No More Needles: Canada Approves a Nasal Spray to Treat Severe Allergic Reactions

Summary

Canada has approved neffy®, the first needle-free epinephrine nasal spray for treating anaphylaxis. The device could improve access and ease of use for millions living with severe allergies, with a rollout expected in summer 2026.

A needle-free epinephrine spray could be a game-changer for the 2.5 million Canadians living with life-threatening allergies.

For decades, the go-to emergency treatment for anaphylaxis has been an epinephrine auto-injector, a device many people find intimidating, fail to carry, or hesitate to use when seconds count. That’s about to change. 

Health Canada has approved neffy®, the first needle-free epinephrine nasal spray for the emergency treatment of anaphylaxis, marking the most significant shift in how severe allergic reactions are treated in over 35 years.

The approval covers neffy® 2 mg for the emergency treatment of allergic reactions due to insect stings or bites, foods, medications, and other allergens, as well as idiopathic or exercise-induced anaphylaxis, in adults and children weighing 30 kg or more. 

Why This Matters

The gap between who needs epinephrine and who actually uses it has long been a serious public health problem. Research shows that half of those living with a life-threatening allergy do not consistently carry their prescribed epinephrine auto-injector, and approximately half do not administer it when needed in an emergency. Needle fear and uncertainty about correct administration are frequently cited as reasons.

Dr. Anne Ellis, allergist and chair of the division of allergy and immunology at Queen’s University, noted that anaphylaxis can occur within minutes of allergen exposure, making rapid treatment critical. She said 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. 

How neffy® Works

neffy® delivers a full, single dose of epinephrine in a user-friendly nasal spray format, without the need for priming. Clinical studies show it is absorbed quickly through the nasal lining, delivering epinephrine consistently and predictably. 

Practical design was clearly a priority. The device is designed to fit into a pocket for portability, has a 30-month shelf life from the time of manufacture, and can withstand temperature excursions up to 50°C, key differentiators from autoinjectors. This is significantly longer shelf life compared to the needles, which has 12 months, which also helps reduce the risk of expired doses.

What the Evidence Shows

The clinical development program for neffy® has generated more data than any other epinephrine device, with over 1,100 administrations across more than 700 participants. No serious side effects were reported. The most common adverse reactions, throat irritation, headache, nasal discomfort, and feeling jittery, were only observed after a second dose (4 mg total) and occurred in roughly 10–19% of participants.

Studies also showed neffy® performed similarly to autoinjectors across a range of real-world scenarios including self-administration, use in children, repeat dosing, and situations involving nasal congestion from colds or allergies.

Price & Access

An official Canadian price for neffy® has not yet been announced. However, it is expected to be in line with existing epinephrine auto-injectors, which typically cost between $100 and $170 per device.

Coverage details are still pending. Reimbursement decisions, including whether neffy® will be included on provincial drug formularies or covered by private insurance, are expected closer to its anticipated summer 2026 rollout.

Until then, access and out-of-pocket costs for patients remain unclear.

When Can Canadians Expect It?

neffy® is expected to be available in pharmacies across Canada in summer 2026. In the meantime, Canadians can register for availability notifications at www.neffy.ca. 

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

Andrew Desbarats, General Manager of ALK Canada, the company behind the product, called the approval “a significant step forward in the treatment of anaphylaxis in more than 35 years,” adding that the goal is to give the approximately 2.5 million Canadians living with life-threatening allergies a way to carry treatment wherever life takes them.

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