The jury is still out, but it’s becoming increasingly likely that the final decision will be that Enovid is an effective barrier against COVID-19 infection of pregnant women. Enovid is an antiviral that introduces NONS (nitric oxide nasal spray) as a physical barrier in the nasal passages that stops 99% of viruses before they pass through to the lungs.
Until now, there may have been some thought that it’s better to avoid using Enovid when a woman is pregnant. It’s not that there is any evidence that there are possible dangers. It’s just that until now, there have not been sufficient tests on the possible side effects in pregnant women.
Why is Enovid not currently approved for expectant mothers?
Medications that require FDA approval (and that can then only be sold by a pharmacy after prescription by a doctor) have to undergo many cycles of double-blind tests with specified target conditions and patient profiles. They must then report all of the recorded side effects and contra-indications and clearly label the drug so that people can know the dangers.
In the case of Enovid, there has been no need for this depth of testing, both because it is an over-the-counter medication that can be sold without prescription, and also because the volume of the only pharmaceutical ingredient (nitric oxide) in a single dose is so tiny that it is far lower than the specifications that the FDA sets for listing in ingredients. As a result, the only relevant thing is the wording on the website and in the official pamphlet that comes with each Enovid that “nitric oxide nasal spray has not been studied in pregnant women.”
What do we learn from current therapies with nitric oxide on pregnant mothers with Covid-19?
The background to this comes from the release of a paper from doctors in the Department of Anaesthesia, Critical Care and Pain Medicine at the Massachusetts General Hospital. It describes the rapid and sustained improvement in cardiopulmonary function and decreased inflammation in a small cohort of pregnant women suffering from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, thanks to the administration of inhaled nitric oxide (NO) gas.
Notably, the paper also reports that three women who all received relatively high doses of nitric oxide gas delivered babies, including a set of twins, while in the hospital. The babies all tested negative for the virus and remained in good condition four weeks after maternal admission.
What part does nitric oxide play in the Enovid shield against COVID-19?
Enovid’s NONS (nitric oxide nasal spray), developed by SaNOtize, a joint Canadian/Israeli biotechnology startup, blocks the entry of viruses via the nose and halts viral replication within the nasal cavity. It rapidly reduces the total viral load, which otherwise can kick off the spread of the virus in your body. Its overall effect is to prevent transmission and lower the severity of infection. Enovid has proven to be effective in trials so far, regardless of the variant.
Nitric oxide interferes with mRNA transcription and replication by inhibiting either viral ribonucleotide or viral RNA synthesis. Enovid works to kill the virus before it has a chance to pass into the lungs and replicate.
Nitric oxide is not itself an ingredient in Enovid. It is produced in minute quantities within each spray, thanks to the innovative technology developed by SaNOtize.
Is the nitric oxide in Enovid dangerous?
Nitric oxide (NO) was approved by the US Food and Drug Administration (FDA) in 1999 for the treatment of persistent pulmonary hypertension in newborns. Since then, NO has also been used off-label for many pediatric and adult clinical applications, including pulmonary hypertension in pregnancy, post-cardiac surgery, lung transplantation and acute respiratory distress syndrome (ARDS).
Nitric oxide for fighting COVID-19
Several studies after the outbreak of the COVID-19 pandemic(for example, here and here) demonstrated the effectiveness of NO as a means of combating the virus. There are other indications of highly positive effects of the gas in parts of the body besides the airways.
Nitric oxide for asthma
A comprehensive study conducted in 2016 in Australia, known as the Breathing for Life Trial (BLT), investigated how nitric oxide can treat mid-term pregnant women with physician-diagnosed asthma, asthma symptoms or having required medication in the previous 12 months. The study was important because asthma is a significant risk in pregnancy, resulting in poor perinatal outcomes. They include pre-eclampsia, preterm delivery, low birth weight, small for gestational age, neonatal hospitalization and perinatal mortality. The trial delivered fractional exhaled nitric oxide (FENO)-based management of the subjects, and the outcome of the trial was very positive. There was a significant (50%) reduction in the number of medical interventions required in the FENO group compared to the control group. The trial also showed a lower need for exposure to oral and inhaled corticosteroids in the FENO intervention group.
Nitric oxide for heart disease
Nitric oxide may help commonly used heart drugs maximize their benefits while improving heart function. A new study out of Case Western Reserve University School of Medicine indicates that many heart medications may get an assist from nitric oxide circulating in the body. Also, that nitric oxide deficiency could both underlie heart failure and tip heart medications into more substantial side effects.
Enovid is an effective barrier against COVID-19
The bottom line of all this evidence reinforces our point that nitric oxide yields far more benefits than risks. In its 20-plus years of widespread use, there has been enough experience and exposure to have raised any red flags if it carries with it serious dangers.
This is the strongest indication that Enovid is a safe and effective medication that can deliver substantial benefits to both pregnant women and their babies after birth.
Is Enovid an option for you if you are pregnant or trying to fall pregnant?
Enovid is an effective barrier against COVID-19 infection of pregnant women. If you are an expectant mother or hoping to be pregnant soon, find out how you can get extra protection from Enovid against COVID-19, both for yourself and for your family, by discussing Enovid with your healthcare provider.