrin side effects.

FDA side effect reports for Afrin »
How it works
AsteproAfrin
Astepro (Azelastine) is an antihistamine nasal spray. It works directly in your nose to block histamine, a chemical that causes runny nose, itching, and sneezing.Afrin (Oxymetazoline) is a nasal decongestant. It reduces swelling in your nose to make breathing easier.
Type of medication
AsteproAfrin
Antihistamine
2nd generation
Prescription only
DecongestantPrescription or OTC
Available as
AsteproAfrin
  • Nasal spray
  • Nasal spray
Used for (click to learn more)
AsteproAfrin
Risk factors for serious side effects
AsteproAfrin
  • Taking with alcohol
  • Taking other medicines that make you less alert
Detailed Astepro (Azelastine) risks & warnings »
  • Using Afrin (Oxymetazoline) for more than 3 days
  • Women of childbearing age
Detailed Afrin (Oxymetazoline) risks & warnings »
Pregnancy category
AsteproAfrin
CFDA pregnancy category (Weigh risks vs. benefits)

Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

See the FDA package insert
NFDA pregnancy category (Unknown)

The FDA hasn’t classified this medicine’s effects on unborn babies. Talk with your doctor about this medicine if you’re pregnant or planning on it.

See the FDA package insert
Alcohol
No specific alcohol-related info.No specific alcohol-related info.
Food
No specific food-related info.No specific food-related info.
Kidneys and liver
No specific kidneys and liver-related info.No specific kidneys and liver-related info.
Sex
No specific sex-related info.No specific sex-related info.
Sleep
  • Some people get a headache or feel drowsy and dizzy after using it.
No specific sleep-related info.
Weight
No specific weight-related info.No specific weight-related info.
Upsides and benefits
AsteproAfrin
  • Astepro (Azelastine) lowers the number of nasal symptoms you'll get during allergy season.
  • Works faster than steroid nasal sprays and can be used as needed.
  • Most people don't have any side effects since it works in the nose and doesn't affect the rest of your body.
  • Won't make you feel sleepy.
  • Works just as well as steroid nasal sprays.
  • It works right away and each dose provides relief for up to 12 hours.
  • Can use for nasal congestion caused by colds and allergies.
  • It only affects your nose, so there aren't too many other side effects.
  • Available as a nasal spray and a nasal mist.
Downsides and risks
AsteproAfrin
  • In older versions of the medicine, you can get a bitter taste in your mouth after spraying it into your nose.
  • Can cause nose bleeds if the spray nozzle is inserted into your nose wrongly.
  • Need a prescription to get Astepro (Azelastine).
  • It's good for 200 sprays, but there isn't a counter to help you keep track of sprays.
  • Afrin (Oxymetazoline), like all other sprays used for stuffy noses, can make your congestion worse if you use it for more than 3 or 4 days in a row (called rebound-congestion).
  • Can cause temporary stinging, burning, or dryness in your nose.
  • Can't be used for kids younger than 6 years old.
Tips from our pharmacists for people taking the medication
AsteproAfrin
  • Starts working in 15 minutes.
  • Check with your doctor or pharmacist to make sure you know how to use this nose spray correctly.
  • Before using the spray for the first time, prime it until you see a fine mist.
  • Clear your nose before using the spray and breathe in slowly as you're spraying. After spraying, wait a few minutes before blowing your nose if needed.
  • Tilt your head forward to avoid getting a bitter taste while spraying the medicine.
  • Some people get a headache or feel drowsy and dizzy after using it.
  • Use 2 to 3 sprays in each nostril every 10 to 12 hours. Don't use Afrin (Oxymetazoline) more than two times a day.
  • Keep your head upright and don't tilt it back when spraying Afrin (Oxymetazoline) into your nose.
  • Breathe in with quick sniffs while spraying and wait a few minutes before blowing your nose.
  • Don't use Afrin (Oxymetazoline) for more than 3 days in a row since it can worsen your congestion after a few days of use.
Learn more
More about AsteproSide effectsReviews & ratingsAlternativesFDA package insert
More about AfrinSide effectsReviews & ratingsAlternativesFDA package insert