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Pronunciation: ne-fee
Generic name: epinephrine nasal spray
Dosage form: nasal spray (1 mg/0.1 mL, 2 mg/0.1 mL)
Drug classes: Adrenergic bronchodilators Catecholamines Vasopressors 

What is neffy?

neffy (epinephrine nasal spray) is used to treat severe allergic reactions, including anaphylaxis, in adults and children 4 years of age and older who weigh 33 lbs (15 kg) or more. 

  • Each neffy nasal spray for severe allergic reactions contains 1 dose of epinephrine.
  • There are 2 strengths:
    • 1 mg/0.1 mL of epinephrine per spray for children 33-66 lbs (15-30 kg) 
    •  2 mg/0.1 mL of epinephrine per spray for patients 66 lbs (30 kg) or greater.
  • Administer right away.
  • Can be self-administered or a caregiver can give it.

How does neffy work?

neffy’s mechanism of action for anaphylaxis is the same as epinephrine injections. It activates both alpha and beta receptors, which results in the following effects:

  • relaxes smooth muscle in the airways to help with breathing
  • narrows blood vessels and redirects blood flow to vital organs, such as the heart
  • maintains adequate blood pressure and increases heart rate
  • relaxes smooth muscles of the stomach and intestine to relieve digestive symptoms.

neffy FDA approval

neffy gained FDA approval on August 9, 2024, and is the first needle-free treatment for severe allergic reactions.

neffy cost

Eligible patients with commercial insurance pay as little as $25 with a neffy Copay card.

If you are uninsured or insured but without any government or commercial drug coverage for neffy and need help paying for it, you may be able to receive it at no cost through the neffy Connect Support Program.

neffy side effects

The most common side effects of neffy are:

  • 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

Always carry neffy with you because you may not know when anaphylaxis may happen. You should carry 2 neffy devices with you because you may need a second neffy nasal spray if symptoms continue or come back.

Talk to your healthcare provider about additional neffy nasal sprays to keep at work, school, or other locations. Tell your family members, caregivers, and others where you keep your neffy nasal spray 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 may aggravate angina or affect the heartbeat in people with heart disease.

neffy contains a sulfite but this should not stop people allergic to sulfites from using it. Talk to your healthcare provider about this.

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 33 pounds (15 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 .

Before using neffy

People with certain nasal conditions, such as nasal polyps or a history of nasal surgery, should talk to their healthcare provider before using neffy because these conditions may affect the absorption of 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 neffy Instructions for Use for detailed information about how to use the neffy nasal spray. 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 nasal spray 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 nasal sprays. You may need to use a second neffy nasal spray if symptoms continue or get worse.
  • You should always carry 2 neffy nasal sprays with you.

neffy dosing information

neffy is for use in the nose 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.

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.

Symptoms of 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).

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 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. See the neffy Prescribing Information for a full list of interactions.

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.

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 1 mg/0.1 mL or 2 mg/0.1 mL of epinephrine per spray.

Who makes neffy?

neffy is made by ARS Pharmaceuticals a pharmaceutical company based in San Diego, California. They specialize in the development of innovative drug delivery technologies, particularly focusing on emergency treatments.

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