A widely available over-the-counter allergy nasal spray containing azelastine has become a trending topic following the publication of ground-breaking research showing it can significantly reduce COVID-19 infections. The clinical trial results, published in JAMA Internal Medicine on September 2, 2025, have generated considerable media attention and public interest.
Clinical trial results
The Phase 2 randomised clinical trial conducted at Saarland University Hospital in Germany involved 450 healthy adults with an average age of 33. Participants were randomly divided into two groups: 227 individuals received azelastine 0.1% nasal spray while 223 received a placebo, both used three times daily for 56 days.
The results demonstrated a remarkable 70% reduction in COVID-19 infections among those using azelastine compared to the placebo group. Only 2.2% of participants in the azelastine group became infected with SARS-CoV-2, compared to 6.7% in the placebo group – representing a three-fold difference.
Additional health benefits
Beyond COVID-19 prevention, the study revealed several other protective effects of azelastine nasal spray. Participants experienced fewer symptomatic COVID-19 cases (1.8% versus 6.3% in the placebo group) and took longer to become infected when exposed to the virus – an average of 31 days compared to 19 days for the placebo group.
The treatment also provided protection against other respiratory infections. The azelastine group showed a lower incidence of rhinovirus infections, with overall respiratory infections occurring in only 9.3% of the treatment group compared to 22% in the placebo group.
Safety profile and accessibility
Azelastine nasal spray demonstrated a favourable safety profile with only mild, well-known side effects such as:
- Bitter taste
- Occasional nosebleeds
- Tiredness
Serious adverse events were rare and not linked to the spray usage. The medication has been used safely for decades to treat allergic rhinitis, making it a familiar and accessible option for many people.
Scientific significance
This research addresses a significant gap in COVID-19 prevention options beyond vaccination. The study’s lead researcher, Professor Robert Bals from Saarland University Medical Center, emphasised the potential impact of these findings for public health.
The trending interest in azelastine nasal spray reflects the public’s ongoing search for additional protective measures against COVID-19, particularly given the medication’s widespread availability, established safety profile, and substantial protective effects demonstrated in this landmark study.
Sources
- NBC News – COVID infection may be prevented by common nasal antihistamine spray
- Medical Xpress – Widely used nasal spray shows promise in preventing coronavirus infection
- NY Post – OTC nasal spray can reduce your risk of COVID: new study
