What to know
- Canada has approved “Neffy,” a needle-free epinephrine nasal spray, giving people with severe allergies an alternative to EpiPens and potentially helping address medication supply shortages.
- Parents and doctors say more options are crucial, especially during anaphylaxis when fear of needles or hesitation can delay treatment. Neffy may also make it easier for children, caregivers, and teachers to administer epinephrine.
- Neffy is approved for adults and children weighing at least 30 kg, or around 66 lbs, and is available by prescription. It delivers 0.2 mg of epinephrine and is designed to work as quickly and effectively as an autoinjector.
- For families managing food allergies, the nasal spray could reduce stress and improve inclusion, with parents saying easier administration may help children participate more safely in everyday activities and feel less different from their peers.
Those with severe allergies may now be able to use an alternative way of administering life-saving medication after a new epinephrine delivery method was approved in Canada this year.
A nasal spray device will now give those who need to carry epinephrine an alternative to EpiPens, enabling noninvasive administration of the drug.
Solving a supply shortage issue
Allergist and clinical immunologist Dr. Mariam Hanna said that having different methods for administering a life-saving medication is not only helpful but crucial.
“Our national organization has lobbied for years to say it’s important [to have multiple options] because when one medication goes on back order or is not available, we’re kind of stuck in Canada with a needle and syringe,” Hanna told Now Toronto.
The EpiPen, an autoinjector that administers epinephrine through a needle to combat anaphylaxis, was approved initially for use by Health Canada in the 1980s. Since then, the EpiPen has been the sole medication available for use against severe allergic reactions.
Over four decades later, the country is finally receiving a new and approved method to administer epinephrine.
Lainey Chodirker is a mother of two young boys who are both allergic to multiple foods and has a supply of multiple EpiPens. Chodirker agrees with Hanna, saying that accessibility to the medication is important.
“Having a stable supply is so important,” she said, explaining that historically families have gone to the pharmacy to purchase EpiPens and found none available.
“So another source of supply is so important to keep everyone safe.”
Chodirker says she and her husband are always on high alert to keep their sons safe. Both boys are allergic to dairy, egg, sesame, soy, peanuts, tree nuts, fish, shellfish, and garlic.
Chodirker’s sons were diagnosed around the age of six months. With them now being four and eight years old, she says being able to give them the same childhood as kids without allergies requires more planning and vigilance in their family’s day-to-day.
“[At an event] we bring food from home, and I try as best as I can to match the things that I’m bringing to what’s being served; we’re going to make sure the kids feel included,” she explained.
“But it’s not just about what they’re eating, especially when kids are little. It’s about what the other kids are eating, and are they all touching the same toys and playing together,” she continued, explaining that this raises the risk of one of her children having an allergic reaction because of food residue on a toy or a play structure.
Fear of the needle
Data from a poll conducted by OnePoll for ALK Canada showed that nearly half of the 2,000 participants studied said they would feel uncomfortable administering epinephrine with an autoinjector.
This sentiment is something Chodirker can relate to. The mother has had to administer both of her son’s EpiPens multiple times, with the most recent incident happening just a few months ago.
She said the needle in the EpiPen can be scary, especially for her two young boys.
“The little one doesn’t quite know that he’s carrying needles around with him all day long. He knows it’s his rescue medicine, but he doesn’t know what it is,” Chodirker explained.
“I think we try to shield them a little bit from what exactly the mechanism is because we just don’t want to add any more fear to the situation.”
And as for Chodirker and her husband, the aspect of a needle can add fear to an already intense and stressful situation.
“When a reaction is starting, there’s a lot of fear that comes with what that reaction can turn into. So it’s an adult recognizing, ‘this is what needs to happen,’ and just doing it,” she said.
Health Canada’s move to approve “Neffy”, the epinephrine nasal spray, can ease worries like Chodirker’s.
“With Neffy, as the onus shifts to the children to self-administer as they become teenagers and adults, there can be that hesitation because of the needle, so having another option is so incredibly important,” she shared.
She also added that being away from her children won’t be as stressful.
“Thank God the kids have been with me every time [we’ve administered] because you always wonder if they’re with a teacher or someone else; would they have that same urgency?” she said.
For those dealing with severe allergic reactions, a quick response time is key when administering epinephrine.
Removing the needle helps to eliminate fear-related delay when administering the medication.
“Anything to help the person in charge not hesitate is a positive,” Chodirker said.
Who is Neffy available to?
The Neffy medication was bought by ALK Canada, giving them the rights to distribute it.
Currently, the single-use nasal spray has been approved for adults and young patients who weigh 30 kilograms, or around 66 lbs, and up. The nasal spray is now available by prescription.
How effective is the medication?
Neffy carries about 0.2 milligrams of epinephrine, while a standard EpiPen carries 0.3 milligrams. Hanna said that the nasal spray works just as quickly and effectively as an autoinjector.
“[With the EpiPen] It’s going into a large muscle group. From there, it’s absorbed into your bloodstream, and it’s picked up and distributed throughout your body. The nasal epinephrine… is a spray that is then absorbed into your bloodstream as well… they get in at the same amount [of time],” she explained.
She added that Health Canada can only approve various types of administrators for medication if they show the same speed and response to what is currently available. Additionally, the nasal spray is still effective for patients whose sinuses are experiencing congestion.
In terms of side effects, the nasal spray can have similar repercussions as the EpiPen, including a fast or pounding heartbeat, shaking, anxiety, dizziness, sweating, headache, paleness, and nausea. An additional side effect may be irritation in the nasal passage or throat.
“Most people find that there is no discomfort with using it. This is one of the rare ones that’s been reported in the studies,” Hannah reassured.
Importance behind inclusion
With the latest way to keep those with food allergies safe, Chodirker said having more treatment options can help make managing related emergencies less intimidating.
“The food allergy community is really excited that more options are coming to Canadians,” she said. “Options that can help anyone overcome any sort of hesitation or fear around administering life-saving drugs are a huge positive.”
She added that she hopes more awareness of food allergies and new treatment options will also help children with allergies feel more included.
“I think recognizing there are more options and just to have more Canadians be aware to facilitate moments of inclusion and awareness is so important.”
