BHRT

Nasal Sprays: The Nose Knows

May 8, 2024

By: Rachel Noonan, PharmD

Imagine a therapy at your patients’ fingertips, providing support at a moment’s notice.  

Nasal sprays offer convenient drug delivery with fixed dosing precision. Patient adherence struggles could be a thing of the past. Because this form of medication is convenient, non-invasive, and painless, barriers to care all but disappear.  

It’s science: medications introduced nasally are designed to quickly absorb into the bloodstream and provide rapid therapeutic support. Our anatomy makes it easy – the nasal mucosa is highly vascularized and permeable.  

Speaking of absorbability, lower medication doses are often possible with nasal preparations. Bypassing the liver and GI tract has its advantages. Less drug generally translates to less side effects, which could be why many studies suggest nasal sprays are well-tolerated, regardless of the medication at hand.  

The potential for local, systemic, and central nervous system activity is a unique advantage of nasal formulations. Take oxytocin for example: its nasal applications are boundless. With a shorter half-life and pulsatile nature, the nose knows how to use it.  

Nasal oxytocin can elicit profound behavioral effects for applications like sexual dysfunction, social anxiety, and weight management. As a neuropeptide, it can enhance openness to intimate activity and social connection, even influence impulse control and food reward signals in the brain. Given nasally, oxytocin’s onset can be as quick as your patients’ busy lives require. 

Keep in mind that certain conditions influence nasal clearance, potentially limiting drug absorption. Diabetic and asthmatic patients, or those battling a viral or bacterial infection, can have impaired nasal mucosa. Proper sinus irrigation may help patients experience the full benefit of their prescription.  

While you may not immediately think of the nose, think again. Nasal sprays offer an unmatched ease to therapy that’s both surprising and inviting. 

References 

  1. Dreijer – van der Glas, S., Hafner, A. (2015). Nose. In: Bouwman-Boer, Y., Fenton-May, V., Le Brun, P. (eds) Practical Pharmaceutics. Springer, Cham. https://doi.org/10.1007/978-3-319-15814-3_8 
  1. Ehrick JD, Shah SA, Shaw C, Kulkarni VS, Coowanitwong I, De S, Suman JD. Considerations for the Development of Nasal Dosage Forms. Sterile Product Development. 2013 Jun 22;6:99–144. doi: 10.1007/978-1-4614-7978-9_5. PMCID: PMC7120012. 
  1. Grassin-Delyle S, Buenestado A, Naline E, Faisy C, Blouquit-Laye S, Couderc LJ, Le Guen M, Fischler M, Devillier P. Intranasal drug delivery: an efficient and non-invasive route for systemic administration: focus on opioids. Pharmacol Ther. 2012 Jun;134(3):366-79. doi:10.1016/j.pharmthera.2012.03.003.Epub 2012 Mar 23. PMID: 22465159 
  1. Keller LA, Merkel O, Popp A. Intranasal drug delivery: opportunities and toxicologic challenges during drug development. Drug Deliv Transl Res. 2022 Apr;12(4):735-757. doi: 10.1007/s13346-020-00891-5. Epub 2021 Jan 25. PMID: 33491126; PMCID: PMC7829061. 
  1. Lawson EA. The effects of oxytocin on eating behaviour and metabolism in humans. Nat Rev Endocrinol. 2017 Dec;13(12):700-709. doi: 10.1038/nrendo.2017.115. Epub 2017 Sep 29. PMID: 28960210; PMCID: PMC5868755. 
  1. Liu N, Yang H, Han L, Ma M. Oxytocin in Women’s Health and Disease. Front Endocrinol (Lausanne). 2022 Feb 15;13:786271. doi: 10.3389/fendo.2022.786271. PMID: 35242106; PMCID: PMC8886718. 
  1. Pires A, Fortuna A, Alves G, Falcão A. Intranasal drug delivery: how, why and what for? J Pharm Pharm Sci. 2009;12(3):288-311. doi: 10.18433/j3nc79. PMID: 20067706. 

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