Anaphylaxis is a severe, life-threatening allergic reaction, and epinephrine is the first and most important treatment. For decades, Canadians had exactly one way to give epinephrine outside a hospital: the EpiPen auto-injector, a needle injection into the outer thigh. That changed in August 2026, when neffy — an epinephrine nasal spray — became available in Canada. Canada now has two methods to treat anaphylaxis: the EpiPen, and neffy.
What is neffy?
neffy is a single-use nasal spray that administers epinephrine through the nostril — no needle, no injection. It comes in two strengths: 1 mg for people who weigh 15 kg to under 30 kg, and 2 mg for people who weigh 30 kg or more. Each device sprays exactly one time. If symptoms continue, a second dose may be given in the same nostril 5 minutes after the first. Because there is no needle, neffy may be an easier option for people who are afraid of injections — children, needle-phobic patients, and caregivers who hesitate at the moment it matters most.
You can learn more on the official neffy website.
Canada now has two ways to treat anaphylaxis
EpiPen: an injection into the outer thigh that can be given through clothing. It comes in 0.15 mg (for 15–30 kg) and 0.3 mg (for 30 kg and over) strengths, is single-use, and a second dose may be given 5 minutes after the first if needed. It has decades of proven use and is familiar to patients, caregivers, and emergency personnel.
neffy: one spray into one nostril. It is single-use, a second dose may be given in the same nostril 5 minutes after the first if needed, and it is completely needle-free.
Both EpiPen and neffy contain epinephrine and treat severe allergic reactions (anaphylaxis). Whichever one you carry: always carry two devices, and call 911 after use. Talk to your allergist about which option is right for you, and review your anaphylaxis action plan.
How to use neffy
1. Remove — Remove neffy from the packaging. Do NOT test or pre-spray it.
2. Hold — Hold the device as shown, with your thumb on the bottom of the plunger and a finger on either side of the nozzle. Do NOT pull or push on the plunger yet.
3. Insert — Place the nozzle into one nostril until your fingers touch the nose, pointing toward the forehead.
4. Press — Press the plunger firmly to spray into the nostril. Each neffy can only be sprayed 1 time, and the person should not sniff during or after use.
Know the signs of anaphylaxis
- Trouble breathing
- Swelling of the lips, tongue, or throat
- Dizziness or fainting
- Severe vomiting or diarrhea
When these signs appear, give epinephrine right away — do not wait — and call 911.
Hands-on neffy training at the Academy
The Academy for First Aid and Safety is the only first aid training company in the Greater Toronto Area that has implemented neffy training.
The Academy for First Aid and Safety now provides hands-on first aid training for neffy use. In our first aid and CPR courses, you practise recognizing anaphylaxis and administering epinephrine with trainer devices — both the EpiPen auto-injector and the neffy nasal spray — with an instructor beside you, so you are ready to act with whichever device the person carries.
Register for a course today — use promo code SAVE-TEN for 10% off.