Epinephrine nasal spray (Neffy) is an alpha-and beta-adrenergic receptor agonist labeled for the emergency treatment of type I allergic reactions including anaphylaxis.¹ It is administered as a single-use nasal spray. Similar to the action of intramuscular epinephrine during anaphylaxis, it decreases vasodilation and vascular permeability through its action on alpha-adrenergic receptors and induces bronchial smooth muscle relaxation to alleviate respiratory symptoms through its beta-adrenergic receptor action. It is labeled for use in patients 4 years and older weighing at least 15 kg (33 lb).