NASAL SPRAYS

A note:

This is intended as a guide to help you determine how to choose the right nasal spray for your situation. That may include availability, cost, type of spray, tolerance, prevention vs. post-infection, etc. Whatever you decide, understand that you must continue to take layered precautions to the very best of your ability. This includes wearing a well-fitting, high-quality respirator (KN95/N95/FFP3+), getting updated vaccinations if you’re safely able to, avoiding crowds when reasonable and possible, cleaning the air, testing if symptomatic/exposed (at the very least), isolating when symptomatic/exposed, and refusing to share misinformation. Please choose what is best for YOUR BODY.  If you need resources, please ask. This is your health.  

Stay safe!

-RobynThRedd

1. THINGS TO KNOW

1. Using nasal sprays 1-2 hours before a SARS-CoV-2 Polymerase Chain Reaction (PCR) test or Rapid Antigen Test (RAT) may have a slight effect on the outcome of the tests when the nasal sprays are present in certain volumes. Each test has different specifications, but you may want to refrain from using nasal sprays for a few hours if you know you’ll be taking a test soon.
2. Not all nasal sprays are created equal. Some are well-tested, and others have very little information behind them. Still others have been issued warnings to remove their products from shelves. Make good choices.
3. If you experience nosebleeds, dizziness, decreased sense of smell, itchiness, redness, or swelling in the nose, peeling skin, (-or any other side effects that you feel simply shouldn’t be happening-) please stop using your nasal spray, and make the best decision for your own situation regarding medical care/treatment.

1. TYPES OF NASAL SPRAYS

1. ASTODRIMER SODIUM

1. “Astodrimer sodium was also virucidal, irreversibly reducing SARS-CoV-2 infectivity by >99.9% (>3 log10) within 1 min of exposure…” (source: Virucidal and antiviral activity of astodrimer sodium against SARS-CoV-2 in vitro - ScienceDirect)
2. “Animals received astodrimer sodium 1% nasal spray or PBS intranasally, or intranasally and intratracheally, for 7 days, and they were infected intranasally with SARS-CoV-2 after the first product administration on Day 0. Another group was infected intranasally with SARS-CoV-2 that had been pre-incubated with astodrimer sodium 1% nasal spray or PBS for 60 min before the neutralization of test product activity.”

• “Astodrimer sodium 1% significantly reduced the viral genome copies (>99.9%) and the infectious virus (~95%) in the lung and trachea vs. PBS.”
• “The pre-incubation of SARS-CoV-2 with astodrimer sodium 1% resulted in a significant reduction in the viral genome copies (>99.9%) and the infectious virus (>99%) in the lung and trachea, and the infectious virus was not detected in the brain or liver.”
• “Astodrimer sodium 1% resulted in a significant reduction of viral genome copies in nasal secretions vs. PBS on Day 7 post-infection.
• “Viraemia was low or undetectable in animals treated with astodrimer sodium 1% or infected with treated virus, correlating with the lack of detectable viral replication in the liver.”
• “Similarly, low virus replication in the nasal cavity after treatment with astodrimer sodium 1% potentially protected the brain from infection.
• “Astodrimer sodium 1% significantly reduced the pro-inflammatory cytokines IL-6, IL-1α, IL-1β, TNFα and TGFβ and the chemokine MCP-1 in the serum, lung and trachea vs. PBS.”
• “Astodrimer sodium 1% nasal spray blocked or reduced SARS-CoV-2 replication and its sequelae in K18-hACE2 mice.” (source: Protective Effects of Astodrimer Sodium 1% Nasal Spray Formulation against SARS-CoV-2 Nasal Challenge in K18-hACE2 Mice)

1. ELAH (ETHYL LAUROYL ARGINATE HCL)

1. “ELAH was granted “Generally Recognized as Safe” (GRAS) status by the FDA in March, 2005. It has been widely used as an antimicrobial in food products ever since.”

“Initial testing against SARS-CoV-2, Rotavirus, H1N1 (Influenza A), and Human Respiratory Syncytial Virus (RSV) proved the efficacy of ELAH against infection in vitro, showing 99+% reduction across all 4 viruses.”  (source: About Covixyl)

2. HYPROMELLOSE

1. “243 members of an ultra-orthodox community that participated in two days prayers were followed for 14 days following this 'superspread' event.

• 83 used Taffix throughout holiday's prayers and the following two weeks (ITT). 81 used it regularly (PP). 2 used it rarely if at all. 160 did not use Taffix.
• Results: After 14 days, 0/81 (0%) of (PP) Tafffix users, 2/83 (2.4%) of (ITT) Taffix users and 16/160 (10%) nonusers were infected. Odds ratio for infection among Taffix users was 0.22, a reduction of 78% (95%CI 1%-95%).
• No side effects reported.” (source: Low pH Hypromellose (Taffix) nasal powder spray could reduce SARS-CoV-2 infection rate post mass-gathering event at a highly endemic community: an observational prospective open label user survey)

1. IOTA-CARRAGEENAN

1. Iota-Carrageenan is a sulfated polysaccharide. It is found in some species of red seaweed (Irish Moss - Chondrus crispus), which grows mostly in the Northern Atlantic, is used as a thickener, and can act as a natural antioxidant agent. It has demonstrated antiviral activity against respiratory and other viruses in cell culture and in animal models. It interacts with the surface of viral particles and prevents them from entering cells in the first place. It also traps the viral particles that are released from infected cells. This, and other species of Carrageenan, have numerous uses. Different species produce different types of carrageenan, so new seaweed species have been incorporated over time into carrageenan manufacture. (source: Chondrus Crispus - an overview | ScienceDirect Topics)
2. "In this pilot study a nasal spray with I-C showed significant efficacy in preventing COVID-19 in health care workers managing patients with COVID-19 disease.” (source: Efficacy of a Nasal Spray Containing Iota-Carrageenan in the Postexposure Prophylaxis of COVID-19 in Hospital Personnel Dedicated to Patients Care with COVID-19 Disease - PMC)

1. This is the category of nasal spray I recommend most frequently as an added preventative measure because it already has proven antiviral activity and clinical efficacy against the common cold. It also has demonstrated viral replication outside of the human body both against SARS-CoV-2 wild type, and against the common cold. (source: Iota-carrageenan neutralizes SARS-CoV-2 and inhibits viral replication in vitro - PMC)

2. NITRIC OXIDE

1. “Mean SARS-CoV-2 RNA concentration was lower on NONS by a factor of 16.2 at days 2 and 4. A rapid reduction (95%) in the SARS-CoV-2 viral load was observed within 24 hours, with a 99% reduction observed within 72 hours with NONS treatments.” (source: Clinical efficacy of nitric oxide nasal spray (NONS) for the treatment of mild COVID-19 infection) 
2. “In the UK, SaNOtize, along with Ashford and St Peter's Hospitals NHS Foundation Trust and Berkshire and Surrey Pathology Services, showed that, in human phase II clinical trials, SaNOtize's nasal spray was an effective antiviral therapy, which reduced COVID-19 spread, decreased its duration as well as severity of symptoms. In a randomized, double-blind, placebo-controlled phase II trial in 79 confirmed COVID-19 cases, SaNOtize's early therapy greatly reduced SARS-Cov-2 titers.” (source: Nasal sprays for treating COVID-19: a scientific note - PMC)
3. “Nitric Oxide (NO) is well-known to be an efficient broadspectrum anti-infective agent. It has been reported to have antimicrobial activity against bacteria, yeast, fungi, and viruses both in vitro and in vivo animal studies.3-13 NO has been shown to have a direct effect on virions. NO, after nitrosylating cysteine moieties, causes conformational changes on surface glycoproteins and binds to proteases within the virus preventing viral replication.”

“Of the 203 students who used VirX™, 190 tested negative for SARS-CoV-2 on all test days, and 13 tested positive on at least one test day. Of the 422 students who did not use VirX™, 314 students tested negative on all test days and 108 tested positive on at least one test day. These results demonstrated a statistically significant difference at the p<0.0001 level in infection rate of 6.40% (13/203) in the VirX™ group versus 25.59% (108/422) in the group that did not use VirX™.” (source: Epidemiological Analysis of Nitric Oxide Nasal Spray (VirX™ ) Use in Students Exposed to COVID-19 Infected Individuals) 

2. There is currently only one Nitric Oxide nasal spray manufacturer on the market. The company is funded/based in Canada, but the product itself is manufactured exclusively in Israel. You can purchase them under two different names, in several countries, but it is all the same product.

Whether or not you choose to purchase these products is your decision. There are other options that are effective and less expensive, and that are not manufactured in a country carrying out a genocide.  

3. POVIDONE IODINE  

1. “Saline and low concentration PVP‐I nasal sprays are well tolerated. Similar reductions in SARS‐CoV‐2 NP viral load were seen over time in all groups. All treatment groups showed improvement in olfaction over 30 days. These data suggest that dilute versions of PVP‐I nasal spray are safe for topical use in the nasal cavity, but that PVP‐I does not demonstrate virucidal activity in COVID‐19 positive outpatients.” (source: The Effect of Povidone‐Iodine Nasal Spray on Nasopharyngeal SARS‐CoV‐2 Viral Load: A Randomized Control Trial)

1. Based on this study, I have not recommended low concentration Povidone-Iodine nasal sprays to anyone as layers of prevention. I have recommended them instead as a nasal spray to begin using immediately following an acute SARS-CoV-2 infection. I do not feel that this nasal spray would provide any more protection than another nasal spray during the post-infection period (30-60 days), but I do feel that it may be worth switching to a Povidone Iodine nasal spray for at least 30-60 days immediately following an acute SARS-CoV-2 infection if:

• you experience a loss of smell, AND
• you are able to tolerate the slight burning sensation that sometimes comes with this product (IF you already have nasal irritation.)

Again, anecdotally, this has been helpful for a few (3) people that experienced loss of smell due to their SARS-CoV-2 infection. Each had different symptoms, risk factors, and severity of infection. All were taking different precautions.

4. XYLITOL

1. Results demonstrate that both xylitol and saline were equally effective in decreasing the time of symptom resolution and preventing hospitalizations, yet, persistent anosmia was only seen in the SAL group. (source: Intranasal Xylitol for the Treatment of COVID-19 in the Outpatient Setting: A Pilot Study - PMC) 
2. The test agent significantly reduced SARS-CoV-2 infection in healthcare workers, with 62% fewer infections when compared to placebo. It was found to be safe and well tolerated and offers a novel treatment option for prophylaxis against SARS-CoV-2 infection. (source: Evaluating the efficacy and safety of a novel prophylactic nasal spray in the prevention of SARS-CoV-2 infection: A multi-centre, double blind, placebo-controlled, randomized trial. - PMC) 

2. PRODUCTS

1. ASTODRIMER SODIUM

1. VIRALEZE™ Antiviral Nasal Spray 

VIRALEZE™ was developed in Australia by Starpharma. Starpharma was awarded development funding for VIRALEZE™ by the Australian Government’s Medical Research Future Fund Biomedical Translation Bridge Program. VIRALEZE™ is registered for sale in the UK/Europe, India, Vietnam and Saudi Arabia. 

“VIRALEZE™ acts locally in the nasal cavity where respiratory viruses that cause colds, flu, and more severe respiratory illness, such as COVID-19, first attach and start to multiply. Astodrimer sodium in VIRALEZE™ is not absorbed into the bloodstream.” (source: https://viraleze.co/about/) 

Ingredients: Purified water, astodrimer sodium, glycerol, propylene glycol, sodium hydroxide, methyl p-hydroxybenzoate, carbomer homopolymer type B, propyl p-hydroxybenzoate, disodium edetate.

NOT FDA-Approved.

2. ELAH (ETHYL LAUROYL ARGINATE HCL)

1. BioSURE® PRO Protective Nasal Spray 

“BioSURE® PRO Protective Nasal Spray has been proven safe and effective to help prevent infections caused by rotavirus A (sickness and diarrhea) RSV (common colds), influenzas (flu) and coronaviruses, including COVID-19.” (source: https://www.biosure.co.uk/tests/covixyl-nasal-spray )

Ingredients: Aqua, Glycerin, Xylitol, 1,2-hexanediol, Povidone, PEG-40 Hydrogenated Castor Oil, Ethyl Lauroyl Arginate HCI (ELAH), Sodium Citrate, Phenoxyethanol, Lavender, Copper Gluconate, Citric Acid, Sodium Hydroxide.

Available primarily in the UK. UKCA marked and registered with the MHRA. NOT FDA-Approved.

2. Covixyl 

Ingredients: Purified Water, Glycerin, Xylitol, 1-2 Hexanediol, Povidone, PEG-40, Ethyl Lauroyl Arginate HCl (0.1%), Phenoxyethanol, Lavender, Copper Gluconate, Sodium Citrate, Citric Acid, Sodium Hydroxide (Buffer).

COVIXYL-V was submitted to the FDA for pre-emergency use authorisation in 2021, and has not yet received FDA approval for the product’s commercial use in the US.

NOT FDA-Approved.

3. HYPROMELLOSE

1. Taffix 

“Taffix is formulated with ingredients designated by FDA as Generally Recognized as Safe (GRAS) approved as nasal inactive ingredient and commonly used as excipients in pharmaceutical preparations, in amounts established as safe for use in nasal spray.”

“Do not use this product if you are sensitive to Cellulose, Citric Acid, Sodium Citrate, Benzalkonium Chloride or Menthol.” (source: https://taffixprotect.com/for-professionals/) 

Taffix is only approved in Israel and Europe. NOT FDA-Approved.

4. IOTA-CARRAGEENAN

1. Agovirax - Virus Prevention and Therapy 

Ingredients: 1 ml solution contains 1.2 mg iota-carrageenan (Carragelose®), 0.4 mg kappa-carrageenan, sodium chloride and purified water.

Available only in Lithuania, Latvia and Estonia.

NOT FDA-Approved.

2. BETADINE® Cold Defence Nasal Spray

Also available for kids.

Ingredients: Iota-Carrageenan (1.2mg), Sodium Chloride (0.5%).

NOT FDA-Approved.

3. NoriZite 

Coats the nasal cavity and creates a fast, long-lasting barrier against airborne viruses. It is designed to help reduce the risk of virus particles entering and infecting cells and to suppress viral replication. (source: NoriZite Nasal Spray — Birmingham Biotech) 

Ingredients: Iota-Carrageenan and gellan gum.

Available primarily in the UK. This company has received safety certifications, but this product has not. NOT FDA-Approved.

4. Salinex 

Ingredients: Iota-Carrageenan 1.2 mg, Sodium chloride 0.5%, water.

NOT FDA-Approved.

2. *may interfere with the Revogene SARS-CoV-2 assay when present in a nasopharyngeal swab specimen at a concentration of ˃ 0.22% (v/v) or ˃ 0.013 mg/mL, respectively. (source: Revogene SARS-CoV-2 - Instructions for Use)

5. NITRIC OXIDE

1. SaNOtize

1. Enovid

Available in Israel, Indonesia and Bahrain. 

NOT FDA-Approved.

2. VirX

Available in Thailand, Singapore, Hong Kong, South Africa, Malaysia, Cambodia, Germany.

“VirX™ has been demonstrated to be safe and was approved in Thailand in 2021 by the Ministry of Public Health as a mechanical and chemical barrier against viruses within the nasal cavities. VirX™ is a liquid nasal spray and works to protect the nasal passages with two mechanisms. A mechanical barrier is created by the use of hydroxypropyl methylcellulose (HPMC) in the VirX™ formulation. HPMC is a film forming hydrophilic matrix material that impedes the attachment of viruses to nasal host cells. The chemical protection comes from both the acidic pH of the citric acid in the solution due to its physical forces on virus’ outer envelope and membrane, and the release of nitric oxide gas from the liquid as the liquids from the two chambers mix when sprayed.”

NOT FDA-Approved.

6. POVIDONE IODINE  

1. ePothex Povidone Iodine Nasal Spray 

Ingredients: Purified Water, Sodium Chloride USP, Povidone-Iodine (0.6%), Disodium Phosphate, Benzyl Alcohol, Monosodium Phosphate, Benzalkonium Chloride.

NOT FDA-Approved.

7. XYLITOL

1. See RED FLAG WARNINGS below

3. 🚩 RED FLAG WARNINGS 🚩

(For screen readers: there is a red-flag emoji on either side of the heading “RED FLAG WARNINGS.” The header itself is red.)

8. COFIXRX NASAL SPRAY - CofixRx, LLC

1. CofixRx, LLC - 626860 - 04/05/2022 | FDA 
2. “FDA WARNING LETTER: Unapproved and Misbranded Product Related to Coronavirus Disease 2019…We request that you take immediate action to cease the sale of any unapproved and unauthorized products for the mitigation, prevention, treatment, diagnosis, or cure of COVID-19…”

• “‘DESTROYS SARS CoV-2 and other COLD & FLU viruses in 15 seconds’ [from your CofixRX Nasal Spray product label]
• ‘CofixRX™ is an antiviral nasal spray that offers up to 8 hours of protection from many cold and flu viruses.’ [from yourCofixRx Nasal Spray product label]
•  ‘Lasts for up to 8 hours per application.’ [from your website https://cofixrx.com]
• ‘CofixRX utilizes patent-pending technology that is effective 45 seconds after application and lasts up to 8 hours, reducing the need for constant re-applications.’ [from your website https://cofixrx.com]”

1. NASITROL NASAL SPRAY - Amcyte Pharma, Inc.

1. Amcyte Pharma, Inc. - 623474 - 01/03/2022 | FDA 
2. “FDA WARNING LETTER: Unapproved and Misbranded Product Related to Coronavirus Disease 2019…We request that you take immediate action to cease the sale of any unapproved and unauthorized products for the mitigation, prevention, treatment, diagnosis, or cure of COVID-19…”

• ‘In vitro study of Iota carrageenan in SARS-CoV-2 . . . This study performed at the University of Tennessee provides evidence of the inhibitory effect of Iota Carrageenan on the propagation of SARS-CoV-2 in a call [sic] based assay.’
• ‘A Nasitrol clinical trial ICU hospital personnel exposed to SARS-CoV-2 . . . An independent, double-blinded, placebo controlled multicenter clinical trial providing evidence of the protective effect of Nasitrol in doctors and nurses highly exposed to SARS-CoV-2 (personnel dedicated to the COVID-19 ICU) during a period of one month.’”

1. XLEAR NASAL SPRAY WITH XYLITOL - Xlear, Inc.

1. FTC Washington, D.C. WARNING LETTER to Xlear, Inc. | 07/29/2020 
2. Xlear, Inc. | Federal Trade Commission

“In October 2021, the FTC sued Xlear, Inc., a Utah-based company, for violating the COVID-19 Consumer Protection Act, alleging that it falsely pitched its saline nasal sprays as an effective way to prevent and treat COVID-19. DOJ filed the complaint on the FTC’s behalf.” U.S. v. Xlear Inc., 2:21-cv-640 RJS DBP, (D. Utah Oct. 27, 2021)

3. U.S. v. Xlear Inc. 

Case summary. “MEMORANDUM DECISION AND ORDER” U.S. v. Xlear Inc., 2:21-cv-640 RJS DBP, (D. Utah Sep. 18, 2023)

2. VIRALDINE POVIDONE-IODINE NASAL SPRAY - Viraldine, LLC

1. Viraldine, LLC - 625675 - 03/07/2022 | FDA 

"...without approval or authorization by FDA, claim to mitigate, prevent, treat, diagnose, or cure COVID-19 in people...take immediate action to cease the sale of any unapproved and unauthorized products..."

• “INTRANASAL POVIDONE-IODINE EFFECTIVELY LIMITS COVID-19 SPREAD, FINDS STUDY HTTPS://PUBMED.NCBI.NL” [from your website https://viraldine.com/faqs-%26-pvp-i-studies]
• “POVIDONE IODINE (PVP-I) ORO-NASAL SPRAY: AN EFFECTIVE SHIELD FOR COVID-19 PROTECTION FOR HEALTH CARE” [from your website https://viraldine.com/faqs-%26-pvp-istudies]
• “…completely inactivated the SARS-CoV-2.”
• “…are effective at inactivating the SARS-CoV-2…”
• “...reduce the transmission of SARS-CoV-2 if used for nasal decontamination, oral decontamination, or surface decontamination…”
• “…completely inactivated SARS-CoV-2 within 15 seconds of contact…”
• “...can reduce SARS-CoV-2 virus infectivity to below detectable levels…”