A study presented at the European Emergency Medicine Congress shows that adrenaline administered as a liquid or dry powder nasal spray is as effective, and sometimes even more effective, than traditional injection devices like EpiPens during anaphylactic shock.
Anaphylaxis is a severe, potentially life-threatening allergic reaction that can cause symptoms such as skin rashes, swelling, difficulty breathing and loss of consciousness. It requires immediate treatment with adrenaline (epinephrine), which is typically delivered by injection into the thigh.
Researchers analysed data from five studies in Israel, Canada, Thailand, the United States and Japan, comparing the effectiveness of injected adrenaline to nasal spray formulations. Results showed that adrenaline absorption via nasal spray was comparable to or faster than injection, reaching the bloodstream in 2.5 to 20 minutes, compared with 9 to 45 minutes for injections. Blood adrenaline levels were also similar or higher with nasal sprays, and vital signs such as heart rate and blood pressure were consistent across both delivery methods. Reported side effects from the nasal spray were mild and short-lived.
Nasal sprays offer several advantages: they are smaller, more portable and have a longer shelf life (up to two years), whereas injection devices typically need to be replaced every 12 to 18 months. They may also be ideal for people with needle phobia or in public settings where quick, easy administration is critical.
“Nasal sprays could become a suitable and equally effective needle-free alternative to the EpiPen, which is the current treatment for anaphylaxis,” the lead researcher noted.