Neffy: First Epinephrine Nasal Spary
- Neffy is the first FDA-approved nasal spray that delivers epinephrine to treat severe allergic reactions, including anaphylaxis.
- It’s needle-free, fast-acting, and designed for adults and children aged 4 and older who weigh at least 33 pounds.
- Each device contains a single dose; use one spray in one nostril at the first sign of symptoms, and a second dose after 5 minutes if needed.
- Common side effects include headache, nasal discomfort, and increased heart rate; always seek emergency care after using Neffy.
What is Neffy?
Neffy is the first epinephrine nasal spray for treating severe allergic reactions, including anaphylaxis. It was developed by ARS Pharmaceuticals and offers a needle-free alternative for people who need fast relief during an allergic emergency.
Anaphylaxis is a serious and potentially life-threatening allergic reaction that can happen suddenly, within minutes after exposure to a trigger. Common triggers include foods (like peanuts or shellfish), insect stings, medications, allergy shots, or even unknown causes. Symptoms can strike quickly and unexpectedly.
Neffy is approved for adults and children aged 4 years and older who weigh at least 15 kilograms (about 33 pounds). It's designed for use in the nose only and comes in a ready-to-use, single-dose device. Each carton contains two sprays, ensuring you have a backup if needed.
After using Neffy, always seek emergency medical care right away, even if you start feeling better. It's not a substitute for professional help, it's a first-line tool to buy time until you can get to a doctor or hospital.
How Neffy Works
Neffy works the same way as EpiPen but is delivered through the nose instead of an injection. It uses Intravail® technology to help the medicine absorb quickly through the nasal lining. It starts working within minutes, sometimes in less than one minute.
Each spray releases a precise single dose of epinephrine that quickly reverses a severe allergic reaction by:
- Opening airways to improve breathing
- Tightening blood vessels to raise blood pressure
- Increasing heart rate to boost circulation
- Reducing swelling, itching, hives, and stomach discomfort
Neffy also has a longer shelf life than most auto-injectors: up to 2.5 years for the 2 mg dose and 2 years for the 1 mg dose.
How to Use Neffy
- Spray once into one nostril at the first sign of symptoms.
- Do not sniff. Let the medication absorb naturally.
- If symptoms persist or return, use the second spray in the same nostril after 5 minutes.
- Seek emergency medical care immediately, even if you start to feel better. If liquid drips out, you may not have received the full dose. Use the second spray if symptoms continue.
Each device contains one dose, do not test or prime it.
Recommended dosing:
- Adults and children 4+ weighing ≥30 kg (66 lb): 2 mg, 1 spray in one nostril
- Children 4+ weighing 15–30 kg (33–66 lb): 1 mg, 1 spray in one nostril
FDA Approval & Clinical Studies
In August 2024, the FDA approved Neffy after reviewing results from multiple clinical studies. These studies showed that Neffy delivers epinephrine just as effectively as traditional injections.
- In a study of children aged 6–17, 100% recovered from symptoms after one dose.
- In adult trials, Neffy showed similar effects on blood pressure and heart rate as injectable epinephrine.
Side Effects and Safety
Like any medication, Neffy can cause side effects, but most are mild and short-lived, similar to those from injectable epinephrine. They occur because epinephrine is stimulating your body to fight the allergic reaction.
Common Side Effects
- Headache or dizziness
- Fatigue or jitteriness
- Nasal irritation or sneezing
- Throat discomfort
- Nausea, sweating, or flushing
- Increased heart rate
Common Side Effects
Although rare, call emergency services if you experience:
- Chest pain or irregular heartbeat
- Sharp rise in blood pressure
- Severe headache
- Worsening symptoms after treatment
Safety Considerations
Neffy hasn't been studied in people with certain nasal conditions, like nasal polyps, previous nasal surgery, or nose injuries. If you have these, absorption might be affected, so talk to your doctor first.
Overall, the benefits of Neffy during a life-threatening allergic reaction greatly outweigh the risks for most people. It's designed to be safe and effective when used as directed.
Speak with Your Doctor
Before starting Neffy, have an open conversation with your healthcare provider about your medical history, current medications, and health concerns. This ensures it's the right choice for you or your child.
Be sure to mention if you:
- Are pregnant or planning to become pregnant. (The effects on an unborn baby aren't fully known, so your doctor can help balance benefits and risks.)
- Are breastfeeding or planning to breastfeed.
- Have heart conditions, high blood pressure, thyroid issues, diabetes, or other ongoing health problems.
Also, share a complete list of all medications, supplements, vitamins, and herbal remedies you take. Some can interact with epinephrine, potentially increasing side effects or reducing effectiveness. Examples include:
- Other nasal sprays
- Water pills (diuretics)
- Antidepressants
- Medications for Parkinson's disease
- Heart medications
- Thyroid medications
- Certain antihistamines (like diphenhydramine)
- Worsening symptoms after treatment
Your doctor or pharmacist can review this list and advise on safe use. Keep it updated whenever you start something new.