Epinephrine Nasal Spray: A Leap Forward in Anaphylaxis Care
A panelist discusses how the newly FDA-approved intranasal epinephrine (Neffy) delivers blood concentrations and physiological responses comparable or superior to traditional intramuscular epinephrine administration methods.
Video content above is prompted by the following:
This segment introduces intranasal epinephrine (Neffy) as an alternative delivery method for anaphylaxis treatment. A polling question reveals varying familiarity levels among attendees: five are unfamiliar, six somewhat familiar, and some have reviewed the clinical data. Dr. Dixit explains that Neffy was recently approved in two dosages: 2mg for adults and children over 30kg, and 1mg for children 15-30kg (ages 4+). He notes that the 1mg pediatric formulation has just become available for prescription.
Dr. Dixit emphasizes Neffy's credibility through its components: the century-tested epinephrine medication, a delivery mechanism (Intravail technology) used in other nasal sprays, and a device identical to Narcan that has proven field reliability. He then presents pharmacokinetic data comparing Neffy to intramuscular (IM) injections and EpiPen. The graphs show Neffy achieving similar or superior mean epinephrine blood concentrations compared to standard delivery methods, with particularly robust early concentration levels critical for anaphylaxis treatment.
The presentation then examines physiological effects, showing that Neffy demonstrated comparable or better responses in systolic blood pressure, diastolic blood pressure, and heart rate compared to IM epinephrine. Dr. Dixit notes that while not all differences reached statistical significance, Neffy performed at least as well as traditional IM administration, which has been the clinical standard for years. He then highlights a Japanese study examining Neffy's effectiveness in 15 pediatric patients experiencing grade 2 or worse reactions during food challenges, providing real-world clinical evidence of efficacy.
