Azelastine Nasal Spray May Cut COVID Risk by 69 Percent and Cold Risk 71 Percent
Learn how it works and see how it compares to traditional COVID booster shots
Five years after the COVID-19 pandemic, you’re likely a pro at the basics—masks when needed, immune support and staying current on booster shots. But as sick season rolls around, you might be wondering: What else can I do to stay healthy? Here’s some exciting news: Protecting yourself against COVID could be as simple as reaching for over-the-counter azelastine nasal spray you probably already have in your medicine cabinet, according to new research.
Azelastine nasal spray may reduce COVID risk by 69 percent
A new study in JAMA Internal Medicine found that participants who used azelastine nasal spray three times daily for 56 days had a 69 percent lower odds of contracting COVID-19. The spray also reduced the risk of rhinovirus infections, a common cold virus, by about 71 percent.
“Azelastine is a type of medicine called an antihistamine,” says Jobby John, PharmD, founder of Nimbus Healthcare and owner of a pharmacy in Austin, Texas. “You can find it in over-the-counter products like Astepro as well as in prescription forms. Think of it this way: when you have allergies, your body releases a substance called histamine, which is like a hyperactive alarm system causing all the sneezing, itching and annoying runny nose. Azelastine works by calming down that alarm system, providing relief.”
Woman's World Answers
So how could an over-the-counter nasal spray often used to treat seasonal allergic rhinitis and year-round allergies be so powerful against COVID and colds? John offers an analogy:
“Imagine your nose is the main doorway into your body for respiratory viruses,” says John. “Azelastine appears to act like a bouncer at that door. It seems to make the cells in your nasal passages much less welcoming to these viruses. It’s almost as if the spray changes the locks on the doors of your cells, so the virus’s key no longer works to get inside and start multiplying. By stopping the virus at the entry point, it may prevent an infection from ever taking hold.”
How does azelastine nasal spray compare to a COVID shot?
Many Americans still opt to get a COVID-19 booster every flu season. If you’re one of them, you may be wondering if you should swap your vaccine for a nasal spray. But John cautions that’s not a good idea. “This nasal spray is not a replacement for a vaccine,” says John. “It’s best to think of them as two different types of protection that can work together.”
Vaccines and sprays differ in how they work to fend off a COVID-19 infection, and both are valuable. “A vaccine is like sending your entire immune system to a training academy,” says John. “It teaches your body to recognize a specific virus and builds a powerful, body-wide army of antibodies and defender cells. This army is prepared to fight the virus anywhere it shows up, which is why vaccines are so effective at preventing serious illness, hospitalization and death.”
In contrast, azelastine nasal spray offers localized protection. “The nasal spray is like posting a single security guard at the front gate,” says John. “That guard can be very helpful in stopping some intruders right at the entrance. But if an intruder gets past them, you still want that fully-trained army inside to protect you. The spray offers a localized, first line of defense in the nose, while a vaccine provides a deeper, systemic immunity.”
Potential azelastine nasal spray side effects
John notes that azelastine nasal spray is generally safe for women over 50, but it’s important to check with your doctor before using. One potential side effect is sleepiness, so be sure to see how it affects you before driving or doing anything that requires focus. Other possible side effects include:
- Bitter taste in the mouth
- Nosebleeds
- Burning or stinging feeling inside the nose
- Headache
If you’re unable to take azelastine nasal spray due to side effects, or simply want to bolster your defenses against COVID even more, Raj Dasgupta, MD, Chief Medical Advisor for Sleepopolis, suggests other stay-well strategies that can help:
- Regularly washing your hands
- Keeping home air well-ventilated and clean (consider a HEPA air purifier, such as Clorox Tabletop True HEPA Air Purifier)
- Prioritizing sleep, eating healthy and managing stress
- Using a mask when you’re in crowds
Should you try azelastine nasal spray?
If your doctor gives the go-ahead, it may be worth adding to your routine this cold and flu season. The typical dosage is one spray in each nostril twice daily, though study participants used it three times daily (check with your doctor what’s best for you). Just remember to treat it as an extra layer of protection, not your only one.
“This new research is promising and may point to another simple way we can use to add an extra layer of protection against common viruses,” says John. “But I’d venture to think of it as just that: one layer in a multi-layered defense. It’s a helpful addition to, not a substitute for, proven strategies like vaccination, good hand hygiene and a general healthy lifestyle.”
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