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nasal insulin
Indications:
- may be of benefit in treatment of delirium [2]
Pharmacology:
- insulin can cross the blood brain barrier & can penetrate the hippocampus
- it can be delivered through the nose to the brain, via a simple nasal spray
- insulin fusion proteins can be transported across the blood brain barrier & into the brain via macropinocytosis
- thus insulin may be a vehicle for transporting therapeutic drugs into the brain
Clinical trials:
- intranasal insulin 40 IU QID* &/or empagliflozin 10 mg PO QD showed improvement in biomarkers for patients with amyloid-positive mild cognitive impairment or early Alzheimer disease [3]
Interactions
drug interactions
drug adverse effects of hypoglycemic agents
General
nasal agent; nasal spray
pharmaceutical insulin
References
- Szalinski C
A New Way to 'Smuggle' Drugs Through the Blood-Brain Barrier.
Medscape. Oct 10, 2024
https://www.medscape.com/viewarticle/new-way-smuggle-drugs-through-blood-brain-barrier-2024a1000ijs
- Nitchingham A, Close JCT, Harvey LA et al
Long-acting intranasal insulin for the treatment of delirium-a randomised clinical trial.
Age Ageing. 2025 Aug 29;54(10):afaf276.
PMID: 41091693 PMCID: PMC12526039 Free PMC article. Clinical Trial.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12526039/
- Erichsen JM, Register TC, Sutphen C et al
A phase 2A/B randomized trial of metabolic modulators intranasal insulin and
empagliflozin for MCI and early AD.
Alzheimers Dement. 2025 Oct;21(10):e70704. doi: 10.1002/alz.70704.
PMID: 41057918 PMCID: PMC12504051 Free PMC article. Clinical Trial.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12504051/