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azelastine vs loratadine

Side-by-side comparison of azelastine and loratadine Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

Drug Class
azelastine Antihistamine (Nasal)
loratadine Second-Generation Antihistamine
Type
azelastine Over-the-Counter
loratadine Over-the-Counter
Summary
azelastine

Azelastine nasal spray is an antihistamine medicine. It helps relieve allergy and non-allergy nasal symptoms.

loratadine

Loratadine is an antihistamine medicine. It helps relieve allergy symptoms.

What It Treats
azelastine

This medicine treats symptoms of seasonal allergies in adults and kids 5 years and older. It also treats symptoms of vasomotor rhinitis (stuffy or runny nose not caused by allergies) in adults and teens 12 years and older. It works by blocking histamine, a substance in the body that causes allergy symptoms.

loratadine

This medicine treats allergy symptoms. It can help with a runny nose, itchy and watery eyes, and sneezing. It also helps with itching of the nose or throat caused by hay fever or other upper respiratory allergies.

How It Works
azelastine

Azelastine is an antihistamine. It blocks histamine, a natural substance that your body makes during an allergic reaction. By blocking histamine, azelastine helps reduce allergy symptoms like sneezing, runny nose, and itchy eyes.

loratadine

Loratadine blocks histamine in your body. Histamine is a natural substance that causes allergy symptoms. By blocking it, loratadine reduces these symptoms.

Common Side Effects
azelastine
  • Bitter taste
  • Headache
  • Sleepiness
  • Nasal burning
  • Sore throat
loratadine
  • Headache
  • Fatigue
  • Drowsiness
FAERS Reports
azelastine
  • The medicine did not work 1,876
  • The medicine was not effective 1,155
  • Tiredness 1,144
  • Missed dose 889
  • Headache 883
loratadine
  • Medicine not working 12,662
  • Tiredness 6,401
  • Feeling sick to your stomach 5,688
  • Head pain 5,182
  • Difficulty breathing 4,656
Serious Warnings
azelastine

Azelastine nasal spray can cause sleepiness. Be careful driving or operating machinery until you know how this medicine affects you. Avoid drinking alcohol or taking other medicines that can cause sleepiness while using this spray.

loratadine

There are no boxed warnings for this medication.

Pregnancy
azelastine

There is limited information about the safety of azelastine nasal spray during pregnancy. Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if azelastine passes into breast milk, so talk to your doctor if you are breastfeeding.

loratadine

If you are pregnant or breastfeeding, talk to your doctor before taking loratadine. They can help you weigh the risks and benefits.

Also Compare — Nearby Drugs

How to Read This azelastine vs loratadine Comparison

azelastine is classified in the Antihistamine (Nasal) drug class, while loratadine sits within the Second-Generation Antihistamine class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are available over the counter.

Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, azelastine has 5,947 submissions while loratadine has 34,589. Those figures reflect cumulative reporting volume — not per-patient risk — so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.

A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between azelastine and loratadine — always consult your physician or pharmacist first.

Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.