SUMMER ALLERGIES ARE HERE

Intranasal Treatments: Allergies and potentially viral infections including COVID 19

Leonard Bielory | 24 February, 2021


          
            Intranasal Treatments: Allergies and potentially viral infections including COVID 19

Intranasal drug administration has a long tradition and is still used for medical as well as recreational purposes. The most common use is for treatment of local symptoms e.g. nasal congestion in the course of a common rhinitis or inflammation linked to allergic rhinitis. Dr. Bielory, as an international member of the World Allergy Organization committee recently published an international expert consensus focusing on current and future directions in the management of allergic rhinitis  (Source 1). It has ben noted that the medications intended for local activity are well established and can be found across the globe in every pharmacy and drug store. Examples for topical treatment of rhinitis are decongestants (oxymetazoline, xylometazoline, naphazoline), anti-histamines (azelastine, levocabastine, olopatadine) and glucocorticoids (e.g. mometasone, budesonide, fluticasone) and natural holistic products including Sinusol Breathe Easy. For this particular indication, drugs should act fast and only locally while systemic absorption should be as low as possible; this to avoid systemic side effects which are linked with typical oral formulations of comparable drug substances. Intranasal treatments have also recently reported the potential impact of intranasal treatment of allergies has also been shown to have an effect on allergies affecting the eye (Dr. Bielory references: Source 2 - Ocular symptoms improvement from intranasalSource 3 - Allergic conjunctivitis and the impact of allergic rhinitis)

 Vaccines may also benefit from the intranasal route. Existing vaccines commonly utilize the intramuscular and oral administration route. While the respiratory and gastrointestinal tract is very immune competent and fights with microbes permanently, the muscle is not the first choice. Intramuscular vaccination primarily induces systemic immune response, mainly via formation of vaccine-strain specific circulating antibodies. Injections of vaccines were done since the early days and they are indeed effective. So for most people today vaccination is equal to getting an intramuscular injection which is linked to pain. For the health care professional it is linked to fears of needle stick injuries, risk of disease transmission and dangerous medical waste.