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Drug Safety-related Labeling Changes (SrLC)

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NEFFY (NDA-214697)

(EPINEPHRINE)

Safety-related Labeling Changes Approved by FDA Center for Drug Evaluation and Research (CDER)

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03/26/2026 (SUPPL-2)

17 PCI/PI/MG (Patient Counseling Information/Patient Information/Medication Guide)

PATIENT COUNSELING INFORMATION

Additions and/or revisions underlined:

Advise the patient to read the FDA-approved patient labeling (Patient Information and Instructions for Use).

Administration Instructions

  • Advise patients and/or caregivers to store neffy nasal spray in the blister pack or neffy carry case until ready to use.

PATIENT INFORMATION

Additions and/or revisions underlined:

How should I use neffy?

  • Avoid sniffing during or after receiving a dose of neffy. If you do sniff by accident, and your symptoms continue or get worse, give a second dose of neffy in the same nostril, starting 5 minutes after the first dose.

How should I store neffy?

  • Store neffy nasal spray in the blister pack or neffy carry case until ready to use. Neffy carry case is included in the carton.

  • Store neffy at room temperature between 68°F to 77°F (20°C to 25°C).

Do not intentionally freeze to below 5°F (-15°C). If neffy is accidentally frozen the device will not spray. Neffy may still be used if it has been thawed after being previously frozen.

  • Exposure of neffy to high temperatures up to 122°F (50°C) is allowed for a few days.

  • Your neffy has an expiration date. Replace neffy before the expiration date.

Keep neffy and all medicines out of the reach of children.

10/24/2025 (SUPPL-3)

Approved Drug Label (PDF)

17 PCI/PI/MG (Patient Counseling Information/Patient Information/Medication Guide)

PATIENT COUNSELING INFORMATION

Additions and/or revisions underlined:

. . .

Administration Instructions

 

  • Advise patients and/or caregivers to store neffy nasal spray in the blister pack until ready to use.

. . .

MEDICATION GUIDE

Additions and/or revisions underlined:

. . .

How should I store neffy?

  • Store neffy nasal spray in the blister pack until ready to use.

. . .

03/05/2025 (SUPPL-1)

Approved Drug Label (PDF)

6 Adverse Reactions

Additions and/or revisions underlined:

….

Adverse Reactions with Neffy in Pediatric Subjects 4 Years of Age and Older Weighing 15 kg or Greater

A single-arm clinical pharmacology study (Study 5) in pediatric subjects 4 to 17 years of age who weigh 15 kg or greater with type I allergy without anaphylaxis was conducted to assess the pharmacokinetic/pharmacodynamic (PK/PD) of neffy 1 mg and 2 mg [see Clinical Pharmacology (12.2, 12.3)]. Pediatric subjects (n=21) who weigh 30 kg or greater received one nasal dose of neffy 2 mg and common adverse reactions reported in these subjects include nasal discomfort (19%), intranasal paresthesia (19%), rhinorrhea (19%), sneezing (14%), epistaxis (10%), rhinalgia (10%), paresthesia (10%), fatigue (10%), and feeling jittery (10%). Pediatric subjects (n=21) who weigh 15 to less than 30 kg received one nasal dose of neffy 1 mg and common adverse reactions reported in these subjects include nasal congestion (19%), upper respiratory tract congestion (14%), dry throat (10%), nasal dryness (10%), and paresthesia (10%).

8 Use in Specific Populations

8.4 Pediatric Use

Additions and/or revisions underlined:

The safety and effectiveness of neffy for emergency treatment of type I allergic reactions, including anaphylaxis, have been established in pediatric patients aged 4 years and older who weigh 15 kg or greater. Use of neffy for this indication is supported by extrapolation from the clinical pharmacology studies in adults that compared the PK/PD profile of neffy to epinephrine injection products with established safety and effectiveness for this indication and clinical pharmacology data (Study 5) in pediatric patients aged 4 years and older who weigh 15 kg or greater [see Adverse Reactions (6) and Clinical Pharmacology (12.2, 12.3)].

The safety and effectiveness of neffy have not been established in pediatric patients less than 4 years of age and who weigh less than 15 kg.

17 PCI/PI/MG (Patient Counseling Information/Patient Information/Medication Guide)

PATIENT INFORMATION

Additions and/or revisions underlined:

What is neffy?

  • Neffy is a nasal spray used to treat life-threatening, allergic emergencies including anaphylaxis in adults and children aged 4 years and older who weigh 33 pounds or more (15 kilograms or more), who are at risk for or have a history of serious allergic emergencies. Each neffy contains a single dose of epinephrine.

  • Neffy is for immediate self (or caregiver) administration in an allergic emergency.

  • Neffy is for people who have been prescribed this medicine by their healthcare provider.

    It is not known if neffy is safe and effective in children who weigh less than 33 pounds (15 kilograms).

    How should I use neffy?

  • If you use too much neffy, call your healthcare provider or Poison Help line at 1-800-222-1222 or go to the nearest hospital emergency room right away.

    What are the possible side effects of neffy? Neffy may cause serious side effects.

    If you have certain medical conditions, or take certain medicines, your condition may get worse or you may have more or longer lasting side effects when you use neffy. Talk to your healthcare provider about all your medical conditions.

    Common side effects of neffy include:

     

  • nasal discomfort

  • runny nose

  • throat irritation

  • dry nose or throat

  • headache

  • tingling sensation, including in the nose

  • chest and nasal congestion

  • feeling tired

  • feeling overly excited, nervous, or anxious

  • dizziness

  • nose bleed

  • nausea

  • nose pain

  • vomiting

  • sneezing