Adrenaline rush: An alternative to epinephrine

An adrenaline rush is a colloquial phrase about the feeling of exhilaration and heightened energy that is brought on by an exciting or stressful situation resulting in the release of the hormone epinephrine. Adrenaline is another term for epinephrine and is often referred to as our fight or flight response. When epinephrine is released in the body it is preparing us for immediate action by increasing our heart rate, blood pressure, breathing rate, and blood sugar. It helps divert blood to our muscles and brain. Medically, we use epinephrine to stimulate the heart during CPR or reverse an allergic (anaphylaxis) reaction in the body. Allergies can be severe and result in a tightening of the chest and throat, making it difficult to breathe. It is estimated between 2-5% of Americans have suffered an allergic reaction requiring rescue with epinephrine. If you or a loved one suffers from severe allergic reactions, known as anaphylaxis, then you know how important it is to have access to fast-acting and lifesaving medication. Epinephrine is the standard treatment for anaphylaxis, and is usually given as an injection in the thigh. Epinephrine works quickly in about 5-10 minutes for full effect, but it wears off in 20-30 minutes. This is why it is important to call 911 when administering an epinephrine. For many, the hardest part about an epinephrine pen is the fear of the needle even though with many of the systems, you actually never see the needle. With a fear of needles, there is a new innovation in allergy treatment called neffy. Neffy is epinephrine given as a nasal spray. This new option offers an alternative to the injection and could be a gamechanger for patients with anaphylaxis. The FDA approved this nasal spray in August of 2024, but the product is hitting the shelves in 2025. A review published in Pharmaceutics looked at the safety, effectiveness, and user experience of the intranasal epinephrine spray, within real-world settings. The review discussed how neffy is quickly taken up into the bloodstream, achieving similar results as the injection-based methods. Neffy was found to be as effective as injectable epinephrine in treating severe allergic reactions and providing symptom relief in a short time. One key advantage noted by study participants was the overall ease of use. Many patients reported more confidence with using the nasal spray compared to the injection, especially in high stress situations. Neffy is a nasal spray formulation of epinephrine that is designed to provide rapid relief during severe allergic reactions, such as those triggered by food allergies. Unlike traditional epinephrine devices, neffy delivers the medication via nasal tissues, offering a needle free option for those at risk of anaphylaxis. Neffy comes in a ready-to-use pump spray containing epinephrine. The pump is placed in the nostril, no matter the position of the person (standing, sitting, lying down). It is recommended to place the device up into the nostril and spray. When filling a prescription for neffy, make sure to ask for 2 pumps because if the first spray does not start working in 5 minutes, you would spray the second pump in the SAME nostril as the first. Make sure to call 911 with use. Why is neffy important to you? This medication allows those at risk for anaphylaxis to have multiple options for epinephrine delivery. Whether at home, school, or traveling, this needle-free option could provide you with peace of mind. Key benefits of neffy include needle-less delivery for ease of administration in high stress situations, fast-acting with absorption within minutes after a quick spray into the nose, and a familiar formulation that works the same as traditional epinephrine, ensuring it works quickly to reverse the symptoms of anaphylaxis. Neffy is an important adrenaline rush up the nose! For individuals with a history of severe allergic reaction, reach out to your pharmacist or health care provider for more information. Alexis Nicoson is a student pharmacist at Ohio Northern University. Karen Kier is a pharmacist with Ohio Northern University HealthWise Pharmacy.