It is a combination of intranasal corticosteroid and an antihistamine. This steroid is not the same as the oral steroid. There you get 5% medical effect and 95% unwanted side effects! Intranasal corticosteroid however safe even in pregnant and lactating mothers as 100% reaches the targeted site and 0% is absorbed systemically! But I do not prescribe this combination as the antihistamine azelastine is viciously bitter at the back of your throat, so, many of my patients would discontinue after 2-3 days, but never reveal it as they would be too embarassed to do so! So, now I prefer to co-prescribe an antihistamine as a syrup or tablet which is equally effective but does not torture my patient with the bitter aftertaste!