April 11, 2022

With the introduction of the Safe Management Measures (SMM) 1-5 framework, Singapore has moved towards normalcy. Despite the easing measures, there are certain regimens such as wearing of masks, safe distancing and capacity limits which are still in place. 

Although the daily local case numbers and the number of Covid-19 related hospitalisations have declined steadily, the newest Omicron variant BA.2 is quickly becoming the source of most infections worldwide. In addition to the protection from vaccines and booster shots, there is now available a new nasal spray made of nitric oxide with proven anti-microbial properties which can be used to fight the Covid-19 virus. Developed by SaNOtize Research in Canada, the nasal spray can be delivered in small amount into a person’s nasal cavity, thus killing viruses in the respiratory upper airways.

Nitric Oxide is a small molecule which is naturally present in our body and in the atmosphere. It has been researched since the 80s for treatment of various medical conditions. Now, with the innovatively designed delivery system developed by SaNOtize Research in Canada, Nitric Oxide in the form of a nasal spray can be delivered in a small amount into our nasal cavity, the entry point of multiple pathogenic respiratory viruses, to kill viruses in the upper airways.

Marketed as VirX in this region, it has proven anti-microbial properties with a direct virucidal effect on SARS-CoV-2. When sprayed over nasal mucosa, it reduces viral load in a person’s nasal cavity, and at the same time, acts as a physical and chemical barrier against the virus, preventing it from incubating and spreading to the lungs.   

The safety and efficacy of VirX have been proven in several clinical trials conducted in Canada, U.K. and India. Clinical trials from its innovator, SaNOtize showed Nitric Oxide Nasal Spray (NONS) was a safe and effective antiviral treatment for SARS CoV-2. In the first 24 hours, NONS reduced the average viral load by around 95 per cent, and then by more than 99 per cent within 72 hours.

Apex Pharma Marketing and Glenmark Pharmaceuticals, an innovation-driven global pharma company announced a strategic partnership for the distribution of NONS in Singapore. As part of this partnership, Glenmark will be responsible for regulatory filing, manufacturing and supply of the product whereas Apex Pharma will be responsible for marketing, sales and distribution of the product under the brand name VirX. 

Loh Pei Juin, General Manager, Apex Pharma Marketing said: “We have seen Covid-19 infecting humans worldwide in waves. It is important to have a defence tool guarding the main point of entry from respiratory viruses into our bodies. VirX can be included as part of our preventive regimen comprising vaccination, mask-wearing, good hygiene standards and safe distancing measures. We are very pleased to work with Glenmark Pharmaceuticals to bring VirX into Singapore.” 

Robert Crockart, Chief Commercial Officer, Glenmark Pharmaceuticals, added: “We are excited to partner with Apex Pharma for the commercialisation of the breakthrough Nitric Oxide nasal Spray (VirX) in Singapore. This nasal spray will play a key role in the country’s fight against Covid-19 by enabling patients access to a safe and highly efficacious antiviral treatment”.

The efficacy and safety of VirX were further proven in a recently concluded double-blind, parallel arm, multicenter Phase 3 trial, conducted on 306 patients with mild symptomatic Covid-19 (confirmed by RT-PCR) in India by Glenmark. In this study which also included high-risk patients infected with Delta or Omicron variants of Covid-19 between August 2021 and January 2022, NONS reduced the average viral load by around 95 per cent in the first 24 hours, and more than 99 per cent within 72 hours, which was statistically significant compared to the placebo group. The median time to virological cure of four days in the NONS group was also significantly shorter compared to 8 days in the placebo group. NONS was safe and well-tolerated with no patient experiencing adverse events or death in the study.

Srikanth Krishnamurthy, one of the Principal Investigators of the Indian Phase 3 study, commented: “Nitric Oxide Nasal Spray (NONS) lowers the viral load and hastens RT-PCR negativity when used early in Covid-19 infection leading to recovery. Most importantly, viral load reduction with NONS has the potential to reduce the chain of transmission. Finally, NONS being topical, is safe and easy to use.”

In July 2021, Glenmark entered into an exclusive long term strategic partnership with Canadian biotech firm SaNOtize, to manufacture, market and distribute its breakthrough NONS for Covid-19 treatment in India and other Asian markets including Singapore, Malaysia, Hong Kong, Taiwan, Nepal, Brunei, Cambodia, Laos, Myanmar, Sri Lanka, Timor-Leste and Vietnam.

NONS has already received a CE mark in Europe, which is the equivalent of marketing authorisation for a Medical Device. By virtue of the CE mark, SaNOtize has permission to launch NONS in the EU. NONS is also approved and being sold in India, Israel, Thailand, Indonesia and Bahrain, under the name FabiSpray® or enovid™ or VirX. NONS is approved in many countries for protection against viruses including SARS COV-2.

VirX is classified as Class-A Medical Device by the Health Sciences Authority. It will be retailing at S$29.50 in clinics, major pharmacies and online marketplaces in Singapore.