Germany Approves First OTC Nasal Spray for Allergic Rhinitis Relief

A new over-the-counter nasal spray for allergic rhinitis will soon be available in Germany. Stada is launching Snup Allerg on 1 November 2023, following regulatory approval. The product combines an antihistamine and a corticosteroid to relieve seasonal allergy symptoms without a prescription. The active ingredients in Snup Allerg are azelastine and fluticasone propionate. Azelastine is a second-generation antihistamine that blocks H1 receptors, helping to reduce sneezing, itching, and a runny nose. Fluticasone propionate is a synthetic corticosteroid with strong anti-inflammatory effects—three to five times more potent than dexamethasone.

Each spray delivers 137 µg of azelastine hydrochloride and 50 µg of fluticasone propionate. Adults should use one spray in each nostril twice daily, in the morning and evening. Before use, the bottle must be shaken vigorously for about five seconds, then tilted up and down to ensure proper mixing. The switch to over-the-counter status was not straightforward. The fixed-dose combination was only approved on the third attempt, after the *Sachverständigenausschuss für Verschreibungspflicht* (SAV) recommended changes to make it suitable for non-prescription use. However, the *Bundesinstitut für Arzneimittel und Medizinprodukte* (BfArM) has raised concerns about whether patients can accurately self-diagnose severe allergic rhinitis without medical advice. The nasal spray has been available without a prescription in Germany since February 2023. Stada's *Snup Allerg* will now offer another option for those seeking relief from seasonal allergies.

Starting 1 November, Snup Allerg will be sold in pharmacies across Germany. The spray provides a combination of antihistamine and corticosteroid for allergy sufferers aged six and older. Regulators have approved its use but advise caution in self-diagnosis for severe cases.