Over-the-counter nasal spray reduces COVID-19 infection rate by 67%
A study published in JAMA Internal Medicine, a medical journal published by the American Medical Association, has revealed that
Azelastine Nasal Spray for Prevention of SARS-CoV-2 Infections: A Phase 2 Randomized Clinical Trial | Infectious Diseases | JAMA Internal Medicine | JAMA Network
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2838335
OTC nasal spray seemed to cut COVID infections by 67% in mid-sized trial - Ars Technica
https://arstechnica.com/health/2025/09/otc-nasal-spray-seemed-to-cut-covid-infections-by-67-in-mid-sized-trial/
The research team conducted a phase 2 randomized, double-blind trial as a medium-sized clinical trial to evaluate whether azelastine nasal spray is effective in preventing infection with the new coronavirus infection (COVID-19).
The study was conducted at Saarland University Hospital in Germany for one year and five months from March 2023 to July 2024. The subjects were 450 healthy adults with an average age of 33.0 years, 92.7% Caucasian, and slightly more women than men (66.4%). Half of the subjects were assigned to receive azelastine nasal spray three times a day, while the other group received a placebo nasal spray containing only the antihistamine. The subjects were assigned to a similar group with regard to vaccination history and COVID-19 infection history.
After approximately 56 days of azelastine nasal spray use, the number of people who tested positive for COVID-19 by PCR test was 5 (2.2%) in the azelastine nasal spray group compared to 15 (6.7%) in the placebo nasal spray group. The study found that the rate of COVID-19 infection was significantly lower in those who used azelastine nasal spray, reducing infection rates by 67%. The study also found that the time to COVID-19 infection was longer in the azelastine group (average 31 days) compared to the placebo group (average 19.5 days).
Additionally, there was a clear difference in the number of respiratory infections between the azelastine group (21 cases) and the placebo group (49 cases). The infection rate of
Previous studies have suggested that azelastine can combat various viruses that enter the nose, and the results of this study support this. This means that azelastine nasal spray may have a general antiviral effect not only against COVID-19 but also against other respiratory viruses. However, the mechanism of action of this agent in the nasal mucosa remains unclear at the time of writing.
However, this was a single-center, randomized phase 2 trial, and the subject population was limited to 'young, healthy, and vaccinated' individuals. Therefore, larger, multicenter trials are needed to generalize the results. Also, Ars Technica pointed out that 'this study was funded by the pharmaceutical company that produces azelastine nasal spray.'
Azelastine nasal spray has a favorable safety profile and is expected to be used in certain situations, such as when traveling or attending large events, as a convenient additional measure to complement existing preventive measures such as vaccines.
in Science, Posted by logu_ii