(ep'' i nef' rin)

Brand Name(s): Neffy^®

WHY is this medicine prescribed?

Epinephrine nasal spray is used to treat symptoms of an anaphylacticreaction (severe, life-threatening allergic reaction where symptoms can include face or mouth or throat swelling, rash or hives and difficulty breathing) in adults and some children. Epinephrine nasal spray is in a class of medications called alpha- and beta-adrenergic agonists (sympathomimetic agents). It works by relaxing the muscles in the airways and tightening the blood vessels.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Epinephrine nasal spray comes as a solution (liquid) to spray in the nose. It is usually given as one spray in one nostril at the first sign of an anaphylactic reaction. If after 5 minutes symptoms do not improve or worsen, then a second spray can be given in the same nostril.

After using epinephrine nasal spray, you should report for emergency care for evaluation to determine if any additional treatment is needed.

Each epinephrine nasal spray is for single use. If you use an epinephrine nasal spray, it is important that you replace it with a new one right away. It is recommended that anyone prescribed epinephrine nasal spray always carry it with them and always have two doses of it available.

Give a dose of epinephrine nasal spray by fully inserting the nozzle of one nasal spray into the nostril. Making sure to keep the nozzle straight in the nose, press the plunger down firmly. Avoid sniffing while receiving epinephrine nasal spray.

Review the instructions for use that comes with epinephrine nasal spray and ask your doctor or pharmacist if you have any other questions.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

What SPECIAL PRECAUTIONS should I follow?

Before using epinephrine nasal spray,

• tell your doctor and pharmacist if you are allergic to epinephrine, sulfites, any other medications, or any of the ingredients in epinephrine nasal spray. Ask your pharmacist or check the Medication Guide for a list of the ingredients.

• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while taking epinephrine nasal spray. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• use of epinephrine nasal spray may cause increased side absorption of other nasal spray medications increasing risk of experiences side effects for up to 2 weeks after using epinephrine nasal spray. Make sure to ask your doctor or pharmacist about using any of the following nasal sprays if you have to use a dose of epinephrine nasal spray: fluticasone nasal spray (Flonase), azelastine nasal spray (Astepro), triamcinolone nasal spray (Nasacort), budesonide nasal spray (Rhinocort), oxymetazoline nasal spray (Afrin).

• tell your doctor if you have or have ever had nasal polyps (non-cancerous growth on inside of nose), history of surgery or procedure on nose or history of injury or fracture of the nose. Your doctor may tell you not to use epinephrine nasal spray.

• tell your doctor if you have or have ever had chest pain, irregular heartbeat, high blood pressure, or heart disease; asthma; diabetes; hyperthyroidism (an overactive thyroid); depression; Parkinson's disease; or kidney disease.

• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What SIDE EFFECTS can this medicine cause?

Epinephrine nasal spray may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• throat irritation
• tingling nose, nasal discomfort, sneezing, itchy nose, nasal congestion or runny nose
• headache
• feeling jittery or excited, nervous or anxious
• shakiness or dizziness
• headache
• stomach pain or nausea or vomiting

Epinephrine nasal spray may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not allow to freeze.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

If someone swallows epinephrine nasal spray, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

• feeling slow or racing heart rate or of irregular heart beat
• rapid breathing or difficulty breathing
• pale and clammy skin
• difficulty urinating
• loss of consciousness

What OTHER INFORMATION should I know?

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™. © Copyright, 2024. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: September 20, 2024.