Could the Answer Already Be in Our Medicine Cabinets?

I trained as a volunteer call firefighter for Los Angeles County at Topanga Station #69 for about two years. Topanga is a red-rock, sage-covered, high-risk fire region in the Santa Monica Mountains. Response time is everything. Seconds lost could be the difference between facing a controllable brush fire or calling in additional units and aerial backup to put down wind-enraged, volatile flames.

We drilled constantly, and everybody and everything was redundant with an immediate replacement available. I had to learn to do everything. I learned how to sling a 65-pound emergency-breathing unit over my shoulders and have it fastened and operating in seconds.

Despite the high risk for fires, most of the calls we received were medical emergencies, including auto and bicycle accidents along Highway 27. When people were bloodied and needed medical attention, I was obviously careful of blood transfer of viruses as I toted the gear and bandages; but the actual emergency medical technicians, who were allowed to treat victims, did not necessarily wear face masks when entering a home or situation; then was nothing like now.

I was thinking of my brothers and sisters last week when I reported a story for HealthyLivinG Magazine about a potentially effective early treatment for first responders, front-line workers, and essential personnel who suspect they’ve been exposed to the coronavirus (also known as COVID-19 and SARS-CoV-2).

We reported the treatment attacks not only symptoms but the COVID-19 virus itself in the early stages of the disease when its particles are fewest and contained within the upper respiratory tissues before it has had the chance to explode and cause devastating flames in the lungs that we now know are causing deaths by the thousands. This medication may be both an early treatment and preventive.

WASHINGTON’S MYOPIA

I’ve been reporting on remdesivir, convalescent plasma, chloroquine and hydroxychloroquine, among other drugs throughout the pandemic. Nothing, with the exception of remdesivir, however, has broken through, and even remdesivir is a highly selective, intravenous treatment for the most ill patients.

We need to keep people out of the hospital, and that means attacking the virus as early as possible. The answer could well be a decidedly not sexy, inexpensive, first-generation nasal decongestant with a minimal side-effect profile and a terrible taste—this is actually potentially important news to a lot of people, despite not being reported on yet in the nation’s papers of record and wire services.

You’ve heard of Chlor-Trimeton or Aller-Chlor? Well, look at their main active ingredient: chlorpheniramine (CPM) is a decades-old antihistamine, first introduced in 1949, that has been available as an over-the-counter (OTC) pill for allergies, cold, and flu symptoms. It’s that safe and widely used.

Don’t get any ideas here that you can don your face mask and go out to your local drug store to buy some CPM under any of its brand names in order to kill the coronavirus. Our report notes the Food and Drug Administration (FDA) is considering its use as a nasal spray with other ingredients that are vitally important to the whole, especially when it comes to making the horrific taste of CPM palatable, and together are possibly synergistic.

WHAT WE DO KNOW

As it turns out, COVID-19 is like the flu in at least one important way: in the early days of the infection process its main viral load occurs in the nose rather than the throat. Researchers confirmed this similarity in a March 19, 2020 letter to the editor published in The New England Journal of Medicine when they analyzed the viral load in nasal and throat swabs obtained from seventeen symptomatic patients and one who was asymptomatic.

For all of the patients, “Higher viral loads… [were] detected in the nose than in the throat,” wrote lead author Lirong Zou, M.Sc., of China’s Guangdong Provincial Center for Disease Control and Prevention.

OLD-SCHOOL MEDICATION REPURPOSED

That the coronavirus congregates initially within the nasal passages made sense to pulmonologist Gustavo Ferrer, founder of the Cleveland Clinic Florida Cough Clinic in Aventura, Florida. Dr. Ferrer and Xlear Inc., of American Fork, Utah, a research-oriented health-care company, had been cooperatively creating and developing a nasal spray preparation based primarily on CPM and xylitol for the relief of allergy symptoms since 2018.

In fact, years earlier, drug companies had funded studies to show that CPM is safe and effective when used as a nasal spray. “Yet the companies doing the original research lost interest in its commercial-use potential as a nasal spray and the studies were never submitted to the FDA. We think that the unpalatable taste of spraying CPM up your nose, combined with the fact that it was a first-generation medication and not a big money-maker, were some of the reasons its use as a nasal spray was never pursued,” says Nathan Jones, CEO of Xlear, Inc.

Xylitol, a five-carbon sugar that is obtained from birch trees and used as a sweetener, has been studied over the years for its use as a sugar substitute for diabetics and its ability to fight cavities and middle-ear infections when used as a sweetener, chewing gum, or a mint. In the case of CPM, xylitol makes the spray palatable and supports functioning of the nose’s cilia that move viruses out before they go further into the respiratory system.

ANTIVIRAL EFFECTS

We’ve heard a lot about favipiravir (Avigan) and oseltamivir (Tamiflu), among other drugs, thought to be the most sexy candidates to vanquish COVID-19. But, in fact, CPM was shown in 2018 in a peer-reviewed article in Frontiers in Microbiology to be a “potent” antiviral.

After screening a FDA-approved drug library containing 1,280 compounds, including COVID-19 treatment candidates favipiravir and oseltamivir, for effects against viruses, the article’s authors said CPM was far more distinguished than the others and shown to have “potent antiviral activity against a broad spectrum of influenza viruses.”

In February 2020, Dr. Ferrer and representatives of Xlear met with FDA officials to discuss the application process that had been underway. Dr. Ferrer informed FDA officials at the time that CPM exhibited potential antiviral activity against a broad-spectrum of flu viruses. Dr. Ferrer then suggested it as a candidate for treating the emerging coronavirus. The FDA’s response was that proving its efficacy for COVID-19 was largely to be done by the private sector including the funding of clinical trials. “They sort of blew us off,” Jones says.

As the coronavirus pandemic took full hold in March, Dr. Ferrer’s team of clinicians were using the CPM-xylitol formula (whose working name is “Chlorvira”) with their staff and non-hospitalized patients. Symptoms were resolving within forty hours. There were no tests then to confirm whether the formula was treating both common flu viruses or COVID-19.

Inspired by these findings and acting immediately, Xlear, Inc. sponsored research at Utah State University’s Institute for Antiviral Research to test the nasal spray against COVID-19.

Last week, HealthyLivinG reported a series of test-tube experiments, which used water and denatured alcohol as controls, found the CPM-xylitol spray eliminated 70% of the COVID-19 virus after 25 minutes (a standard time to assay antiviral activity).

“This study demonstrates the strong virucidal effect against SARS-CoV-2 of a nasal spray containing chlorpheniramine maleate,” reported Dr. Jonna B. Westover, the lead author of study, in an advanced copy of the study that we received.

“CPM has broad antiviral effects against influenza, virucidal effect against SARS-CoV-2… with minimal side effects,” the paper states.

“Three independent replicates of each sample were tested, and the average and standard deviation were calculated,” reports Dr. Westover. The results were “statistically significant,” he adds.

CLINICAL TRIALS NEEDED

I don’t trust anecdotal results. You shouldn’t either. That’s why clinical evidence needs to be collected under controlled circumstances.

“We’ve known for several years that CPM is a powerful antiviral,” says Dr. Ferrer. “We know that xylitol enhances the antiviral effects as it helps to break up biofilm, keeps the nasal tissue hydrated, and makes the nasal spray palatable. From past research, we know that up to 90 percent of the COVID-19 viral particles are actually lodged in the nasal passages that comprise the upper respiratory tract. Based on the individual clinical results combined with the sound scientific theory, since the advent of the coronavirus, we’ve felt this is definitely an area of research we needed to pursue. We now have two lines of evidence from in vitro experiments and clinical reports that the spray is killing viral infections in the upper nasal passages. A CPM-xylitol nasal spray is especially important because of its early-treatment and prevention potential.”

Since the meeting in February, Dr. Ferrer and Jones informed FDA about the Utah State study results and in a communication have proposed clinical trials that Xlear, Inc., has said it will fund to get the preparation to the market.

The FDA issued a response letter to their life-sciences attorney James A. Boiani of Epstein Becker & Green, P.C. It promised to respond to the use of CPM-based “nasal spray for the acute treatment of COVID-19” by May 29, according to Dr. Sherry A. Stewart, senior regulatory project manager at the Center for Drug Evaluation and Research.

For a regulatory body like the FDA that could be said to be a relatively fast response time. But there’s a long way to go still and not a lot of time when lives are at stake.

The first responders, medical professionals, and essential personnel I have come to know, especially when I was training in Topanga at station #69, like their brothers and sisters across the land, are vitally interested in self-managed health care. They want to stay healthy and prevent problems at the earliest point possible. Most are fitness buffs and live healthy lives.

Here is something simple that could work quickly and effectively and be used at first onset of symptoms. (Apparently, CPM is experimentally able to knock out a broad spectrum of flu viruses as well as COVID-19.)

The coronavirus appears mighty and powerful, but its nemesis could well be sitting in our medicine cabinets right now, simply awaiting the greenlight from FDA to be sold as a nasal spray with xylitol. Not bad for a senior citizen among antihistamines.

Whether CPM’s use with xylitol in a nasal spray will prove out over clinical trials isn’t known, and we have to tread carefully. But there’s hope.

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Note: This is for informational purposes only and is not intended to diagnose or treat covid-19.


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Photo credit: Tom Merton on iStock.