Can Nasal Sprays Treat or Prevent COVID?

Since the beginning of the COVID-19 pandemic, the FDA has authorized and approved many medications that fight the coronavirus. COVID vaccines have also been recommended ever since the first ones were authorized in December 2020.

These medications and vaccines are effective overall. But they make up just a small percentage of what’s been studied. Researchers are continuing to develop other medications that aim to prevent or treat COVID.

Among these, COVID nasal sprays have caught the attention of many people. They’re easy to use, and some researchers believe they could have an impact on preventing or treating COVID. But are any of them effective? And are they available for use?

Which nasal sprays are being studied to prevent COVID?

Most nasal sprays in development for COVID are designed to prevent sickness — not treat it. Many are still in the early stages of development, but some are being studied and used by people around the world. Some of the top ones are highlighted below.

COVID nasal vaccines

Several COVID nasal spray vaccines are being researched in clinical studies. These vaccines aim to build up protective antibodies in your nose that fight SARS-CoV-2, the virus that causes COVID. A few COVID nasal vaccines are authorized in other countries — including India and China — but none are available in the U.S. yet. 

Authorized COVID nasal spray vaccines around the world

In April 2022, Russian authorities approved the world’s first COVID nasal spray vaccine: Sputnik V. It’s the nasal equivalent of the injectable vaccine that shares the same name. In July 2022, a similar vaccine called Salnavac was also authorized in Russia. At this time, the makers of Sputnik V and Salnavac aren’t seeking authorization in the U.S.

Another vaccine, called iNCOVACC (BBV154), is made by Bharat Biotech — which licensed the technology from Washington University in St. Louis. In September 2022, the vaccine was authorized for emergency use in India as a two-dose primary series vaccine. It’s also authorized as a booster dose. One of Bharat Biotech’s partners has licensed the vaccine in the U.S., but it’s unclear if or when they’ll seek authorization from the FDA.

In December 2022, a COVID vaccine called Pneucolin (dNS1-RBD) was authorized in China. It uses nasal spray flu vaccine technology to deliver the COVID vaccine. Results from phase 1 and 2 trials show that they’re safe to use. But other data showed mixed results about how effective Pneucolin really is at preventing COVID infections. More research for the vaccine is now underway.

Other nasal spray vaccines in development

Scientists from the Icahn School of Medicine at Mount Sinai in New York City and CastleVax, Inc., have developed a nasal spray COVID vaccine that recently went through a phase 1 trial. This type of clinical trial evaluates products for safety and tolerability. Initial results show that the vaccine is safe.

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Codagenix partnered with the WHO to develop an intranasal COVID vaccine of their own. The vaccine, CoviLiv, is a live-attenuated COVID vaccine. This means that the vaccine is made up of weakened parts of the actual COVID virus. Early studies of CoviLiv have shown promising results. It showed a strong protective response that provided broad immunity. This means that the CoviLiv vaccine may protect against future viral variants without needing to be reformulated, or made again with the variants in mind. CoviLiv started its phase 3 trial in late fall 2022 to evaluate efficacy and side effects. Early results show people who received two vaccine doses had a strong immune response. Phase 3 trials typically last several years.

Researchers backed by the National Institute of Allergy and Infectious Diseases (NIAID) are also developing nasal vaccines. The NIAID is currently enrolling about 60 adults in a study on their vaccine (called MPV/S-2P, named for its active ingredients) in the U.S. 

Nitric oxide nasal sprays

Nitric oxide is a chemical that’s naturally found throughout your body. It has many jobs. One of its roles is helping to regulate your immune system. Researchers are curious if nitric oxide nasal sprays could help prevent or treat COVID because of this.

A few studies have looked to see if nitric oxide nasal sprays can prevent severe illness from COVID. One small study found that these sprays can reduce viral load by about 95% after roughly 1 day. A randomized controlled trial of more than 300 people found that using nitric oxide nasal spray cleared the virus from the body faster, potentially decreasing the time someone is contagious. 

This research has proved influential in some countries. For instance, one nitric oxide nasal spray — called Enovid — is now available in some countries, including Israel and Indonesia. This product is also known as NOWONDER, VirX, and FabiSpray. In 2022, news outlets reported that Enovid’s manufacturer had raised $24 million to fund an ongoing phase 3 prevention trial. This large clinical trial for nitric oxide nasal spray was ultimately discontinued due to lack of participation. 

Other nasal sprays for COVID prevention

Other nasal sprays have also been studied for COVID prevention. They’re in slightly earlier stages of development.

Azelastine nasal spray

Azelastine is a nasal spray you may already recognize. It’s sold under brand names like Astelin or Astepro and used to treat allergies. But researchers are studying whether it might also help lower the risk of getting COVID.

In one recent clinical trial of about 450 adults, people who used azelastine nasal spray several times a day were less likely to test positive for COVID compared with those who used a placebo spray. Scientists think azelastine might work by blocking the virus from entering cells in the nose, or by calming the immune system’s local response in a way that makes infection less likely.

That said, azelastine isn’t approved or recommended as a COVID prevention treatment right now. More studies are needed to confirm whether it truly helps.

Iota-carrageenan

Iota-carrageenan is another nasal spray being studied to prevent COVID. Iota-carrageenan is a sugar that comes from algae.

So far, one study of about 400 healthcare workers suggested that iota-carrageenan may potentially lower the risk of getting COVID by up to 80%. Another study analyzed iota-carrageenan’s ability to prevent COVID. This study wrapped up in 2022. 

As of late 2025, there aren’t any active studies for iota-carrageenan.

Covixyl

Covixyl (ethyl lauroyl arginine hydrochloride) is another nasal spray being studied for COVID prevention. It offers a layer of protection in your nose that can block the virus from entering your body. Early data from lab and animal studies seems promising, but we still need to see how the nasal spray performs in humans.

Covixyl is already commercially available in the U.S. The manufacturer is marketing it as a way to protect your nasal passages against airborne viruses, but it isn’t actually approved or authorized as an antiviral nasal spray. In February 2024, the FDA warned Covixyl’s manufacturer not to make claims that Covixyl prevents COVID.

Xylitol nasal sprays

Some reports suggest that xylitol nasal sprays may help prevent COVID. Similar to other nasal sprays, it’s thought that these products help reduce the amount of virus in your nose and stop it from entering your body.

Limited case reports hint that xylitol nasal sprays may help improve COVID symptoms when used with other treatments. Clinical trials are needed to confirm these findings, and it’s unknown whether they’re ongoing.

Xlear is one example of a xylitol nasal spray that’s commercially available. But it’s been the subject of FTC controversy in the past.

CofixRX

CofixRX is another nasal spray that’s available in the U.S. It contains various ingredients, such as povidone iodine and xylitol. Povidone iodine is typically applied to the skin to treat infections. But limited studies suggest that povidone iodine may be effective as a nasal rinse for COVID. More data is needed to confirm this.

Good to know: In 2022, the FDA warned CofixRX’s manufacturer that they needed to remove products claiming to prevent or treat COVID. These were similar claims that Covixyl and Xlear made about their products, too. Currently, there aren’t any known ongoing CofixRX studies for COVID.

NoriZite

The nasal spray device NoriZite offers a different preventive concept: a physical barrier, rather than an antiviral medication. Its formulation creates a gel-like layer in the nasal cavity. Lab studies show that this gel barrier is effective in blocking the COVID virus from infecting cells for up to 48 hours.

An important note: Though lab studies show that NoriZite is effective, there are no high-quality studies in humans. Because of this, we can’t know for sure if NoriZite really works as well in people as it does in the lab.

Which nasal sprays are being studied to treat COVID?

Some nasal sprays aim to prevent COVID, and others are being developed to treat it. Steroid nasal sprays have the most data so far.

Steroid nasal sprays

Corticosteroid (steroid) nasal sprays, such as Flonase (fluticasone propionate), are widely available in the U.S. They’re often used for treating conditions such as allergies and nasal polyps. And some researchers are exploring their potential as a treatment for COVID. It’s thought that these sprays can help control inflammation while stopping the virus from entering your respiratory system.

In one Cleveland Clinic study, researchers collected registry data from over 70,000 people with mild-to-moderate COVID. Results suggested that steroid nasal sprays may help prevent hospitalizations, intensive care unit (ICU) admissions, or death from COVID. However, research is mixed about whether steroid nasal sprays are effective at getting back your sense of smell, which is sometimes affected by COVID.

Researchers need to collect more data to determine how safe and effective steroid nasal sprays are for managing COVID. As of now, there aren’t any active clinical trials, but this could change.

What medications can you take to treat or prevent COVID?

Nasal sprays aside, many medications are already authorized or approved to treat or prevent COVID. A healthcare professional can tell you if you’re eligible for any of these treatments.

Medications that can treat COVID if you aren’t in the hospital

If you’ve tested positive for COVID, a healthcare professional may prescribe you a medication to lower your risk of severe illness. Listed in preferential order, these include:

• Paxlovid (nirmatrelvir / ritonavir), an oral tablet

• Veklury (remdesivir), an intravenous (IV) infusion

• Lagevrio (molnupiravir), an oral capsule

A variety of medications are also authorized or approved to treat COVID if you’re hospitalized due to the condition. Your hospital care team will determine the best medication for your situation, if needed. 

Vaccines and medications that prevent COVID

Getting vaccinated is the best way to protect yourself and your loved ones from COVID. There are three COVID vaccines to choose from in the U.S.: Pfizer, Moderna, and Novavax.

Pemgarda (pemivibart) is an injectable medication that prevents COVID. It’s reserved for people ages 12 years and older who are considered moderately to severely immunocompromised. Keep in mind that you should still get vaccinated, even if you receive Pemgarda.

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Written by:

Jennifer Gershman, PharmD, CPh, PACS

Jennifer Gershman, PharmD, is a licensed pharmacist in Florida. She has worked in the pharmacy industry for more than 15 years and is currently a medical writer.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Farzon A. Nahvi, MD

Farzon Nahvi, MD, is an emergency medicine physician and author of “Code Gray: Death, Life, and Uncertainty in the ER.” He works at Concord Hospital in Concord, New Hampshire, and teaches at the Geisel School of Medicine at Dartmouth.

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