People who have serious allergies are often given a medicine called epinephrine to use during an emergency. Before 2024, all approved epinephrine products had to be injected into the body. Now there is another option available, called Neffy, which is sprayed into the nose.
How Does Neffy Work for an Allergic Reaction?
Allergic reactions happen when the body’s immune system overreacts to the presence of a specific substance. The substance that causes this reaction is called an allergen. There are many different types of allergens. Some of the more common allergens are foods, drugs, pollen, and animals.
In many cases, allergic reactions can be mild. Mild allergic reactions may include watery eyes, runny nose, sneezing, and skin reactions (such as a rash or hives). In other cases, allergic reactions can be very serious. Serious allergic reactions, called anaphylaxis, can be life-threatening. These reactions can include the following symptoms:
- A sense that something bad is about to happen
- Dizziness or fainting
- Itchy skin reactions such as a rash or hives
- Stomach pain, nausea, and vomiting
- Swelling of the lips, tongue, or throat, which can make it difficult to breathe
- Very low blood pressure
The best way to prevent an allergic reaction is to avoid the allergen. If you have a drug allergy, you should make sure you are familiar with all of the names for that drug and review drug labels before use. If you have a food allergy, you should review all ingredients on food labels. When eating in a restaurant, you should ask how the food is prepared and whether it may have been exposed to any allergens.
In case a serious allergic reaction does happen, it is important to always have an emergency medicine with you. Neffy contains epinephrine, which acts on certain receptors in the body called alpha- and beta-adrenergic receptors. By acting on these receptors, Neffy causes the blood vessels to narrow, which increases blood pressure, opens the airways, and reduces swelling. It also reduces the amount of histamine released by the body, which is the chemical that causes itchy skin reactions.
How Do I Use It During an Emergency?
Neffy is an emergency medicine that should be given only during an allergic reaction. In some cases, the person experiencing the allergic reaction can give themselves the dose. In other cases, someone nearby may need to give the dose. The dose can be given regardless of whether the person is sitting, standing, or lying down.
To give a dose of Neffy, follow these steps:
- Remove the Neffy device from its packaging.
- Place the device in your hand so that one finger rests on either side of the nozzle (the part of the device that is placed into the nostril) and your thumb rests on the plunger at the bottom of the device. The nozzle should be faced upward.
- Insert the nozzle into a nostril. Keep pushing it up into the nostril until your fingers touch the nose. Make sure that you keep the nozzle pointed upwards, towards the person’s forehead. It should not be allowed to point towards either side of the nose.
- Press the plunger upward with your thumb until you feel it snap up. This will force a spray of liquid (one dose) into the nostril. The person receiving the dose should not sniff or inhale deeply during or immediately after the dose.
If symptoms keep getting worse after the first dose, a second dose may be needed. This is why each prescription of Neffy comes with two devices, each with one dose. Do not give a second dose until at least 5 minutes after the first dose. If a second dose is needed, make sure that it is given into the same nostril as the first dose. Your health care provider will teach you how to tell if a second dose is needed. They will also teach you how to tell whether you need to get medical help after using the medicine.
It is important not to accidentally press on the plunger before the nozzle is in the nostril. Once you have used a dose of Neffy, throw the device into the trash.
Can Anyone Use Neffy to Treat a Serious Allergic Reaction?
Neffy is only approved for people who weigh at least 66 pounds (30 kilograms). If you or your child weighs more than 66 pounds, Neffy may be an option for the treatment of serious allergic reactions. If your child weighs less than 66 pounds, they will need to use an injected epinephrine product instead, such as Auvi-Q or EpiPen .
Neffy has not been studied in people with structural changes to the nose, so it isn’t known if people with these changes will get a full dose of the medicine. Some examples include nasal polyps, surgery on the nose or nasal passages, or history of a broken nose or other injury. Let your health care provider know if you have any of these structural changes. They may recommend using an injected epinephrine product instead.
Is There Anything I Should Know About Neffy Before Using It in an Emergency?
Since an allergic reaction can happen anywhere, at any time, you should always have two doses of Neffy with you. Make sure that family, friends, caretakers, teachers, co-workers, or anyone else who may be able to help during an emergency knows where it’s stored and how to use it.
Each dose of Neffy comes in a package that can fit inside of a pocket. This package has step-by-step instructions printed on the back, which can be helpful to use during an emergency. It is important to make sure that your Neffy is still in good, usable condition at all times by checking the expiration date regularly. This way you can order a replacement before it expires.
How Was Neffy Studied for Treating Serious Allergic Reactions?
It is already well understood that epinephrine helps to treat serious allergic reactions. Since Neffy contains epinephrine, there were no clinical studies done to confirm that it works for serious allergic reactions. Instead, clinical studies were done to see whether Neffy moves through the body the same way as injected epinephrine, and also whether people were able to use Neffy correctly.
Three studies measured the levels of epinephrine in the body after a dose of Neffy. Everyone in these studies was between 19-55 years of age, and most (70%) were male. Only two of the studies reported the race of each person. In those two studies, most (64%) were White, 24% were Black, 7% were Asian, and less than 1% were Native Hawaiian or Pacific Islander. The race of the other people in these studies was not reported. Here is some other important information about these three studies:
- Two of the studies compared Neffy (a nasal spray) with an injected epinephrine product. In one of these studies, everyone was generally healthy. In the other study, everyone had nasal allergies (allergic rhinitis). Some people used Neffy and other people used injected epinephrine. These studies compared the levels of epinephrine in the body.
- One study included adults who were sick with an airway infection at the time of the study. In this study, everyone used a dose of Neffy while they were sick. Once they were no longer sick, they used another dose of Neffy. The study compared the levels of epinephrine in the body after each of these doses.
Two studies asked adults and children to use Neffy in a simulated (fake) emergency to see if they were able to follow the instructions and deliver a dose correctly. During the fake emergency, some people were told to give themselves a dose and others were told to give a dose to someone else. About half of the people in these studies had never used any type of nasal spray before.
What Did These Studies Find?
- Did the nasal spray work differently than the injection? The people who used Neffy and the people who used injected epinephrine had similar levels of epinephrine in their blood. They also had similar increases in blood pressure and heart rate, and these lasted for about the same amount of time. This means that the nasal spray and the injection move through the body in a similar way.
- Did Neffy work differently in people with nasal allergies or an airway infection? Neffy worked similarly in everyone, regardless of whether they had nasal allergies or an airway infection. In the people who used Neffy while they were sick with an airway infection and again after they had recovered, Neffy worked similarly both times. This means that the nasal spray can deliver a full dose of medicine even if you are sick or have nasal allergies.
- Were people able to follow all of the steps to give the nasal spray? Everyone (100%) who used Neffy during a fake emergency was able to follow the instructions and give the dose correctly.
How Can I Tell If It’s Working?
Although Neffy should work very quickly, it is not always possible to tell right away whether it is working. If your symptoms continue to get worse more than 5 minutes after the first dose, you may need a second dose. Some people who are having a serious allergic reaction may need other treatments, so you may need to seek medical care by calling 911 or going to a hospital. Your health care provider will teach you how to tell if you need a second dose or if you need to seek medical help.
How Can I Prevent and Manage Side Effects?
Since Neffy is a nasal spray, it can cause some discomfort in the nose or throat, as well as an itchy or runny nose. Some people have also gotten a headache after using Neffy. These side effects are more likely to happen if two doses are needed during a single emergency. All of these issues are generally mild and will go away soon after using Neffy.
Some of the possible side effects of Neffy are similar to the symptoms of an allergic reaction. It may not always be possible to tell whether these symptoms are caused by the medicine or the allergic reaction. Even if you have experienced side effects from an epinephrine product before, you should still use epinephrine during a serious allergic reaction.
Are There Any Interactions With Other Medicines?
Several medicines may affect the way that Neffy works. But no matter what medicines you are taking, you should still use Neffy during a serious allergic reaction.
The levels of other medicines that are sprayed into the nose may be increased for up to 2 weeks after using Neffy, which can increase your risk for side effects. Speak with your health care provider about any other nasal sprays that you use. They will help you come up with a plan to use those medicines safely.
Are There Any Special Steps Required to Get Neffy?
Neffy is available through a special program provided by a company called BlinkRx. Your health care provider can send your prescription to BlinkRx, which will then mail your prescription directly to you.
Is There a Coupon Card Available?
There is a savings coupon available from the manufacturer that may allow you to pay as little as $25 for your prescription. Whether you are eligible depends on whether you have prescription insurance and what type of insurance you have. You can find out more at www.neffy.com/savings-and-support/.
