Post-nasal drip (PND) is the sensation of excess mucus accumulating and running down the back of the throat, often triggering persistent coughing and frequent throat clearing. While mucus naturally moistens the airways, an increase in its volume or thickness makes it noticeable and irritating. Azelastine is an intranasal spray, available by prescription or over-the-counter, used to manage various nasal symptoms, including the drainage associated with PND. This medication targets the inflammatory processes that cause excessive mucus production.
Common Triggers of Post Nasal Drip
Post-nasal drip is primarily a symptom of inflammation within the nasal passages. A major underlying cause is allergic rhinitis (hay fever), where the immune system overreacts to environmental triggers like pollen or dust mites. This allergic response releases inflammatory chemicals, leading to swelling and increased, watery mucus production that creates the drip sensation.
PND is also frequently caused by non-allergic rhinitis (vasomotor rhinitis), which is not tied to the immune system. This type can be triggered by factors such as changes in temperature, strong odors, or certain medications. In these cases, nasal blood vessels become engorged, leading to congestion and subsequent PND. Other causes include infections like the common cold or sinusitis, structural issues like a deviated septum, or irritants like smoke.
How Azelastine Targets the Drip
Azelastine employs a dual mechanism of action that addresses both the allergic response and inflammation. Its primary function is as a potent H1-receptor antagonist, quickly blocking the effects of histamine. Histamine is a chemical released during an allergic reaction, and blocking its action reduces the inflammation, itching, and excessive mucus secretion that contribute to the drip.
The medication also possesses anti-inflammatory and mast-cell stabilizing properties, providing a more comprehensive effect than a traditional antihistamine alone. By stabilizing mast cells, Azelastine prevents these immune cells from releasing other inflammatory mediators, such as leukotrienes and kinins. This dual action reduces the overall volume of nasal secretions and decreases the swelling of the nasal lining, directly alleviating the feeling of mucus running down the throat.
Using Azelastine Effectively for Symptom Relief
Azelastine nasal spray must be administered correctly to ensure the medication coats the nasal lining. If the bottle has not been used for three or more days, the pump should be primed by spraying a few times into the air until a fine mist appears. To apply, gently blow your nose to clear the nostrils. Tilt your head slightly forward, aiming the spray tip toward the back wall of the nostril, away from the nasal septum.
The typical dosing frequency for adults and children over 12 is one or two sprays in each nostril, twice daily, though some formulations allow for once-daily use. Azelastine offers a rapid onset of action, with symptom improvement noticeable within 15 to 30 minutes. Consistent, twice-daily use is required to achieve maximum benefit and maintain relief from chronic PND. A common side effect is a bitter taste in the mouth, which is minimized by avoiding tilting the head back immediately after spraying.