Intranasal Epinephrine Found to Effectively Treat Most Allergic Reactions with a Single Dose: Daily Dose

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On November 13, 2025, we reported on findings from a real-world study presented at the 2025 American College of Allergy, Asthma & Immunology (ACAAI) Annual Scientific Meeting that suggested intranasal epinephrine spray (neffy) may offer an effective, needle-free alternative for treatment of severe allergic reactions.

The study

Researchers conducted an experience-program survey to evaluate the use of the FDA-approved intranasal epinephrine 2 mg spray in clinical practice settings.

The findings

Among 2947 health care professionals (HCPs) participating in the survey, 375 reported administering the intranasal spray in a combined 680 patients who experienced allergic reactions, including anaphylaxis following oral food challenges (OFCs) or allergen immunotherapy.

According to survey responses:

• 603 of 680 patients (88.7%) were effectively treated with a single dose of intranasal epinephrine.

• 77 patients (11.3%) required a second dose, a rate comparable to published reports for food-induced anaphylaxis (11.1%) and lower than rates reported following allergen immunotherapy (30.5%).

Authors' comments

"Intranasal epinephrine demonstrated clinical efficacy comparable to that expected for epinephrine injection products and was judged easy to use by both HCPs and patients. Thus, it is an effective alternative to injectable epinephrine."

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