Neffy

Pronunciation: ne-fee
Generic name: epinephrine
Dosage form: nasal spray
Drug classes: Adrenergic bronchodilators, Catecholamines, Vasopressors

Medically reviewed by Carmen Pope, BPharm. Last updated on Aug 12, 2024.

What is Neffy?

Neffy is a nasal spray containing epinephrine that may be used for the emergency treatment of life-threatening, allergic reactions including anaphylaxis in adults and children weighing 66 pounds or more (30 kilograms or more) with a history of, or risk factors for, serious allergic reactions.

Each Neffy nasal spray contains a single dose of epinephrine.
Neffy is designed for immediate self (or caregiver) administration in an allergic emergency.

Neffy (epinephrine 2 mg nasal spray) works by activating specific receptors in the body, called alpha and beta receptors. Alpha receptors help to constrict blood vessels while beta receptors relax airways and increase heart rate. This combined action helps counteract the dangerous effects of an allergic reaction.

Neffy gained FDA approval on August 9, 2024, and is the first needle-free epinephrine treatment for life-threatening allergic reactions.

Neffy uses and important information

Neffy contains epinephrine, a medicine for allergic emergencies (anaphylaxis). Anaphylaxis can be life-threatening, can happen in minutes, and can be caused by stinging and biting insects, allergy injections, foods, medicines, exercise, or other unknown causes. Symptoms of anaphylaxis may include:

trouble breathing
wheezing
hoarseness (changes in the way your voice sounds)
hives (raised reddened rash that may itch)
severe itching
swelling of your face, lips, mouth, or tongue
skin rash, redness, or swelling
fast heartbeat
weak pulse
feeling very anxious
confusion
stomach pain
losing control of urine or bowel movements (incontinence)
diarrhea or stomach cramps
dizziness, fainting, or “passing out” (unconsciousness).

Always carry Neffy with you because you may not know when anaphylaxis may happen. It is recommended that you carry 2 Neffy devices because you may need a second dose of Neffy if symptoms continue or come back.

Talk to your healthcare provider if you need additional devices to keep at work, school, or other locations. Tell your family members, caregivers, and others where you keep your Neffy device and how to use it before you need it. You may be unable to speak in an allergic emergency. When you have an allergic emergency (anaphylaxis)

Use Neffy right away.
Get emergency medical help for further treatment of the allergic emergency (anaphylaxis), if needed after using Neffy. Before you receive Neffy, your healthcare provider should talk to you about when to get emergency help.

Neffy side effects

The most common side effects of Neffy include:

throat irritation
tingling nose
headache
nasal discomfort
feeling over excitement, nervousness, or anxiety
tingling sensation
fatigue
shakiness
runny nose
itchy nose
sneezing
stomach pain
pain in the gums of teeth
numbness in the mouth
nasal congestion
dizziness
nausea
vomiting.

Serious side effects and warnings

If you have certain medical conditions or take certain medicines, your condition may get worse or you may have more or longer lasting side effects when you use Neffy. Talk to your healthcare provider about all your medical conditions.

You should still use Neffy to treat anaphylaxis as prescribed by your healthcare provider, regardless of your medical conditions or the medicine you take.

It is not known if Neffy is safe and effective in children who weigh less than 66 pounds (30 kilograms).

Tell your healthcare provider if you have any side effect that bothers you or does not go away. These are not all the possible side effects of neffy. For more information, ask your healthcare provider or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Before using Neffy

Before using Neffy, tell your healthcare provider about all your medical conditions, especially if you:

have nasal problems including nasal polyps, a history of injury such as a broken nose, or any past nasal surgery
have heart problems
have kidney problems
have low potassium levels in your blood
have Parkinson’s disease
have thyroid problems
have high blood pressure
have diabetes
are pregnant or plan to become pregnant
are breastfeeding or plan to breastfeed.

Pregnancy

It is not known if Neffy will harm your unborn baby.

Breastfeeding

It is not known if Neffy passes into your breast milk.

How should I use Neffy?

Read the Instructions for Use that come with Neffy for detailed information about the right way to use the device. Use Neffy exactly as your healthcare provider tells you to use it. Talk to your healthcare provider or pharmacist if you have questions about the use of Neffy.

Neffy is for use in the nose only. Do not spray in the eyes or mouth.
Each Neffy device has 1 dose of medicine and cannot be reused. Do not test or prime (pre-spray) the device.
Your Neffy comes in a carton with 2 devices. You may need to use a second neffy if symptoms continue or get worse.
You should always carry 2 Neffy devices with you.

Neffy dosing information

Neffy is for nasal use only.

Neffy is given as 1 dose in either nostril.
If a second dose of Neffy is needed, it should be given in the same nostril, starting 5 minutes after the first dose.
Do not sniff during or after receiving a dose of Neffy.

If any liquid drips out of the nose, you may not receive the full dose of medicine. If your symptoms continue or get worse, give a second dose of Neffy in the same nostril, starting 5 minutes after the first dose.

Important: If symptoms continue or get worse after the first dose of Neffy, administer a second dose, even if you did not see liquid drip out of the nose.

Give the second dose in the same nostril, starting 5 minutes after the first dose.

Get emergency help for further treatment of the anaphylactic episode, if needed, after using Neffy. Before you receive Neffy, your healthcare provider should talk to you about when to get emergency help. For more information and video instructions on the use of Neffy, go to www.neffy.com or call 1-877-MY-NEFFY (1-877-696-3339).

What other drugs will affect Neffy?

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Tell your healthcare provider of all known allergies. Especially tell your healthcare provider if you take or use:

other nasal sprays
water pills (diuretics)
medicines to treat depression such as tricyclic antidepressants or monoamine oxidase inhibitors (MAO inhibitors)
medicines to treat abnormal heartbeats (arrhythmias) such as cardiac glycosides
medicines to treat Parkinson’s disease such as catechol-O-methyl-transferase inhibitors (COMT inhibitors) and ergot alkaloids
medicines for heart disease including alpha-blockers (such as phentolamine) and beta-blockers (such as propranolol)
medicines for thyroid disease such as levothyroxine sodium
medicines used in labor
medicines to treat allergies such as diphenhydramine, tripelennamine, or chlorpheniramine (antihistamines).

Neffy and other medicines may affect each other, causing side effects. Neffy may affect the way other medicines work, and other medicines may affect how Neffy works. Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.

Neffy storage

Store Neffy at room temperature between 68°F to 77°F (20°C to 25°C).

Do not freeze. If Neffy freezes, the device will not spray.
Storage of Neffy at high temperatures up to 122°F (50°C) is allowed for a few days.

Your Neffy has an expiration date. Replace Neffy before the expiration date.

Keep out of the reach of children.

Neffy ingredients

Active Ingredient: epinephrine 2 mg.

Inactive Ingredients: benzalkonium chloride, disodium edetate, n-dodecyl beta-D-maltoside, sodium chloride, sodium metabisulfite, and hydrochloric acid or sodium hydroxide to adjust pH, in water for injection.

Each Neffy Nasal spray contains 2 mg/0.1 mL of epinephrine per spray.

Who makes Neffy?

ARS Pharmaceuticals Operations, Inc. manufacturers Neffy.

Popular FAQ

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If someone is having an anaphylactic reaction, and all you have on hand is a recently expired EpiPen, then use it so long as it is not discolored and does not contain any particles. There is minimal risk in using a recently expired EpiPen, but the benefits are significant. But check the clear viewing window of the pen and if you notice it is discolored or contains particles then don’t use it as the solution may have oxidized, making it less effective. Continue reading

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What's the mechanism of action for epinephrine?

Epinephrine works by activating both alpha and beta receptors found in your body in response to a severe allergy (called anaphylaxis). By acting on alpha receptors, it helps to maintain your blood pressure and heart function, and by acting on beta receptors, it relaxes your lung airways to help relieve shortness of breath and wheezing. Continue reading

What is Neffy (nasal epinephrine)?

Neffy (epinephrine 2 mg/dose) is a nasal spray which may be given to treat a severe allergic reaction, including anaphylaxis, in adults and children who weigh 66 pounds (30kg) or more. It is needle-free and simple to administer. It is the first non-injectable treatment available for people with life-threatening allergic reactions and gained FDA approval on August 9, 2024. Continue reading