Several nasal sprays which claimed to stop Covid-19 in its tracks have amended their marketing or paused the sale of products after Which? raised concerns about claims that could potentially mislead consumers with regulators.
Viraleze (£15, previously sold in LloydsPharmacy), Taffix and ViroStop nasal sprays (sold online) all made bold claims about killing Covid in the nasal passage before it has the chance to make you ill.
The idea is that it's a handy remedy you can carry around in your pocket and use for an extra layer of protection against variants while travelling or in crowded, higher-risk situations.
But if this sounds a little too good to be true, it's because in many ways it is.
While there are some nasal sprays currently in clinical trials that sound promising, you can't buy them yet and the ones that were on sale have now dialled back on Covid-related claims.
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Anti-Covid sprays: the small print matters
Viraleze, sold in LloydsPharmacy, claimed to 'irreversibly inactivate greater than 99.9% of coronavirus/SARS-CoV2 within one minute'.
But in the small print this product, and the other sprays we looked into, billed itself as an extra line of defense that shouldn't replace face masks, social distancing and vaccinations.
What's more, these sprays have also only been tested in relatively small lab-based studies and haven't yet been proven effective in human clinical trials.
For Viraleze, the study the claim was based on was commissioned by the manufacturer Starpharma, and although the results were certainly promising, they were based on a chemical reaction observed in a lab - not clinical trials on humans.
Results could differ significantly in clinical trials, so although technically the claim used to market this product was true, we felt the claim that the nasal spray was able to kill Covid was misleading and could give users a false sense of security.
Covid claims must conform to strict rules
We flagged our concerns about the way these products were being marketed to the Advertising Standards Authority (ASA) and the Medicines and Healthcare products Regulatory Agency (MHRA).
The ASA told us that it couldn't comment on a specific example without raising a case and going through its processes, but that ads claiming to prevent Covid are likely to be considered medicinal claims and nasal sprays are typically classed as medical devices.
Therefore, claims to prevent Covid via a nasal spray are only likely to be acceptable if the marketer can demonstrate that the product holds the appropriate clinical trial evidence to support the claims.
The MHRA made similar comments around its regulation of medical devices, saying the product manufacturer must hold sufficient clinical evidence to support the quality, safety and performance of their product in fulfilling its intended purpose. This may be based on data gathered via clinical trials of the product or existing published scientific literature.
It's clear that the medicines regulator in the UK feels there isn't enough evidence to support these products' action against Covid right now, as there has since been a crackdown on these products and the way they are promoted.
When we last checked, Viraleze had been removed from sale, Taffix no longer appears to be available in the UK and Virostop, while still available, no longer makes claims around killing Covid.
The MHRA told us that it wasn't able to comment on individual investigations, but that it's aware of the issue, and can confirm that promotion and sales of Viraleze have been paused in the UK.
LloydsPharmcy told us:
'We take our position as a trusted healthcare provider within communities extremely seriously which is why we have temporarily paused sales of Viraleze.
'We are working with Starpharma, the manufacturer of Viralezeu2122 Antiviral Nasal Spray, to seek further clarification from the MHRA over questions raised about the product categorisation and promotional language - the correspondence received does not relate to the safety or quality of Viraleze.
'In the meantime, we have followed the MHRA's initial instructions, and all affected stock has been removed from sale and quarantined.'
We also contacted Taffix and Virostop for comment, but didn't receive a response.
We may yet see these products return to the market once the MHRA has concluded its investigation, and it's possible that once further clinical evidence is gathered they could be approved as an extra line of defense against Covid.
But it's important that manufacturers market their products responsibly, especially in the context of Covid, and that they can show sufficient clinical evidence to back up claims.
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Nasal sprays may yet be a promising weapon against Covid
All of this is not to say that nasal sprays such as these might not play an important part in the prevention or treatment of Covid in the future.
There are more preventative nasal sprays in development, currently being tested in trials. Products such as this could be particularly useful for crowded places, large events and travelling.
Clinical trials of a nasal spray called Sanotize in the UK also look promising for use in people already infected with Covid.
The spray, which is not yet available to purchase, could prevent the transmission of Covid, shorten its course and reduce the severity of symptoms in those already infected - according to strong phase two trial results.
Pankaj Sharma, Professor of neurology and director of the Institute of Cardiovascular Research at Royal Holloway, University of London, explains that the spray works by delivering nitric oxide into the nasal cavity, where the virus incubates when it first enters our bodies.
Nitric oxide has been shown to inactivate the Covid virus by disrupting its structural integrity. Our bodies produce nitric oxide naturally and it helps with important bodily functions such as widening the blood vessels to allow for blood flow.
Nasal spray vaccines also in development
There are also trials going on to develop Covid vaccines which can be administered as a nasal spray, like with the children's flu vaccine.
Researchers at Oxford University, where one such vaccine is in development, said that nasal spray vaccines can have advantages, including introducing local immunity where pathogens build up and being a better option for the needle-phobic.
The Federal Trade Commission 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.
Fortunately, most patients with COVID-19 recover their sense of smell when congestion resolves however some do not. So, what do you do if you notice difficulty with your ability to taste or smell? Consider gently and safely clearing out your nasal passages using normal saline nasal spray or a Nettie pot.
How does enovidTM/ VirX TM work? SaNOtize has created a proprietary formulation that creates nitric oxide when the spray is released from the tip of the bottle. The spray has been formulated to create nitric oxide in a predictable and measurable dose with each spray.
During the pandemic, two recent consensus statements recommended the continued use of intranasal corticosteroids (INC). However, systemic corticosteroid therapy is not recommended for disorders of the sinuses and nasal cavities during the pandemic.
Also, do not use this medication for more than 3 days or it may cause a condition called rebound congestion. Symptoms of rebound congestion include long-term redness and swelling inside the nose and increased runny nose.
Conclusions: Xylitol in water is a well-tolerated agent for sinonasal irrigation. In the short term, xylitol irrigations result in greater improvement of symptoms of chronic rhinosinusitis as compared to saline irrigation.
Which is better, Flonase or Nasacort? Data shows that both Nasacort and Flonase are equally effective treatments for allergic rhinitis. Both products contain steroids that alleviate local allergy symptoms. They are both well-tolerated with similar side effect profiles.
According to recent studies, COVID-19 symptoms of loss of smell and taste typically begin 4-5 days after other symptoms have appeared and may last 7-14 days. Symptoms often improve after 7 days, with more noticeable improvements after 14 days.
*enovidTM and VirX TM are the identical product, branded under different names for marketing in various territories around the world. Nitric Oxide Nasal Spray (NONS) is the generic name of the product.
The incidence of COVID-19 differs significantly between subjects receiving the nasal spray with Iota-Carrageenan (2 of 196 [1.0%]) and those receiving placebo (10 of 198 [5.0%]). Relative risk reduction: 79.8% (95% CI 5.3 to 95.4; p=0.03).Absolute risk reduction: 4% (95% CI 0.6 to 7.4).
The viruses end up being destroyed by the acid environment from the stomach [7]. Regarding the safety profile, all clinical trials have concluded that iota-carrageenan is a safe alternative.
Xylitol has been shown to display virucidal effects against SARS-CoV-2 and with the addition of hypertonic saline and hyaluronate may shorten the viral shedding duration in asymptomatic COVID-19 positive subjects [16, 17].
The most common side effects are headaches and nausea. Children may feel agitated or vomit after the laughing gas is removed. The good news is that only about 5% of patients have these side effects. There are no long-term side effects when nitrous oxide is used now and then.
Most decongestant sprays contain the preservative benzalkonium chloride (BKC), which causes toxic reactions in the nose, eyes, ears, and lungs, and may exacerbate the symptoms of allergic rhinitis.
Your Covixyl Nasal Spray product is not generally recognized as safe and effective (GRASE) for its above referenced uses and, therefore, this product is a “new drug” under section 201(p) of the FD&C Act, 21 U.S.C.
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