Health Canada has approved neffy, a needle-free epinephrine nasal spray designed to treat anaphylaxis, a serious allergic reaction that can be life-threatening. This marks the first major innovation in anaphylaxis treatment in over 35 years and addresses a significant problem: approximately 2.5 million Canadians live with severe allergies, yet research shows that half of those prescribed emergency epinephrine auto-injectors do not consistently carry them, and about half do not use them when needed .

Why Are People Avoiding Their Emergency Allergy Treatment?

The gap between those at risk of anaphylaxis and those who actually use their prescribed treatment is a serious public health concern. Many patients and caregivers hesitate to carry or use traditional epinephrine auto-injectors due to needle fear and uncertainty about correct administration. Anaphylaxis can occur within minutes of exposure to allergens like peanuts, tree nuts, shellfish, milk, eggs, insect stings, or medications, making rapid treatment critical to survival .

"The gap between those who have severe allergies and are at risk for anaphylaxis, and those who actually carry self-administered epinephrine is a serious issue. Anaphylaxis can occur within minutes of exposure to allergens and rapid treatment with epinephrine is critical to treatment success. However, many patients and caregivers don't carry their epinephrine autoinjector or hesitate to use it, often due to needle fear and uncertainty about correct administration. A needle-free nasal spray that people can use confidently and easily may help improve how quickly and effectively people respond to an anaphylactic reaction," explained Dr. Anne Ellis, allergist and chair of the division of allergy and immunology at Queen's University.

Dr. Anne Ellis, Allergist and Chair of Division of Allergy and Immunology, Queen's University

How Does neffy Work and What Makes It Different?

neffy is a portable nasal spray that delivers a 2 mg dose of epinephrine through the nasal lining, where it is absorbed quickly and predictably. Unlike traditional auto-injectors, neffy requires no needle, no priming, and no special storage requirements. It has a 30-month shelf life and can withstand temperature excursions up to 50 degrees Celsius (122 degrees Fahrenheit), making it far more durable than conventional epinephrine auto-injectors .

The approval was based on extensive clinical evidence. The development program generated more clinical data than any other epinephrine device, with over 1,100 administrations tested in more than 700 participants. Clinical studies showed that neffy delivered consistent results across real-world scenarios, including single and repeat doses, self-administration, use in children, and situations where people had nasal congestion from colds or allergies .

What Are the Safety Concerns and Side Effects?

No serious side effects were reported during clinical trials. The most frequently occurring adverse reactions appeared only after a second 2 mg dose (totaling 4 mg) and included throat irritation, headache, nasal discomfort, and feeling jittery. These side effects were mild and temporary .

• Throat Irritation: Reported in 18.8% of participants who received a second dose
• Headache: Occurred in 17.6% of participants after a second dose
• Nasal Discomfort: Experienced by 12.9% of participants receiving a second dose
• Jittery Feeling: Reported in 10.6% of participants after a second dose

Key Advantages Over Traditional Auto-Injectors

neffy offers several practical advantages that may encourage people to carry and use their emergency epinephrine. The spray is pocket-sized and portable, eliminating the bulk of traditional auto-injectors. Its extended shelf life and temperature tolerance mean it does not require special storage conditions or frequent replacement. Most importantly, the needle-free design removes a major barrier to use for people with needle phobia .

When Will neffy Be Available and Who Can Use It?

neffy is approved for adults and pediatric patients who weigh 30 kilograms (approximately 66 pounds) or greater. It is indicated for emergency treatment of allergic reactions caused by insect stings or bites, foods, medications, and other allergens, as well as idiopathic or exercise-induced anaphylaxis. The medication is expected to be available in Canadian pharmacies in summer 2026. In the meantime, Canadians can register for notifications at www.neffy.ca .

Beyond Canada, neffy has already been approved in the United States, Japan, the European Union, and the United Kingdom, where it is known as EURneffy .

What This Means for the Future of Allergy Care

The approval of neffy represents a significant shift in how severe allergies are managed. By removing barriers to carrying and using emergency epinephrine, the innovation has the potential to save lives. Epinephrine is the only medication proven to reduce hospitalization and death from anaphylaxis, and rapid administration is critical. A more accessible, user-friendly delivery system may help close the gap between those at risk and those who are actually prepared to respond to a life-threatening allergic reaction .

For the approximately 2.5 million Canadians living with severe allergies, neffy offers a new option that prioritizes both safety and ease of use. As the medication becomes available over the coming months, it may fundamentally change how people approach emergency allergy preparedness.