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Seasonal allergic conjunctivitis: Ophthalmic: Instill 1 drop into affected eye(s) twice daily. Dosing: Pediatric (For additional information see "Azelastine (ophthalmic): Pediatric drug information" )

Seasonal allergic conjunctivitis: Ophthalmic: Children ≥3 years: Refer to adult dosing. Dosing: Geriatric Refer to adult dosing. Dosing: Renal Impairment No dosage adjustment provided in the manufacturer’s labeling. Dosing: Hepatic Impairment No dosage adjustment provided in manufacturer’s labeling. Dosage Forms: U.S. Excipient information presented when available (limited, particularly for generics); consult specific product labeling. Solution, ophthalmic, as hydrochloride [drops]: 0.05% (6 mL) Optivar®: 0.05% (6 mL) [contains benzalkonium chloride] Generic Equivalent Available: U.S. Yes Use Treatment of itching of the eye associated with seasonal allergic conjunctivitis Medication Safety Issues Sound-alike/look-alike issues: Optivar® may be confused with Optiray®, Optive™ International issues: Optivar [U.S.] may be confused with Opthavir brand name for acyclovir [Mexico] Adverse Reactions Significant >10%: Central nervous system: Headache (15%) Ocular: Transient burning/stinging (30%) 1% to 10%: Central nervous system: Fatigue Dermatologic: Pruritus Gastrointestinal: Bitter taste (10%) Ocular: Conjunctivitis, eye pain, blurred vision (temporary) Respiratory: Asthma, dyspnea, pharyngitis, rhinitis Miscellaneous: Flu-like syndrome Contraindications Hypersensitivity to azelastine or any component of the formulation Warnings/Precautions

Dosage form specific issues: • Solution contains benzalkonium chloride; remove lens prior to administration and wait at least 10 minutes before reinserting. Do not use contact lenses if eyes are red. Metabolism/Transport Effects None known. Drug Interactions (For additional information: Launch Lexi-Interact™ Drug Interactions Program ) There are no known significant interactions. Pregnancy Risk Factor C ( show table ) Pregnancy Implications Animal reproduction studies have shown toxic effects to the fetus at maternally toxic doses. Lactation Excretion in breast milk unknown/use caution Pricing: U.S. (Medi-Span®)

Solution (Optivar Ophthalmic) 0.05% (6 mL): $174.19 International Brand Names Alergot (VE); Allergodil (AT, BE, CH, CZ, DE, DK, EE, FR, IT, NL, PT, RU); Az Ofteno (CN, CR, DO, GT, HN, NI, PA, SV, VE); Azel (CO); Brixia (AR, CN, PY, UY); Eyezep (AU, KP); Lastin (FI, SE); Oculast (IN); Opthazel (PE); Optilast (IL); Xanaes (AR) Mechanism of Action Competes with histamine for H 1 -receptor sites on effector cells and inhibits the release of histamine and other mediators involved in the allergic response Pharmacodynamics/Kinetics Onset of action: Peak effect: 3 minutes Duration: 8 hours Absorption: Plasma concentrations following ocular administration are low for azelastine (0.02-0.25 ng/mL) and n-desmethylazelastine (0.25-0.87 ng/mL) Use of UpToDate is subject to the Subscription and License Agreement . Topic 8677 Version 37.0 © 2013 UpToDate, Inc. All rights reserved. | Subscription and License Agreement | Release: 21.6- C21.56 Licensed to: AsanBook Dig. Med. Lib. | Support Tag: [0602-122.72.80.101-2F8DE301F2-S244013.14]