Can Nasal Sprays Treat or Prevent COVID-19?

Since the beginning of the COVID-19 pandemic, the FDA has authorized and approved many treatments and preventative medications that fight the virus. COVID-19 vaccines have also been recommended ever since the first ones were authorized in December 2020. 


However, medications that are already available make up a small percentage of what's been studied. Researchers are continuing to develop other medications that aim to prevent or treat COVID-19.

Among these, nasal sprays have caught the attention of many people. They’re easy to use, and some researchers believe they could have an impact on the ongoing pandemic. But are any of them effective at preventing or treating COVID-19? And are any of them available for use?

Which nasal sprays are being studied to prevent COVID-19?

Most nasal sprays in development for COVID-19 are designed to prevent sickness, not treat it. Many are still in the early stages of development, but some are being studied and used by people around the world. Some of the top ones are highlighted below. 

Nasal spray vaccines

Several COVID-19 nasal spray vaccines are being researched in studies — 13 to be exact. They aim to build up protective antibodies in your nose that fight SARS-CoV-2, the virus that causes COVID-19. A few are authorized in Asia, but none are available in the U.S. yet. 

Authorized nasal spray vaccines so far

In April 2022, Russian authorities authorized (registered) the world’s first COVID-19 nasal spray vaccine — Sputnik V. It’s the nasal equivalent of the intramuscular vaccine that shares the same name. In July 2022, a similar vaccine called Salnavac was also authorized in Russia. At this time, the makers of Sputnik V and Salnavac aren’t seeking authorization in the U.S.

Another vaccine that’s far along, BBV154, is made by Bharat Biotech. In September 2022, it was authorized for emergency use in India as a two-dose primary series vaccine. It’s the world’s third COVID-19 nasal spray vaccine to be approved or authorized. 

One of Bharat Biotech’s partners has licensed the vaccine in the U.S., but it’s unclear if or when they’ll seek authorization from the FDA.

Other nasal spray vaccines

Scientists from the University of California, Berkeley are developing their own COVID-19 nasal vaccine. Their vaccine aims to prevent SARS-CoV-2 from replicating in your body. Results from animal studies published in August 2022 were positive, but UC Berkeley scientists still need to study the vaccine in humans. If all goes to plan, they’re reportedly looking to obtain U.S. authorization by fall 2023.

Separately, researchers backed by the National Institute of Allergy and Infectious Diseases are also developing a nasal vaccine. It’s called N-0385. Animal studies have been encouraging, so researchers are looking to study N-0385 in people next. A specific development timeline isn’t clear. 

Nitric oxide nasal sprays

Nitric oxide is a gas that’s found throughout your body. It has many jobs, but one of its roles is helping regulate your immune system. Because of this, researchers are curious if nitric oxide nasal sprays could help prevent or treat COVID-19. 

In particular, a few studies have looked to see if nitric oxide nasal sprays can prevent severe illness caused by COVID-19. One small study found that they can reduce viral load by about 95% after 24 hours. And larger clinical trials for nitric oxide nasal sprays are still taking place. 

So far, this research has been influential in some countries. For instance, one nitric oxide nasal spray — called Enovid — is now available in Israel, India, and other countries throughout Asia. In late August 2022, it was also reported that Enovid’s manufacturer raised $24M to fund an ongoing phase 3 prevention trial.

Other nasal sprays

Other nasal sprays have also been studied for COVID-19 prevention, but they’re not vaccines. They each work in a unique way. 

pHOXWELL

In October 2022, U.K. researchers published findings in the Journal of Clinical Virology about their developing nasal spray, pHOXWELL. In their clinical trial, pHOXWELL reduced the risk of developing COVID-19 by about 62% in healthcare workers. It’s thought to work by blocking the SARS-CoV-2 virus from entering your body through your nose.

In the study, pHOXWELL was administered 3 times daily for 45 days, and it was compared to placebo (a nasal spray with no medication in it). The makers of pHOXWELL are hoping to obtain authorization in India in the near future, with ambitions of expanding to other countries later on.

IGM-6268

A nasal and mouth spray called “IGM-6268” is in the early stages of clinical trials. It’s being studied as a potential way to prevent mild to moderate cases of COVID-19. It’s a type of antibody that targets the coronavirus’ spike protein. 

phase 1 study for IGM-6268 is still taking place, and it’s expected to be finished by December 2022. Another phase 1 study was initially scheduled to be completed by April 2022, but results haven’t been posted yet. If these results are positive, IGM-6268 could advance to more advanced studies. 

Iota-carrageenan

Iota-carrageenan is another nasal spray being studied to prevent COVID-19. Iota-carrageenan is a sugar that comes from algae.

So far, one study of about 400 healthcare workers suggested that iota-carrageenan may potentially lower the risk of getting COVID-19 by up to 80%. Another study is looking to analyze iota-carrageenan’s ability to prevent COVID-19, but it's still recruiting participants. This study is expected to wrap up by February 2023.

COVIXYL-V

COVIXYL-V (ethyl lauroyl arginine hydrochloride) is another nasal spray that aims to prevent COVID-19. Similar to pHOXWELL, it offers a layer of protection in your nose that can block the virus from entering your body. Early data from lab and animal studies has found that COVIXYL-V can help block SARS-CoV-2. But we still need to see how the nasal spray performs in humans. 

Xylitol nasal sprays

Some reports suggest that xylitol nasal sprays could help prevent COVID-19. Similar to other nasal sprays, it’s suggested that they may help reduce the amount of virus in your nose and stop it from entering your body. 

One preprint lab report suggests that the ingredients in xylitol nasal sprays can help lower viral load. The lab study claims that xylitol may act as an antiviral against SARS-CoV-2. Limited case reports also hint that xylitol nasal sprays may help improve COVID-19 symptoms when used with other treatments. Clinical trials are needed to confirm these findings.

Which nasal sprays are being studied to treat COVID-19?

Alongside nasal sprays that aim to prevent COVID-19, others are being developed to treat it. In addition to nitric oxide nasal sprays, steroid nasal sprays have the most data so far.

Steroid nasal sprays

Corticosteroid (steroid) nasal sprays are widely available in the U.S. They’re often used for treating conditions like allergies and nasal polyps, but some researchers are exploring their potential as a treatment for COVID-19. It’s thought that they can help control inflammation while stopping SARS-CoV-2 from entering your respiratory system

In one Cleveland Clinic study, registry data from over 70,000 people with mild-to-moderate COVID-19 was collected. Results suggested that corticosteroid nasal sprays may help prevent hospitalizations, ICU admissions, or death from COVID-19. But in order to confirm if they’re safe and effective for COVID-19, researchers would need to perform clinical trials. 

As of now, there aren’t any ongoing clinical trials that are studying steroid nasal sprays for COVID-19. But since early data is positive, we may see some clinical trials in the future. 

What medications can I take to treat or prevent COVID-19?

Nasal sprays aside, many medications are already authorized to treat and prevent COVID-19. Your healthcare provider can tell you if you’re eligible to access any of these treatments.

Medications that can treat COVID-19 if you aren’t in the hospital

If you’ve tested positive for COVID-19 and aren’t in the hospital, your healthcare provider may prescribe a medication to help lower your risk of severe illness. Listed in preferential order, these include:

  • Paxlovid (nirmatrelvir and ritonavir), an oral tablet

  • Veklury (remdesivir), an intravenous (IV) infusion

  • Bebtelovimab, another IV infusion

  • Lagevrio (molniupiravir), an oral capsule

Medications that can help prevent COVID-19

Evusheld (tixagevimab and cilgavimab) is a combination of two injections used for pre-exposure prophylaxis (PrEP) to prevent future COVID-19 infections. But only certain people qualify for it, and its effectiveness against the Omicron variant is mixed.

The bottom line

Nasal sprays are being studied as a potential way to prevent and treat COVID-19. Vaccines like Sputnik V and BBV154 are authorized in Russia and India, respectively, but they’re yet not available in other countries. A nitric oxide nasal spray is also available in countries like Israel and India. At this time, the FDA hasn’t authorized any nasal sprays for COVID-19. 

Main Reference: https://www.goodrx.com/conditions/covid-19/nasal-spray-covid

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