FDA declines to approve first nasal spray alternative to EpiPen


Full story

On Tuesday, Sept. 19, the Food and Drug Administration decline to approve Neffy, a nasal spray equivalent of an EpiPen. The first needle-free option to treat severe allergic reactions made by ARS Pharmaceuticals was declined approval as the FDA requested more testing on repeat doses.

The decision by the FDA was surprising for the drug developer ARS. According to an ARS statement, in a May 2023 meeting, the FDA’s Pulmonary-Allergy Drugs Advisory Committee concluded the benefits of Neffy outweigh the risks.

“In that session, no member of the Committee raised specific concerns about the result of the completed study in people with allergen-induced acute rhinitis with single-dose Neffy, which showed enhanced absorption during the time period when a clinical response would be expected,” the statement read.

The May 2023 conclusion came with a PADAC vote backing the use of the needle-injected epinephrine alternative in adults and children weighing at least 66 pounds.

The FDA wants a repeat-dose study on the nasal spray to compare results to an epinephrine injection before the drug can be approved. This is a requirement that ARS said had already been discussed.

“This request comes after the recommendation of the FDA Advisory Committee (PADAC) in May 2023 to approve Neffy without the need for additional studies to demonstrate its efficacy or safety,” the statement read.

ARS added a less expensive needle-free alternative is needed now more than ever as the cost of emergency allergy injectors increases. One study shows that two-thirds of patients pay $200 annually for emergency allergy injections.

ARS plans on resubmitting Neffy for FDA approval in 2024 and anticipates action in the second half of 2024.

Brock Koller (Senior Producer) and Ian Kennedy (Editor) contributed to this report.
Tags: , , ,

SAN provides
Unbiased. Straight Facts.

Don’t just take our word for it.


Certified balanced reporting

According to media bias experts at AllSides

AllSides Certified Balanced May 2025

Transparent and credible

Awarded a perfect reliability rating from NewsGuard

100/100

Welcome back to trustworthy journalism.

Find out more

SAN provides
Unbiased. Straight Facts.

Don’t just take our word for it.


Certified balanced reporting

According to media bias experts at AllSides

AllSides Certified Balanced May 2025

Transparent and credible

Awarded a perfect reliability rating from NewsGuard

100/100

Welcome back to trustworthy journalism.

Find out more

Daily Newsletter

Start your day with fact-based news

Start your day with fact-based news

Learn more about our emails. Unsubscribe anytime.

By entering your email, you agree to the Terms and Conditions and acknowledge the Privacy Policy.