Adrenaline nasal spray in anaphylaxis

An adrenaline nasal spray has been developed for the emergency treatment of anaphylaxis:

• is a spray that delivers a dose of 2 mg of adrenaline to the nasal mucosa (1)
  • dose of 2mg of adrenaline is suitable for people weighing 30 kg or more
  • plunger should not be pressed before inserting the product into the nostril, otherwise the single dose will be lost prior to use
  • can be used when the nose is congested due to a cold or allergy (2)
  • the addition of a carrier substance facilitates the absorption of adrenaline by increasing the permeability of the mucosal cells
    
• if there is no improvement in symptoms within the first 10 minutes, a second dose is recommended (1)
  
• no special storage conditions are required, as the medication is designed to remain stable even at high temperatures
  
• the most common side effect of nasal adrenaline administration is local irritation of the nasal mucosa (1)
  • also, particularly after administration of a second dose, some subjects also experienced headaches, nervousness, and tremors

Reference:

1. Treudler R et al. Adrenaline nasal spray in emergency management: An initial expert opinion. Allergol Select. 2025 Sep 4;9:80-85.
2. MHRA (Press release 18th July 2025). MHRA approves adrenaline nasal spray - the first needle-free emergency treatment for anaphylaxis in the UK.