I recently discovered that most of the antihistamines and steroid
nasal sprays that are prescription-only in the U.S are sold as
nonprescription products in Australia and New Zealand, sometimes at a
subsantially lower price than an *insurance copay* would be for the
same product here!

As many of you know, in the U.S. Astelin (azelastine) is an an
antihistamine that is administered as a nasal spray.  One purported
advantage of Astelin over oral antihistamines is that its topical mode
of administration may allow it to help with nasal congestion and to
cause less dry mouth.  Another is that it is indicated for both
allergic and non-allergic rhinitis (at least in the U.S.)

I recently ordered Azep (= Astelin, but manufactured by VIATRIS of
Germany) from a company in New Zealand.  It arrived quickly.  One of
the first things I did was compare the Azep packaging and instructions
with some expired Astelin I have, and was surprised to see that --
while most of the additives were the same --  the Azep lacked the
Benzalkonium Chloride found in Astelin.  I found this curious,
especially since almost all the American prescription and OTC sprays
except Rhinocort have BC, and many ENTs, researchers and patients feel
that BC can actually *worsen* sinus-related problems in many folks.

I wonder why BC is deemed as "necessary" in the U.S version (Astelin)
but not in Azep?

BTW, the dosage listed for Azep is one spray per nostril twice a day,
while the Astelin monograph specifies a usual dose of *two* sprays per
nostril twice a day.  This is despite the fact that each spray (or
"puff" as it's called by Azep) contains an equivalent amount of
azelastine HCL for both products.

HS