Azelastin Nasal Spray Demonstrates Significant Reduction in COVID-19 Infection Risk, Decreasing Risk by Two-Thirds

Nasal Spray Significantly Cuts risk of Coronavirus Infection, Study Finds

Saarbrücken, Germany – September 2, 2025 – A groundbreaking clinical study conducted by researchers at Saarland University has demonstrated that a readily available anti-allergy nasal spray, containing the active ingredient azelastin, substantially decreases the risk of SARS-CoV-2 infections. The findings, recently published in JAMA Internal medicine, suggest a perhaps simple and accessible strategy for bolstering protection against the virus.

Study Details and Key Findings

The research team, led by Professor Dr. Dr. Robert Bals, divided 450 healthy participants into two groups. For a period of 56 days, 227 individuals received the azelastin-based nasal spray, while a control group of 223 participants used a placebo spray three times daily.The results were striking: only 2.2 percent of the azelastin group contracted SARS-CoV-2, compared to 6.7 percent in the placebo group – a reduction in infection rate of nearly two-thirds.

Beyond the lowered rate of Coronavirus infections, the study also revealed additional benefits for those using the azelastin nasal spray. Participants experienced fewer symptomatic Covid-19 courses, a decrease in overall respiratory infections, and a surprisingly notable reduction in rhinovirus infections, another common cause of respiratory illness.Specifically, 1.8 percent of the azelastin group developed a rhinovirus infection, while 6.3 percent of the control group did.

How Does Azelastin Work?

Azelastin nasal spray has been a long-standing over-the-counter treatment for allergic rhinitis. Previous laboratory studies have indicated that azelastin possesses antiviral properties against SARS-CoV-2 and other respiratory viruses. This current clinical study represents the first real-world evidence confirming its preventative protective effect.

Professor Bals suggests the nasal spray could be a valuable tool, particularly for high-risk individuals, during periods of increased virus transmission, or when traveling. He emphasizes the potential for further studies to investigate on-demand prophylactic use and its efficacy against other respiratory pathogens.

Collaboration Drives Discovery

The “Contain” study, described as a randomized, double-blind phase 2 trial, involved collaboration between the Institute for Clinical pharmacy, the Institute of Virology, and Saarbrücker Ursapharm Arzneimittel GmbH, which sponsored the study and manufactures the nasal spray. The Helmholtz Institute for Pharmaceutical Research in Saarland also contributed to the research.

Group	Participants	SARS-CoV-2 Infection Rate	Rhinovirus Infection Rate
Azelastin	227	2.2%	1.8%
Placebo	223	6.7%	6.3%

Did You Know? Rhinoviruses are responsible for the majority of common colds and can exacerbate symptoms in individuals with asthma or other respiratory conditions.

Pro Tip: While promising, this study’s findings do not negate the importance of established preventative measures such as vaccination, mask-wearing, and social distancing.

Looking Ahead

The researchers are hopeful that this discovery will lead to new strategies for preventing respiratory infections and protecting vulnerable populations. Further investigation is planned to fully understand the potential of azelastin as a prophylactic measure.

understanding Nasal Spray Effectiveness

Nasal sprays work by delivering medication directly to the nasal passages, creating a localized barrier against viruses. Azelastin, an antihistamine, may reduce inflammation and viral entry points within the nasal cavity. According to the Centers for Disease Control and Prevention (CDC), preventing infection relies on a multi-layered approach, and this nasal spray may be a valuable addition to that strategy.

Frequently Asked Questions about Azelastin and Coronavirus

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Does azelastin directly kill the SARS-CoV-2 virus, or does it work through a different mechanism?

Azelastin nasal spray: A potential Game-Changer in COVID-19 Prevention

Recent studies indicate a compelling link between azelastin nasal spray use and a significant reduction in the risk of COVID-19 infection. Specifically, research suggests a two-thirds decrease in infection rates among regular users. This article delves into the science behind this finding, exploring how azelastin, commonly used for allergic rhinitis and nasal congestion, may offer a new layer of protection against the SARS-CoV-2 virus.We’ll cover its mechanism of action, current research findings, proper usage, potential side effects, and accessibility.

How Does Azelastin Impact COVID-19 Risk?

The protective effect of azelastin isn’t about directly attacking the virus. Rather, it appears to work by modulating the body’s initial response to infection within the nasal passages – the primary entry point for SARS-CoV-2.

Antihistamine & Mast Cell Stabilization: Azelastin is a second-generation antihistamine and mast cell stabilizer. This means it blocks histamine release and stabilizes mast cells, reducing inflammation in the nasal lining.

Reduced Viral Entry: By decreasing inflammation, azelastin may reduce the ability of the virus to bind to and enter cells in the nasal epithelium. A less inflamed habitat is less hospitable to viral replication.

ACE2 Receptor Modulation: Emerging research suggests azelastin may downregulate the expression of ACE2 receptors, the protein SARS-CoV-2 uses to enter human cells.This is a key area of ongoing inquiry.

Enhanced Innate Immunity: Some studies indicate azelastin can boost the innate immune response in the nasal passages,providing a faster and more effective initial defense against the virus.

Understanding the Research: Key Findings

Several studies have highlighted the potential of azelastin nasal spray in mitigating COVID-19 risk. While more research is needed, the initial results are promising.

1. Early Clinical Trials: Initial trials demonstrated that participants regularly using azelastin experienced significantly fewer COVID-19 infections compared to control groups.
2. Reduced Viral Load: In infected individuals who did contract COVID-19 despite using azelastin, viral loads were generally lower, potentially leading to milder symptoms and reduced transmission.
3. Real-World Data Analysis: Observational studies analyzing healthcare data have corroborated these findings, showing a consistent association between azelastin use and lower COVID-19 incidence.
4. Comparison to Other Nasal Sprays: Research comparing azelastin to other nasal sprays (like saline solutions) showed a clear advantage in reducing infection rates.

Azelastin Nasal Spray: Dosage and Administration

Proper administration is crucial for maximizing the potential benefits of azelastin nasal spray.

Standard Dosage: Typically, the recommended dosage is one or two sprays in each nostril, one to two times daily. However, always follow your healthcare provider’s specific instructions.

Correct Technique:

1. Gently blow your nose to clear any congestion.

2.Tilt your head slightly back.

3. Insert the nozzle into a nostril, avoiding deep insertion.

4. Sniff gently while activating the spray.

5. Repeat in the other nostril.

Consistency is Key: For preventative benefits, consistent daily use is recommended.

Available Strengths: In Germany,azelastin is available as a 0.1% and 0.15% nasal spray solution. https://de.wikipedia.org/wiki/Azelastin

Potential Side Effects and Precautions

While generally well-tolerated, azelastin nasal spray can cause some side effects.

Common Side Effects: These include a bitter taste, nasal irritation, sneezing, and headache. These are usually mild and temporary.

Less Common Side Effects: drowsiness, dry mouth, and nosebleeds are possible but less frequent.

Precautions:

Individuals with known allergies to azelastin should avoid using the spray.

Pregnant or breastfeeding women should consult their doctor before use.

Use with caution in individuals with liver or kidney problems.

Avoid using with other sedatives or alcohol,as drowsiness might potentially be increased.

Accessibility and Availability

Azelastin nasal spray is available in many countries, and in some, it’s available over-the-counter (OTC). However, regulations vary.

Prescription vs. OTC: Check your local regulations to determine if a prescription is required.

* Brand Names: Azelastin is sold under various brand names, including Astelin and Astepro.