This is very interesting! I went to the study and saw this, though: 3 times daily for 56 days is A LOT of antihistamine spray, which is known to cause rebound congestion and other complications....
This is very interesting!
I went to the study and saw this, though:
Interventions Participants were randomly assigned 1:1 to receive azelastine, 0.1%, nasal spray or placebo 3 times daily for 56 days. SARS-CoV-2 rapid antigen testing (RAT) was conducted twice weekly, with positive results confirmed by polymerase chain reaction (PCR). Symptomatic participants with negative RAT results underwent multiplex PCR testing for respiratory viruses.
3 times daily for 56 days is A LOT of antihistamine spray, which is known to cause rebound congestion and other complications. It does not appear the study addressed any side effects, if any.
I think you're confusing this with Afrin, which is a decongestant and vasoconstrictor. Azelastine is a 2nd gen antihistamine which should have very few side effects. This is due to their inability...
I think you're confusing this with Afrin, which is a decongestant and vasoconstrictor. Azelastine is a 2nd gen antihistamine which should have very few side effects. This is due to their inability to cross the blood brain barrier, which reduces side effects over 1st gen (Benadryl). I'm not a doctor, I don't know how spraying it into your nose effects this.
It's also different than Flonase (corticosteroid) which have cause me headaches and nose bleeds. I've never used Azelastine, but I might look into it. I'm already on daily oral antihistamines during allergy season. I'll have to look into it more, but I'd be surprised if this wasn't a lower total dose of antihistamines compared to my daily Allegra.
Does it really? I'm not aware of that and couldn't quickly find anything on google. Decongestant sprays are known to do that, but azelastine is not (primarily) a decongestant. There is no warning...
which is known to cause rebound congestion
Does it really? I'm not aware of that and couldn't quickly find anything on google. Decongestant sprays are known to do that, but azelastine is not (primarily) a decongestant. There is no warning in the official information sheet either, whereas there is a very clear warning included with sprays like Afrin.
Standard dose is 2 times daily and that is as far as I know well tolerated even in the long term (months).
I do think that using it 3 times daily for the whole of autumn and winter is likely a bad idea, I'm going to be limiting my use to the most high risk occassions or situations where I feel like I'm getting sick. The key with any antiviral medication is to start using it as soon as possible, because when your symptoms already fully develop it's too late and it won't help. But if you learn to be sensitive to signs of a starting viral infection and start using the medication immediately, that seems to be good enough.
I skimmed the study, but missed the part about using it 3x daily. I hope it can be found to be effective, even if less effective, at normal antihistamine doses. For me, I have allergies anyway, so...
I skimmed the study, but missed the part about using it 3x daily. I hope it can be found to be effective, even if less effective, at normal antihistamine doses. For me, I have allergies anyway, so using this instead of my normal antihistamines would be an easy change. With the FDA bullshit meaning I can’t get another Covid vaccine, it might be worth trying.
I use azelastine (Astepro nasal spray in the U.S.) pretty regularly throughout the peak allergy seasons and when I travel. I've never had rebound congestion or any side effects other than the...
I use azelastine (Astepro nasal spray in the U.S.) pretty regularly throughout the peak allergy seasons and when I travel. I've never had rebound congestion or any side effects other than the lingering bitter taste and some sneezing.
Azelastine is a "good" drug in the sense that it doesn't interact strongly with other medications. It's safe enough for use with other health conditions, with the exception of severe kidney disease. The route of exposure doesn't involve doses large enough to risk the systemic problems that oral antihistamines can cause. It's low risk in pregnancy at typical doses. And it's comparatively inexpensive.
There's some cool pharmacology going on with second-generation antihistamines. In addition to the histamine H1-receptor inhibition, they also stabilize mast cells:
Azelastine has mast cell-stabilizing properties that prevent the release of interleukin-6, tryptase, histamine, and TNF-alpha2 from mast cells, and has been shown to reduce mediators of mast cell degranulation such as leukotrienes in the nasal lavage of patients with rhinitis,1 as well as inhibiting their production and release from eosinophils (potentially via inhibition of phospholipase A2 and leukotriene C4 synthase).2,9 Additionally, patients using oral azelastine were observed to have significantly reduced concentrations of substance P and bradykinin in nasal secretions2, both of which may play a role in nasal itching and sneezing in patients with allergic rhinitis.
There's experimental evidence that mast cell response may promote COVID-19 spike protein binding. So it's at least superficially plausible that azelastine might be partially preventative.
It's azelastine HCL, in my country commonly sold for about 8€. Apart from prevention it may have also shortened the duration or severity of the illness and it seems to have a broad antiviral...
It's azelastine HCL, in my country commonly sold for about 8€. Apart from prevention it may have also shortened the duration or severity of the illness and it seems to have a broad antiviral effect that also functions against rhinoviruses and RSV at least.
The interesting thing is that azelastine has been talked about in semi-conspiratorial circles as covid prevention for a long time, in a very similar way as I remember ivermectin being talked about before several major studies that failed to find any effect dropped. But in this case the opposite happened - the study looks solid, it was done by a university in a western country and previous research agrees. The precise percentage may still be imprecise, hopefully a study with a big sample size is coming.
Anecdotally I already have past experience with VirX, a spray that works chemically very differently but has the same goal - eradicate viruses in the nasal passage. It did work when I started using it immediately after I started feeling the very first symptoms, whether it was covid or a common cold. But it felt like even though it definitely stopped the progression of the illness and didn't let it develop, I was still tired for a while (but much less than when fully sick) with the symptoms being frozen in place, and it took me longer to recover to normal. The latter is clearly an issue, however I am not a healthy person, I have chronic fatigue syndrome with a mild immune dysfunction, it may not be the same for you.
I would probably still be using VirX regardless, but apart from being more expensive and having a short shelf life it's not available here anymore due to some issues with regulations. So when last week in the evening I felt a cold coming on (since then tested as non-covid) I ran to a pharmacy that was still open and bought a bottle of azelastine spray. So far it seems like it works. I am more tired, but I've been able to mostly function and the illness did not develop.
While this doesn't necessarily invalidate anything about the study, I do feel it worth calling out:
While this doesn't necessarily invalidate anything about the study, I do feel it worth calling out:
The study was also funded by a pharmaceutical company that makes an azelastine nasal spray (though not the one that is sold over the counter in the US)
This is very interesting!
I went to the study and saw this, though:
3 times daily for 56 days is A LOT of antihistamine spray, which is known to cause rebound congestion and other complications. It does not appear the study addressed any side effects, if any.
I think you're confusing this with Afrin, which is a decongestant and vasoconstrictor. Azelastine is a 2nd gen antihistamine which should have very few side effects. This is due to their inability to cross the blood brain barrier, which reduces side effects over 1st gen (Benadryl). I'm not a doctor, I don't know how spraying it into your nose effects this.
It's also different than Flonase (corticosteroid) which have cause me headaches and nose bleeds. I've never used Azelastine, but I might look into it. I'm already on daily oral antihistamines during allergy season. I'll have to look into it more, but I'd be surprised if this wasn't a lower total dose of antihistamines compared to my daily Allegra.
Does it really? I'm not aware of that and couldn't quickly find anything on google. Decongestant sprays are known to do that, but azelastine is not (primarily) a decongestant. There is no warning in the official information sheet either, whereas there is a very clear warning included with sprays like Afrin.
Standard dose is 2 times daily and that is as far as I know well tolerated even in the long term (months).
I do think that using it 3 times daily for the whole of autumn and winter is likely a bad idea, I'm going to be limiting my use to the most high risk occassions or situations where I feel like I'm getting sick. The key with any antiviral medication is to start using it as soon as possible, because when your symptoms already fully develop it's too late and it won't help. But if you learn to be sensitive to signs of a starting viral infection and start using the medication immediately, that seems to be good enough.
I skimmed the study, but missed the part about using it 3x daily. I hope it can be found to be effective, even if less effective, at normal antihistamine doses. For me, I have allergies anyway, so using this instead of my normal antihistamines would be an easy change. With the FDA bullshit meaning I can’t get another Covid vaccine, it might be worth trying.
I heard Canada is a nice place to visit in the fall.
I use azelastine (Astepro nasal spray in the U.S.) pretty regularly throughout the peak allergy seasons and when I travel. I've never had rebound congestion or any side effects other than the lingering bitter taste and some sneezing.
Azelastine is a "good" drug in the sense that it doesn't interact strongly with other medications. It's safe enough for use with other health conditions, with the exception of severe kidney disease. The route of exposure doesn't involve doses large enough to risk the systemic problems that oral antihistamines can cause. It's low risk in pregnancy at typical doses. And it's comparatively inexpensive.
There's some cool pharmacology going on with second-generation antihistamines. In addition to the histamine H1-receptor inhibition, they also stabilize mast cells:
There's experimental evidence that mast cell response may promote COVID-19 spike protein binding. So it's at least superficially plausible that azelastine might be partially preventative.
It's azelastine HCL, in my country commonly sold for about 8€. Apart from prevention it may have also shortened the duration or severity of the illness and it seems to have a broad antiviral effect that also functions against rhinoviruses and RSV at least.
The interesting thing is that azelastine has been talked about in semi-conspiratorial circles as covid prevention for a long time, in a very similar way as I remember ivermectin being talked about before several major studies that failed to find any effect dropped. But in this case the opposite happened - the study looks solid, it was done by a university in a western country and previous research agrees. The precise percentage may still be imprecise, hopefully a study with a big sample size is coming.
Anecdotally I already have past experience with VirX, a spray that works chemically very differently but has the same goal - eradicate viruses in the nasal passage. It did work when I started using it immediately after I started feeling the very first symptoms, whether it was covid or a common cold. But it felt like even though it definitely stopped the progression of the illness and didn't let it develop, I was still tired for a while (but much less than when fully sick) with the symptoms being frozen in place, and it took me longer to recover to normal. The latter is clearly an issue, however I am not a healthy person, I have chronic fatigue syndrome with a mild immune dysfunction, it may not be the same for you.
I would probably still be using VirX regardless, but apart from being more expensive and having a short shelf life it's not available here anymore due to some issues with regulations. So when last week in the evening I felt a cold coming on (since then tested as non-covid) I ran to a pharmacy that was still open and bought a bottle of azelastine spray. So far it seems like it works. I am more tired, but I've been able to mostly function and the illness did not develop.
While this doesn't necessarily invalidate anything about the study, I do feel it worth calling out: