Neffy nasal spray for severe allergies now available without prescription

Neffy, the epinephrine nasal spray for severe allergies, is now available without a prescription at pharmacies in Canada—but not for everyone.

The National Association of Pharmacy Regulatory Authorities (NAPRA) classified Neffy’s two milligram dose as a Schedule II product across Canada.

This means that the drug is now available without a prescription in provinces and territories where a prescription was previously required, ALK-Abelló Pharmaceuticals Inc. Canada said.

In April, Health Canada approved epinephrine nasal spray for use in adults and children with a body weight of 30 kilograms or 66 pounds for emergency treatment of severe allergic reactions, but it still needed classification from NAPRA.

The U.S. Food and Drug Administration approved the drug in the U.S. in 2024.

Allowing it to be sold behind the counter will give caregivers another way to carry and use epinephrine for first-line emergency treatment for severe allergic reactions, ALK Canada said.

Consumers will need to speak directly with the pharmacist who will conduct proper counselling before dispensing Neffy to patients without a prescription, the company added.

In 2024, results of four studies in 175 healthy adults, without anaphylaxis, showed Neffy worked about as well as injected epinephrine to boost heart rate and blood pressure, which counter severe reactions.

The two milligram dose of the Neffy nasal spray is equivalent to a 0.3 milligram dose in an epinephrine auto-injector, according to Food Allergy Canada.

The Neffy one milligram dose, which is not yet approved for use in Canada, can be used on patients weighing 15-30 kilograms. For now, the EpiPen Jr. with its 0.15 milligram dose, remains the only option for younger patients.

According to the FDA, some of the most common side effects of Neffy include throat irritation, tingling nose, headache, nasal discomfort, fatigue, runny nose, sneezing, abdominal pain, gum pain, numbness in the mouth, nasal congestion, dizziness, nausea and vomiting.