Is Astepro safe during pregnancy?

What does the evidence say about Astepro during pregnancy?

1. Studies have not been done in humans to see whether azelastine increases the chance of a pregnancy with a birth defect, though animal studies at doses comparable to human intranasal use showed no increased risk. 1
2. No studies have looked at whether azelastine increases the chance of miscarriage, premature delivery, or reduced infant weight, so those questions are open rather than answered either way. 1
3. Eye drops and nasal sprays result in lower medication exposure for a pregnancy than medicines that are swallowed, which is the general principle behind favoring a spray over a tablet where both would work. 2
4. Drowsiness may occur with Astepro Allergy despite the nasal route, and the label warns about driving or operating machinery and notes that alcohol, sedatives, and tranquilizers increase the effect. 3
5. Adults dose Astepro Allergy as either two sprays in each nostril once daily or one to two sprays every 12 hours, and the label tells anyone pregnant or breastfeeding to ask a health professional before use. 3

Is Astepro safe in each trimester?

• First trimester. Human studies on azelastine in pregnancy simply have not been carried out, so nobody can quote you a first-trimester number. Animal studies at doses comparable to human intranasal use did not show increased risk. Because budesonide has an established pregnancy record and azelastine does not, many clinicians start there in the first trimester.
• Second trimester. Azelastine's practical strength is speed. Unlike steroid sprays that take one to two weeks to build, an antihistamine spray acts on symptoms quickly, which suits sneezing and a runny nose that come and go. That fast onset is worth weighing against the thinner pregnancy evidence with your provider.
• Third trimester. Drowsiness is the surprise with this one. Even sprayed into the nose, azelastine can make you sleepy, and the label warns about driving and about alcohol or sedatives adding to it. Late in pregnancy that stacks on fatigue you already have, so try the first dose on a day you are not driving.