July 27, 2026
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Q: I heard there is an alternative to injectable epinephrine for anaphylactic reactions. What can you tell me about it?
A: If you have ever experienced a serious allergic reaction that affected your swallowing or breathing, you know how frightening it can be. The more familiar culprits are bee stings and peanuts, but your body can have a severe allergic reaction to almost anything. For those who are unfamiliar with anaphylaxis, let us first explain what it is.
When you are exposed to a specific allergen, you may experience a mild allergic reaction, such as sneezing, a runny nose, hives, swelling, flushing, or abdominal discomfort. In some cases, however, repeated exposure to the allergen may trigger a much more severe reaction. This may progress to anaphylaxis, a serious, potentially life-threatening reaction that can occur within seconds, minutes, or even 30 minutes or more after exposure.
Signs and symptoms of anaphylaxis can include a rapid, weak pulse, widespread rash or hives, nausea, vomiting, a sudden drop in blood pressure, dizziness, narrowing of the airways, swelling of the tongue or throat, and difficulty breathing. Obviously, when breathing is affected, every second counts. The quickest and most effective treatment is to administer epinephrine as soon as possible to help reverse the body's severe allergic response. Those who have previously experienced anaphylaxis have likely been prescribed an epinephrine auto-injector (such as an EpiPen) to carry with them in case another reaction occurs.
For decades, the only form of epinephrine available for emergency treatment of anaphylaxis has been an injection administered into the muscle, usually the thigh. Although the EpiPen is a pre-filled device with a concealed needle, many people are still hesitant about giving themselves or someone else an injection, which can unfortunately delay treatment.
This spring, Health Canada approved an epinephrine nasal spray called neffy, which is expected to become available later this summer or early fall. It offers another treatment option for people who are uncomfortable using an injection on themselves or a loved one. It will initially be available as a two-milligram (mg) dose for people weighing at least 30 kilograms (66 pounds).
According to ALK-Abelló Pharmaceuticals (ALK Canada), the manufacturer of neffy, clinical studies demonstrated that the nasal spray produced similar epinephrine levels and effects compared with epinephrine auto-injectors. These studies included adults, children, repeated dosing, and even individuals with nasal congestion. The nasal spray does not require priming and is ready to use immediately when needed. A single spray into one nostril delivers a two-mg dose of epinephrine. The most commonly reported side effects include throat irritation, headache, nasal discomfort, and jitteriness.
Neffy has also been approved in the United States, Japan, the United Kingdom, and the European Union. In the United States, it is available as both a two-mg dose for people weighing at least 30 kilograms (66 pounds) and a one-mg dose for children weighing between 15-30 kilograms (33-66 pounds).
If you are having an allergic reaction and require life-saving intervention with epinephrine, you should still call 911 immediately because further treatment and observation may be required and/or a second dose of epinephrine may be needed if symptoms persist or return.
For more information about this or any other health-related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination. Also check the website at www.gordon-pharmasave.com/ and the Facebook page at www.facebook.com/GordonPharmasave/.
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