Nasal Sprays to Treat or Prevent COVID-19 - GoodRx (2024)

Since the beginning of the COVID-19 pandemic, the FDA has authorized and approved many treatments and preventative medications that fight the coronavirus. COVID 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 has been studied. Researchers are continuing to develop other medications that aim to prevent or treat COVID.

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 preventing or treating the virus. But are any of them effective at preventing or treating COVID? And are any of them available for use?

Which nasal sprays are being studied to prevent COVID?

Most nasal sprays in development for COVID 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.

COVID nasal vaccines

Several COVID nasal spray vaccines are being researched in studies — 16 to be exact. They aim to build up protective antibodies in your nose that fight SARS-CoV-2, the virus that causes COVID. A few are authorized in other countries — like India and China — 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 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, which licensed the technology from Washington University in St. Louis. In September 2022, it was authorized for emergency use in India as a two-dose primary series vaccine. It was the world’s third COVID 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 it will seek authorization from the FDA.

Other nasal spray vaccines

Scientists from the Icahn School of Medicine at Mount Sinai in New York City and CastleVax, Inc., have developed a nasal spray vaccine that is currently in phase 1 trial. Phase 1 of a clinical trial evaluates products for safety and tolerability. The study completion date is estimated to be in spring 2024.

Codagenix has partnered with the World Health Organization (WHO) to develop an intranasal COVID vaccine. The vaccine, CoviLiv, is a live-attenuated COVID vaccine. This means that the vaccine is made up of weakened parts of the actual COVID virus.

Early studies have promising results. CoviLiv showed a strong protective response that provided broad immunity. This means that the CoviLiv vaccine may protect against future variants without needing to be reformulated, or made again with the variants in mind. CoviLiv started its phase 3 trial in late Fall 2022 to evaluate efficacy and side effects. Phase 3 trials typically last several years.

Researchers in China have also developed a live-attenuated intranasal COVID vaccine. They used the nasal spray flu vaccine as a vehicle to deliver the COVID vaccine. Results from phase 1 and 2 trials show good safety, but it is unclear if the vaccine provided adequate protection against COVID infection. More research is being done.

Separately, researchers backed by the National Institute of Allergy and Infectious Diseases (NIAID) 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.

Nitric oxide nasal sprays

Nitric oxide is a chemical that’s naturally 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.

In particular, a few studies have looked to see if nitric oxide nasal sprays can prevent severe illness caused by COVID. One small study found that they can reduce viral load by about 95% after 24 hours. A randomized-control study of over 300 people found that using nitric oxide nasal spray sped up clearance of the virus, potentially decreasing the time someone is contagious. 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 by manufacturer SaNOtize — called Enovid — is now available in other countries. In late August 2022, it was also reported that Enovid’s manufacturer had raised $24 million to fund an ongoing phase 3 prevention trial.

Even though there are some promising studies and momentum behind the use of nitric oxide, the evidence is mixed. A recent study evaluated how nitric oxide impacted COVID virus replication, meaning how the virus reproduces itself in your body. The researchers found that the inhaled nitric oxide gas did not impact the virus at all. In fact, they recommended nitric oxide gas not be studied further for this purpose.

Other nasal sprays for COVID

Other nasal sprays have also been studied for COVID 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 its clinical trial, pHOXWELL reduced the risk of developing COVID by about 62% in healthcare workers. It’s thought to work by blocking the virus from entering your body through your nose.

In the study, pHOXWELL was given 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. It’s a type of antibody that targets the coronavirus’s spike protein.

Iota-carrageenan

Iota-carrageenan is another nasal spray being studied to prevent COVID. 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 by up to 80%. Another study analyzed iota-carrageenan’s ability to prevent COVID. This study wrapped up in November 2022.

Covixyl-V

Covixyl-V (ethyl lauroyl arginine hydrochloride) is another nasal spray that aims to prevent COVID. 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. 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 in vitro study (done in a test tube and not with humans) suggests that the ingredients in xylitol nasal sprays can help lower viral load and make it more comfortable to wear face masks. The study claims that xylitol may act as an antiviral against the virus that causes COVID. Limited case reports also hint that xylitol nasal sprays may help improve COVID symptoms when used with other treatments. Clinical trials are needed to confirm these findings, and they are ongoing through 2024.

Which nasal sprays are being studied to treat COVID?

Alongside nasal sprays that aim to prevent COVID, 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. It’s thought that they can help control inflammation while stopping the virus from entering your respiratory system.

In one Cleveland Clinic study, registry data from over 70,000 people with mild-to-moderate COVID was collected. Results suggested that corticosteroid nasal sprays may help prevent hospitalizations, intensive care unit (ICU) admissions, or death from COVID. But in order to confirm if they’re safe and effective for COVID, 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. But since early data is positive, we may see some clinical trials in the future.

What medications can you take to treat or prevent COVID?

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

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

If you’ve tested positive for COVID 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/ritonavir), an oral tablet

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

• Lagevrio (molniupiravir), an oral capsule