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Epinephrine Nasal Spray (Anaphylaxis)

What is this medication?

EPINEPHRINE (ep i NEF rin) treats severe allergic reactions (anaphylaxis). It reduces the effects of an allergic reaction, such as trouble breathing or swelling of the face, lips, and throat. Call emergency services after using this medication. You may need additional treatment.

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This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): NEFFY

What should I tell my care team before I take this medication?

They need to know if you have any of the following conditions:

  • Diabetes
  • Heart disease
  • High blood pressure
  • Kidney disease
  • Low levels of potassium in the blood
  • Nasal conditions that affect the shape of your nose, such as nasal polyps, broken nose, nasal surgery
  • Parkinson disease
  • Thyroid disease
  • An unusual or allergic reaction to epinephrine, other medications, foods, dyes, or preservatives
  • Pregnant or trying to get pregnant
  • Breastfeeding

How should I use this medication?

This medication is for use in the nose. The device is ready to use. You will be taught how to use it. Give the nasal spray into one nostril. Call emergency services right away after giving the first dose. If another dose is needed, give the additional dose using a new device. Give the dose in the same nostril 5 minutes after the first dose.

This medication comes with INSTRUCTIONS FOR USE. Ask your pharmacist for directions on how to use this medication. Read the information carefully. Talk to your pharmacist or care team if you have questions.

Talk to your care team about the use of this medication in children. While it may be prescribed for children as young as 4 years for selected conditions, precautions do apply.

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Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

This does not apply.

What may interact with this medication?

  • Antihistamines for allergy, cough, and cold
  • Certain medications for blood pressure, heart disease, irregular heartbeat
  • Certain medications for depression, anxiety, or other mental health conditions
  • Certain medications for Parkinson disease, such as entacapone
  • Digoxin
  • Diuretics
  • Ergot alkaloids, such as dihydroergotamine, ergotamine, methylergonovine
  • Levothyroxine
  • MAOIs, such as Marplan, Nardil, and Parnate
  • Other nasal sprays
  • Oxytocin

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Keep this medication with you at all times.

Show your family members, caregivers, and others where you keep this medication. You will all need to know how to use this medication before you need it. Call emergency services right away after the first dose. This is very important. Do this even if you are awake or feel better.

Each device only contains one dose. You may need more than one dose in an emergency. Talk to your care team about how many doses to carry with you.

Check the expiration date of your medication often. Replace it before the expiration date has passed.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

  • Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
  • Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

  • Anxiety, nervousness
  • Burning or tingling of the tongue, mouth, throat, or face
  • Headache
  • Irritation inside the nose or throat
  • Runny or stuffy nose
  • Sneezing

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Do not freeze. Get rid of any unused medication after the expiration date.

To get rid of medications that are no longer needed or have expired:

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  • Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
  • If you cannot return the medication, ask your pharmacist or care team how to get rid of this medication safely.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

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Note: Introduction and Additional Common Questions written and medically approved by Cleveland Clinic professionals.

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