Needle-free Anaphylaxis Treatment

An intranasal presentation of adrenaline (epinephrine) is now available for the emergency treatment of severe allergic reactions, including anaphylaxis. Neffy® is not currently listed on the Pharmaceutical Benefits Scheme (PBS), although an application has been made which is due for consideration in March.

Neffy® is formulated with dodecyl-beta-D-maltoside (DDM). This excipient functions as an absorption enhancer to promote systemic bioavailability. Studies demonstrate that Neffy® achieves adrenaline blood levels and cardiovascular effects (i.e. increased blood pressure and heart rate) within the range observed with approved adrenaline injection devices.

Real-world evidence from over 500 patients experiencing anaphylactic symptoms show a successful treatment rate of 89.2% with a single Neffy® dose. This is comparable to the rates reported in meta-analyses where around 90% of patients were successfully treated with a single intramuscular dose of adrenaline.

Practical guidance:

• Neffy® should be prescribed as part of an anaphylaxis action plan.
• There are two strengths available. The 1mg device is for patients from four years of age weighing between 15kg and 30kg; the 2mg device is for patients 30kg or more.
• Patients and carers must be instructed on how to use the device correctly. Placebo demonstrator devices can be obtained from Allergy & Anaphylaxis Australia.
• Each device is ready-to-use and contains only one dose. The nasal spray must not be primed before use.
• A second device may be used to deliver an additional dose if clinical improvement is absent or deterioration occurs after five minutes of the first dose.
• Patients should be encouraged to always carry two devices.
• Patients must seek emergency medical care after using the device.