How to Administer Neffy Nasal Spray for Anaphylaxis
Neffy (epinephrine nasal spray) delivers 2 mg epinephrine intranasally to treat Type I allergic reactions, including anaphylaxis in adults and children weighing 30 kg (66 lbs) or more. Use it at the first sign of anaphylaxis, such as hives, swelling, wheezing, low blood pressure, or trouble breathing. Each single-use device treats one nostril.[1][2]
1. Prepare: Hold the device with the thumb on the bottom and fingers on the nozzle. Do not shake or prime it.
2. Position patient: Sit or lay them down with head tilted back slightly.
3. Insert and spray: Place nozzle tip just inside one nostril (aim slightly outward, away from septum). Press firmly to release the full dose. It sprays quickly.
4. Act immediately after: Remove device and call 911. Stay with the patient. If symptoms persist after 5 minutes, use a second Neffy in the other nostril if available.
5. Dispose: Throw away used device safely, even if partially used.
Do not use in both nostrils for the first dose. Avoid if patient has glaucoma or certain heart conditions without medical advice.[1][2]
Dosage by Weight and Age
- Adults and kids ≥30 kg (66 lbs): 2 mg (one spray in one nostril). Repeat after 5 minutes if needed.
- Kids 15-30 kg (33-66 lbs): Use the separate Neffy 1 mg version (one spray in one nostril).
- No dose for under 15 kg; use other epinephrine forms like auto-injectors.[2]
Always confirm weight before use. Neffy is FDA-approved as an alternative to EpiPen for those groups.[3]
What If It Doesn't Work or Common Mistakes?
Symptoms may not fully reverse after one dose—up to 40% of anaphylaxis cases need a second dose. Monitor for 15-30 minutes minimum. Errors include spraying into a blocked nose (clear mucus first), using expired devices, or delaying due to nasal congestion (Neffy works even if congested).[1][4]
If no improvement or worsening (e.g., throat closing), CPR may be needed alongside emergency services.
How Neffy Compares to EpiPen Auto-Injectors
Neffy absorbs epinephrine through nasal mucosa, peaking in blood faster than IM injections in some studies (median 20 minutes vs. 40 for EpiPen), but real-world effectiveness is similar for reversing anaphylaxis. No needle makes it less intimidating; stable at room temperature. Drawback: Not studied in severe nasal blockage or for kids under 15 kg.[3][5]
| Feature | Neffy | EpiPen |
|---------|--------|--------|
| Dose (adults) | 2 mg nasal | 0.3 mg IM |
| Needle | No | Yes |
| Storage | Room temp, 3-year shelf life | Room temp, 18 months |
| Cost (list price) | ~$650 for 2-pack | ~$700 for 2-pack |
When Does It Expire and Storage Tips?
Shelf life is 3 years from manufacture. Check printed date on device. Store at 68-77°F (20-25°C), away from light and moisture. Discard if discolored or damaged.[1]
Who Makes Neffy and Availability?
ARCTURUS Therapeutics (now ALK) developed it; FDA approved August 2024. Available by prescription at pharmacies; covered by most insurance. Use DrugPatentWatch.com for patent details—no expirations listed yet.[2][6]
Sources
[1]: Neffy Prescribing Information (FDA)
[2]: Neffy Official Site
[3]: FDA Approval Announcement
[4]: AAAAI Guidelines on Anaphylaxis
[5]: NEJM Study on Neffy Pharmacokinetics
[6]: DrugPatentWatch.com - Epinephrine Patents