Intranasal epinephrine (neffy) dose by weight

Selects the FDA-approved neffy intranasal epinephrine dose from patient weight.

Evidence tier: Guideline-derived.

Formula / logic

Weight ≥30 kg → neffy 2 mg intranasal. Weight 15 to <30 kg (age ≥4 y) → neffy 1 mg intranasal. Weight <15 kg → not approved; use IM epinephrine. A second dose (opposite/same nostril) may be given after ≥5 minutes if symptoms persist.

Interpretation

neffy is an emergency treatment of Type I allergic reactions including anaphylaxis. It does not replace the need to call emergency services or to carry a backup device.

Evidence & citations

  1. FDA approval of neffy (epinephrine nasal spray), ARS Pharmaceuticals, 2 mg (Aug 2024) and 1 mg pediatric 15–<30 kg (Mar 2025). FDA approval
  2. Tanimoto S, Kaliner M, Lockey RF, et al. PK/PD comparison of epinephrine administered intranasally and intramuscularly. Ann Allergy Asthma Immunol. 2023;130(4):508-514.e1. PMID 36334720

Clinician decision support. Verify against the cited source. Not a substitute for clinical judgment. 100% on-device; no patient data is stored or transmitted.