How to Administer Neffy — Plus 5 Other Tips to Maximize This Emergency Allergy Treatment

Allergic reactions can be life-threatening. But swift treatment with the right medication helps prevent the unthinkable.

Neffy (epinephrine) is a newer medication to consider keeping on hand. It's the first non-injectable form of epinephrine available for use. It treats severe Type 1 allergic reactions, including anaphylaxis, in adults and children who weigh 66 lbs (30 kg) or more. It can quickly treat symptoms such as swelling, difficulty breathing, and low blood pressure.

Neffy comes in a two-pack of nasal sprays, each delivering a single 2 mg dose of epinephrine. It's convenient, but how to administer it might not be common sense at first. Here, we'll guide you through how to use neffy - including a few common mistakes to avoid.

1. A step-by-step guide for administering neffy

For many people, neffy is a less intimidating treatment option than injectable epinephrine. But it's still important that you know how to use neffy as directed for maximum benefit.

Here's how:

1. Remove neffy from its packaging.

2. Hold the nasal spray by placing the base of the nozzle between your index and middle fingers. Support the bottom of the spray bottle with your thumb.

3. Insert the nasal spray nozzle into one of your nostrils. If you're spraying neffy into your right nostril, use your right hand. Use your left hand if you're spraying it into your left nostril. Once your index and middle finger touch your nostril, you don't need to insert the nozzle any further. Make sure that you hold the nasal spray straight into the nose. Don't aim neffy toward the inner or outer wall of your nostril.

4. Press the plunger in firmly to administer the dose into your nostril. Try to avoid sniffing after administering the dose. Remove the nozzle from your nose.

5. Call 911 or head to your nearest ER. Severe allergic reactions typically need medical attention even after epinephrine is administered.

6. If your symptoms don't start to improve, a second dose can be administered into the same nostril after 5 minutes, if needed. Don't administer more than 2 doses without guidance from a healthcare professional or emergency responder.

Emergency allergic reactions can feel scary or anxiety-inducing. But try your best to remain calm during this process. Following these steps exactly and seeking prompt medical help can help you put the situation in the rear-view mirror.

2. Common mistakes people make while administering neffy

Mistakes can happen with any medication. Here are some of the most common neffy administration errors and how to avoid them.

• Not pressing firmly enough: If the plunger isn't pressed firmly, the full dose of epinephrine might not be delivered. This can make the treatment less effective. Be sure to press in all the way when administering your dose.

• Using neffy too late: In the case of an emergency, every minute counts. Some people wait too long to use neffy, hoping their symptoms will go away on their own. It's important to act fast at the first sign of a potential reaction.

• Forgetting to call 911: Neffy is effective, but it's a temporary solution. Some people think they're good to go after using neffy, but symptoms of an allergic reaction can return. Always seek emergency medical attention immediately after administering neffy.

• Using neffy after it has expired: Like with any medication, neffy and other epinephrine products have expiration dates. Expired products may not be as effective. It's helpful to regularly check that your spray bottles aren't expired and to replace them when needed.

• Using the same device for a second dose: Each device delivers a single dose of neffy. If a second dose is needed, it's important to use the second nasal spray included in neffy's packaging.

Avoiding these mistakes can make all the difference in the case of an emergency. Be sure to address any questions or concerns with a healthcare professional so you can be prepared if you need to use neffy.

3. Neffy's side effects are generally temporary

Neffy effectively treats allergic reactions. But it may still cause some side effects. These side effects are generally mild and temporary.

Common neffy side effects include:

• Throat irritation

• Nasal discomfort

• Headache

• Increased heart rate

• Nervousness or anxiety

• Dizziness

Most side effects go away within about 30 minutes, but others can last a couple weeks. Be sure to let your prescriber know about any bothersome side effects you notice.

4. Use caution with other nasal products for 2 weeks after administering neffy

It's ideal to avoid using other nasal products for 2 weeks after you use neffy. These include over-the-counter (OTC) nasal decongestants, corticosteroids, and prescription nasal medications. This is because tissue in your nose can be more sensitive following exposure to epinephrine.

When nasal tissues are more sensitive than usual, they can absorb greater amounts of medication from other nasal products. This heightened absorption may increase the likelihood of experiencing side effects from these sprays.

If you must use another nasal product during this timeframe, be sure to ask a healthcare professional first.

5. Neffy is different from EpiPen and Auvi-Q

While neffy, EpiPen (epinephrine), and Auvi-Q (epinephrine) are all used for severe allergic reactions, they're different in how they deliver a dose. Neffy is a nasal spray, while EpiPen and Auvi-Q are injections.

Here's a product-by-product breakdown:

• Neffy: A nasal spray that delivers epinephrine through the nose. Neffy is needle-free and easier for some people to use - especially kids and people uncomfortable with injections.

• EpiPen (and EpiPen Jr): Auto-injectors that deliver epinephrine through a needle. EpiPen must be injected into the thigh.

• Auvi-Q: An auto-injector that's paired with voice instructions. The device guides users through the injection process.

Good to know:Adrenaclick and Symjepi are other injectable epinephrine products. But they're no longer available as brand-name medications.

6. Who shouldn't use neffy

Neffy is safe for most people experiencing anaphylaxis, but not everyone should use it. A healthcare professional may avoid prescribing neffy to you or your child if any of these restrictions are applicable:

• Children who weigh less than 66 lbs: Neffy isn't recommended for smaller children. The dosage may not be safe for them. However, a lower-dose version of neffy is being evaluated and may be available as soon as 2025 for children weighing as little as 33 lbs.

• People with nasal blockages or severe nasal injuries: Since neffy is a nasal spray, people who have blocked or damaged nasal passages might not receive the full dose of epinephrine. An injectable epinephrine product may be a better option in this case.

• People with certain eye conditions: Neffy can constrict (or tighten) the blood vessels in your eyes. This can be especially risky for people with angle-closure glaucoma, an eye condition where the pressure in your eye is increased. If you have this form of glaucoma and are at risk for severe allergic reactions, consider discussing alternative treatments with a healthcare professional.

People with heart conditions may want to use caution with neffy too. This is because neffy can raise your blood pressure and heart rate. But you may not need to avoid it altogether. If you have certain heart conditions, such as uncontrolled high blood pressure or an irregular heart rhythm (arrhythmia), it's important to monitor your heart rate and blood pressure after using neffy.

People living with health conditions such as hyperthyroidism, Parkinson's disease, or diabetes should also use caution with neffy. The medication can temporarily exacerbate these conditions.