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Allergic coughs, cold, fever. Advised azeflo nasal spray, montair. What are the long term effects of these medications?

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Practicing since : 2001
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My son used to have allergic coughs and was prone to frequent cold/fever.
My son has been advised to take Azeflo Nasal Spray and Montair 4 once daily at night.
I am concerned about the long term effects of such medications on a daily basis. Can you please illustrates of the possible side effects and also suggest alternatives, if any.
Posted Mon, 16 Jul 2012 in Asthma and Allergy
Answered by Dr. Naveen Kumar 2 hours later

Thanks for the query

Do not worry! The side effects of Azeflo nasal spray (combination of azelastine hydrochloride 140 mcg, fluticasone propionate 50 mcg) and Montair (monteleukast) are very minimal.
Montair is used to prevent asthma symptoms. It can be used in children 2 years of age and older, teenagers and adults. The Azeflo spray can be used for a period of one month and Montair for not more than 2 months.
Side effects are minimal if used under medical supervision. Occasional side effects include headache, dizziness, stomach upset, stuffy nose, cough, etc. These are usually noticed on sudden stopping of the medicines without tapering the dose.

My suggestion to you is:
1. Encourage your child to drink plenty of warm water
2. Use saline nasal spray for the nose 3-4 times a day, which helps in keeping the nose moist
3. Change the pillow cover or bed sheet of the child every night before going to bed
4. Never make your child sleep under the fan or in front of the AC blower
5. Avoid those food and beverages which induces allergy for your child
6. Steam inhalation 2-3 times a day helps in reducing the cough and nasal congestion
7. Encourage your child to have healthy and wholesome food

Hope this answers your query; I will be available for the follow-up queries.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
Follow-up: Allergic coughs, cold, fever. Advised azeflo nasal spray, montair. What are the long term effects of these medications? 19 hours later
Dear Doctor,
Thank you for the detailed suggestion.
My worry is that my son has been adviced to take the medication on a daily basis for prolonged period. He has been having it for the last 7-8 months.
Please suggest if it is alright to continue the medication for prolonged period.

I would like to mention another thing: My son had enlarged tonsilitis and adenoids. In addition to the problems I have already mentioned, he also used to snore and also wake up from sleep as if he were breathless. With the current medication (montair + azeflo), i observe that his tonsils are better and the above problems have also disappeared.

I understand from you note that it is ok to have the medication for a short period but my concern still remains on the long terms effects of prolonged medication ( as I believe they are steriods). Are there any alternatives?
Answered by Dr. Naveen Kumar 16 hours later


Thanks for writing back

In children, Azeflo is not advised for a long period as it can cause atrophy of the nasal turbinates and can lead to dryness of the nasal mucosa.

Instead, you can try plain steroid nasal spray only when the symptoms surface. There is no cure for allergy, only preventive measures can get rid of allergy. The symptoms have subsided because of the use of azeflo spray, but once it is stopped, there are possibilities of symptoms resurfacing.

The adenoids usually swell-up during allergic episodes causing stasis of the nasal secretions leading to repeated nasal infections. Hence, the swelling of adenoids reduces to a certain extent with the steroids and antihistaminic.

Alternatively, if the tonsils and adenoids are enlarged enough to cause the blockage of the airway, it is wiser to remove the obstruction rather than using the medicines for prolonged periods. With this, there will be improvement in the symptoms by more than 70% without medicines. Saline nasal spray followed by steam inhalation can help in clearing off the nasal secretions and nasal block. Also, follow the preventive measures as mentioned in my previous post; your child will be alight.

I wish your child good health.

Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
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