Overview

• The systematic review, presented at the European Emergency Medicine Congress, compared intranasal liquid and dry‑powder adrenaline with intramuscular autoinjectors across five phase I studies.
• Pharmacokinetic results showed comparable or faster uptake for nasal sprays (maximum 2.5–20 minutes versus 9–45 minutes for injections) and similar effects on heart rate and blood pressure, with mild, short‑lived side effects.
• The authors noted practical advantages for nasal sprays, including a two‑year shelf life and smaller device size (neffy about 6 cm versus EpiPen about 15 cm), which could ease out‑of‑hospital use.
• Evidence remains limited to healthy adult volunteers with small samples and varying doses and devices, prompting calls for larger clinical trials, real‑world safety data, and monitored rollout before guideline changes.
• Regulatory status includes neffy approved in the U.S. and parts of Europe and cleared by the UK MHRA, with UK availability expected toward late 2025 and applications filed in China, Japan, and Australia and under review in Canada.