Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

1. Adrenalin
2. Neffy

Descriptions

Epinephrine nasal spray is used for emergency treatment of severe allergic reactions, including anaphylaxis.

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

• Spray
• Solution

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of epinephrine nasal spray in children. However, safety and efficacy have not been established in children weighing less than 30 kilograms (kg).

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of epinephrine nasal pray in the elderly. However, elderly patients are more sensitive to the effects of this medicine and more likely to have unwanted effects, which may require caution in patients receiving this medicine.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Dihydroergotamine
• Isocarboxazid
• Linezolid
• Phenelzine
• Tranylcypromine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acebutolol
• Acecainide
• Adenosine
• Ajmaline
• Amiloride
• Amineptine
• Amiodarone
• Amitriptyline
• Amitriptylinoxide
• Amoxapine
• Amphetamine
• Aprindine
• Atenolol
• Bemetizide
• Bendroflumethiazide
• Benperidol
• Benzthiazide
• Bepridil
• Betaxolol
• Bisoprolol
• Bretylium
• Bromocriptine
• Bromperidol
• Bucindolol
• Bumetanide
• Canrenoate
• Canrenone
• Carteolol
• Carvedilol
• Celiprolol
• Chlorothiazide
• Chlorthalidone
• Clomipramine
• Clopamide
• Cyclopenthiazide
• Cyclothiazide
• Desipramine
• Dextroamphetamine
• Diazoxide
• Dibenzepin
• Digoxin
• Dilevalol
• Disopyramide
• Dixyrazine
• Dofetilide
• Doxepin
• Dronedarone
• Droperidol
• Encainide
• Entacapone
• Eplerenone
• Ergoloid Mesylates
• Ergonovine
• Ergotamine
• Esmolol
• Ethacrynic Acid
• Etozolin
• Fexofenadine
• Flecainide
• Fluphenazine
• Furosemide
• Haloperidol
• Halothane
• Hydrochlorothiazide
• Hydroflumethiazide
• Hydroquinidine
• Ibutilide
• Imipramine
• Indapamide
• Indecainide
• Iobenguane I 123
• Labetalol
• Levalbuterol
• Levobunolol
• Lidocaine
• Lisdexamfetamine
• Lisuride
• Lofepramine
• Loxapine
• Melitracen
• Melperone
• Metergoline
• Methdilazine
• Methotrimeprazine
• Methyclothiazide
• Methylene Blue
• Methylergonovine
• Methysergide
• Metipranolol
• Metolazone
• Metopimazine
• Metoprolol
• Mexiletine
• Milnacipran
• Moperone
• Moricizine
• Nadolol
• Nebivolol
• Nicergoline
• Nortriptyline
• Opicapone
• Opipramol
• Oxprenolol
• Ozanimod
• Penbutolol
• Perazine
• Periciazine
• Perphenazine
• Phentolamine
• Pindolol
• Pipamperone
• Piperazine
• Pipotiazine
• Piretanide
• Polythiazide
• Practolol
• Prajmaline
• Procainamide
• Procarbazine
• Prochlorperazine
• Promazine
• Promethazine
• Propafenone
• Propiomazine
• Propranolol
• Protriptyline
• Quinethazone
• Quinidine
• Rasagiline
• Safinamide
• Selegiline
• Sotalol
• Sparteine
• Spironolactone
• Tedisamil
• Terfenadine
• Tertatolol
• Thiethylperazine
• Thioproperazine
• Thioridazine
• Tianeptine
• Timolol
• Tocainide
• Torsemide
• Triamterene
• Trichlormethiazide
• Trifluoperazine
• Trifluperidol
• Triflupromazine
• Trimipramine
• Verapamil
• Vernakalant
• Xipamide
• Zavegepant

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Diabetes or
• Heart or blood vessel disease (eg, coronary artery disease) or
• Heart rhythm problems or
• Hypertension (high blood pressure) or
• Hyperthyroidism (overactive thyroid) or
• Hypokalemia (low potassium levels in the blood) or
• Injury to the nose, history of or
• Kidney disease or
• Nasal polyps or
• Nose surgery, history of or
• Parkinson's disease—Use with caution. May make these conditions worse.

Proper Use

Use this medicine only as directed by your doctor. Do not use more of it and do not use it more often than your doctor ordered. To do so may increase the chance of side effects.

Call for emergency help right away after the first dose of this medicine.

This medicine comes with patient information leaflet and patient instructions. Read and follow these instructions carefully. Read it again each time you refill your prescription in case there is new information. Ask your doctor or pharmacist if you have any questions.

Use each nasal spray only one time. Do not test spray or prime the plunger before use.

Do not sniff during or after the dose is given. If any liquid drips out of the nose, you may need to give another dose of this medicine.

If symptoms continue or get worse, you may need to use more than one nasal spray. It should be given in the same nostril 5 minutes after the first dose.

Carry this medicine with you at all times for emergency use in case you have a severe allergic reaction. It is recommended that you carry 2 Neffy® devices.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For nasal dosage form (spray):
  • For allergic reactions:
    • Adults and children weighing 30 kilograms (kg) or more—One spray in one nostril as needed. Each spray contains 2 milligrams (mg) of epinephrine.
    • Children weighing less than 30 kg—Use and dose must be determined by your doctor.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Do not freeze. If the spray is frozen and is needed in an emergency, do not wait for the spray to thaw.

Precautions

Anaphylaxis is a life-threatening reaction and requires immediate medical attention. Check with your doctor right away, or go to an emergency room as soon as possible, even if you feel better after using this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

1. Shakiness in the legs, arms, hands, feet
2. trembling or shaking of the hands or feet

Incidence not known

1. Anxiety
2. blurred vision
3. chest pain or discomfort
4. confusion about identity, place, and time
5. dizziness
6. dry mouth
7. fainting
8. fast, irregular, pounding, or racing heartbeat or pulse
9. fast, slow, or irregular heartbeat
10. flushed, dry skin
11. fruit-like breath odor
12. headache
13. increased hunger
14. increased thirst
15. increased urination
16. nausea
17. nervousness
18. pale skin
19. panic
20. pounding in the ears
21. restlessness
22. sleepiness
23. stomach pain
24. stroke
25. sweating
26. swelling of the feet or lower legs
27. trouble breathing
28. trouble remembering
29. unexplained weight loss
30. unusual tiredness or weakness
31. vomiting

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

1. Feeling jittery
2. throat irritation
3. runny nose

Less common

1. Gum pain
2. sneezing
3. stuffy nose

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Portions of this document last updated: Oct. 01, 2024

Original article: https://www.mayoclinic.org/drugs-supplements/epinephrine-nasal-route/precautions/drg-20572412