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Commonly Used Nasal Spray May Prevent COVID-19 Infection: Study

A clinical trial of 450 adults found azelastine nasal spray reduced Covid infections to 2.2%, compared to 6.7% in placebo, suggesting potential for accessible prevention.

  • Clinical trial results released Tuesday showed an over-the-counter azelastine nasal spray could prevent Covid infections, with Dr. Robert Bals saying it `could serve as a scalable, over-the-counter prophylactic`.
  • Azelastine's prior in vitro data indicate antiviral activity against SARS-CoV-2, influenza and RSV, potentially binding in the nasal mucosa to inhibit a viral enzyme and block early replication.
  • The trial enrolled 450 adults, assigning 227 to azelastine and 223 to placebo groups over a 56-day period with three times daily dosing; PCR tests confirmed 2.2% infection in azelastine versus 6.7% in placebo, and 1.8% versus 6.3% rhinovirus incidence.
  • Researchers emphasized the need for larger trials as Dr. Robert Bals cautioned the nasal spray should complement vaccines, while outside researchers like Dr. William Messer urged more data in older adults and immunocompromised people.
  • Given azelastine's OTC status, the nasal spray might face fewer FDA regulatory barriers, yet public health and scalability concerns about dosing and rebound congestion remain, especially for influenza and RSV use.
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NBC Dallas-Fort Worth broke the news in Fort Worth, United States on Tuesday, September 2, 2025.
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