FDA approves first emergency allergy nasal spray

The U.S. Food and Drug Administration (FDA) has approved Neffy, a new nasal spray that injects epinephrine to treat emergency and sometimes life-threatening allergic reactions known as anaphylaxis.

Before the FDA approved Neffy, the only way to administer epinephrine in an emergency was by injection. This injection, sometimes called an EpiPen, can be a little scary for children.

The new nasal spray is expected to increase access to epinephrine for more people, especially children. This can also be a big relief for many allergy parents.

How allergic reactions occur

Sometimes, a person’s immune system reacts abnormally to a substance, whether it’s food, medicine, or a bug bite, causing an adverse, serious reaction called an allergic reaction.

“It’s a rapid-release response of inflammatory cells to what the body recognizes as a foreign substance,” says Katharine Clouser, MD, FAAP, CHCQM, a pediatric resident at the Joseph M. Sanzari Children’s Hospital at Hackensack University Medical Center in New Jersey. “Allergies may Just the skin, maybe some swelling, but when it affects multiple organ systems, it’s considered an allergic reaction.”

How this reaction manifests varies from person to person. Some people experience hives, swelling, itching, and vomiting, while others may have trouble breathing or even lose consciousness.

Dr. Clouser adds that children may not always interpret tickling the way adults do when experiencing an allergic reaction, but may clear their throat or cough frequently.

Why this new nasal spray treatment is good news

The only treatment for anaphylaxis is epinephrine—a drug used to relax the muscles in the human respiratory tract.

“Current issues in the treatment of allergic reactions [via injection]”It’s very effective, but sometimes parents are concerned about injecting it ‘right’, injecting deeply enough, and leaving enough time,” Dr. Clouser explains. “Needles are also very uncomfortable and, while life-saving in this situation, can also cause the child some pain. [Nasal spray] Make the process of treating allergic reactions more acceptable to families.

In addition to the common difficulties associated with injection treatments, Dr. Crowther explains another factor that can add to the difficulty.

“Sometimes people also wear thicker clothing, which makes it more difficult to get the needle deep enough into the muscle,” she said.

She also noted that nasal spray treatment would provide a more convenient option for families who may be afraid of needles, causing delays in treatment. Increased comfort during the procedure will facilitate appropriate and timely treatment.

“It may also be easier to give a quick squirt of epinephrine into a squirming child’s nose,” adds Dr. Crowther. “Nasal sprays pose less risk to the dispenser because if the child moves, they may spray near their nose but not prick themselves with the needle.”

Nefi security details

Neffy can only be used by children weighing over 66 pounds. As a single-dose nasal spray, Neffy is injected into one nostril. As with injectables, if a person’s symptoms do not subside or worsen, a second dose of Nephenide can be given in the same nostril.

The FDA lists the most common side effects of Neffy, which include:

• Throat irritation
• Stinging nose
• Headache
• Nasal discomfort
• Feeling nervous and shaky
• Tingling (paresthesia)
• fatigue
• runny nose (rhinorrhea)
• Itching inside the nose (nose itching)
• nasal congestion
• sneeze
• stomach ache
• Gum (gum) pain
• Oral numbness (diminished oral sensation)
• Dizziness
• Nausea and vomiting.

New treatments do come with some warnings, so be sure to talk to your child’s doctor about the medications. Some nasal conditions, such as nasal polyps or a history of nasal surgery, may affect how Nephate is absorbed. People with certain sulfite-related co-morbidities or allergies are advised to take extra precautions.

“If your child has abnormal nose anatomy, this may not be the right option for your child,” Dr. Crowther says. “Children who previously had food intolerances can still develop reactions to foods, so it’s important to recognize symptoms quickly.”

She also noted the importance of seeking emergency care after giving rescue epinephrine (by injection or nasal spray) because your child may need more treatment than the initial dose.

“Families should be more cautious and respond quickly whenever oral issues are involved, especially when they report that their mouth or throat is itchy.”