Newly Approved Intranasal Epinephrine

On August 9, 2024, the U.S. Food and Drug Administration approved a 2-mg epinephrine nasal spray (brand name “neffy”) for the emergency treatment of type 1 allergic reactions in adults and children (weight, ≥30 kg [≥66 lbs]).

Background

Epinephrine is the only agent for anaphylaxis that attenuates life-threatening symptoms. Until now, intramuscular administration in the lateral thigh has been the only option, and this process has discouraged some needle-phobic patients or parents of young children. But now, patients will have the option of a nasal spray.

Studies that led to U.S. FDA approval

In a randomized crossover trial, 59 healthy adults were given single manual injections of epinephrine (0.3 mg via syringe), nasal epinephrine (2 mg; the FD…