In a pivotal development this year, the U.S. Food and Drug Administration approved neffy (epinephrine nasal spray) in August 2024 for emergency use in type 1 allergic reactions, such as anaphylaxis. This approval extends to adults and children weighing at least 66 lb (30 kg).
The key innovation? Neffy is a nasal spray, removing the need for injections, which may provide critical advantages for patients who fear needles or hesitate during emergencies.
Cost-effective and easy to use
Barbara Madej, RPh.
Neffy offers more than convenience -- it also presents a highly affordable option. While injectable epinephrine products typically come with a hefty price tag, costing around $839, neffy is priced at an estimated $199. This significant cost reduction -- around 76% lower -- makes the product more accessible for families, caregivers, and healthcare providers who need to stock emergency kits.
Additionally, the nasal spray delivery method eliminates the barriers of fear and discomfort commonly associated with injections, potentially improving patient compliance and speeding lifesaving interventions.
Neffy's fast action, taking effect within one minute, mimics the response time of intramuscular epinephrine, providing vital results in an emergency. As always, it's crucial to seek medical attention immediately after administration to ensure the patient gets any necessary follow-up care.
How to use neffy
- Each package contains two single-use nasal inhalers: It's important to carry both in case a second dose is needed.
- Timing for the second dose: If symptoms persist, administer a second spray in the same nostril five minutes after the first.
- Versatility in use: Neffy can be administered in any position -- whether the patient is sitting, standing, or lying down -- offering flexibility in different emergency scenarios.
Storage and longevity
The neffy nasal spray. Image courtesy of ARS Pharmaceuticals.
Neffy should be stored at room temperature, though brief exposure to temperatures as high as 122°F is acceptable. The manufacturer's website cautions against freezing the product, as it will prevent the nasal spray from delivering epinephrine. With a 30-month shelf life, neffy is designed to be a long-lasting option for emergency preparedness.
Possible side effects and special considerations
Patients may experience some moderate side effects after using neffy, such as the following:
- Throat irritation
- Nasal discomfort
- Headache
- Jitteriness or tremors
- Nasal congestion
Less commonly, patients might report dizziness, nausea, or abdominal pain. Additionally, changes in the nasal lining may occur for up to two weeks, which could affect the absorption of other nasal medications.
In life-threatening cases of anaphylaxis, speed is of the essence, even for patients with heart disease. Although epinephrine can exacerbate heart conditions like arrhythmias, delaying treatment poses a far greater risk.
After administering neffy, providers should closely monitor patients with preexisting heart conditions to manage any potential adverse effects related to the heart, especially those on medications like diuretics or antiarrhythmics.
Why neffy is a game changer
Neffy marks a significant breakthrough in allergy care, offering the following:
- A needle-free, user-friendly alternative to traditional epinephrine injectors
- A more affordable option, making it accessible to a wider range of patients and healthcare providers
- A fast-acting and reliable solution for emergency use
In emergencies, tools like the Digital Drug Handbook can help healthcare providers ensure patient safety by offering quick access to information on medications and drug interactions. Having this resource on hand can greatly improve patient outcomes in life-threatening allergic reactions.
Barbara Madej, RPh, is a licensed pharmacist who has dedicated her life to serving her home country of Canada, as well as her new home of Los Angeles, after receiving her degree in pharmacy from the University of Saskatchewan. Madej co-founded MedAssent Rx in 2015, drawing from her decades of experience in pharmacy and putting her passion to action.
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