ALK’s 2mg nasal adrenaline spray has been recommended for use in NHS Wales for the emergency treatment of anaphylaxis in adults and children weighing 30kg or more.

AWMSG recommends nasal adrenaline

The All Wales Medicines Strategy Group (AWMSG) has recommended EURneffy (2 mg nasal adrenaline spray) for the emergency treatment of severe allergic reactions, including anaphylaxis.

The recommendation applies to adults and children weighing 30kg or more whose anaphylaxis is caused by insect stings or bites, foods, medicines or other allergens, as well as idiopathic or exercise-induced anaphylaxis.

The decision follows an assessment by the Licensed One Wales Medicines Assessment Group (LOWMAG). The All Wales Therapeutics and Toxicology Centre confirms that EURneffy was given a recommended status following the AWMSG meeting on September 9, with the advice issued on September 15.

EURneffy is a needle-free nasal spray designed to deliver adrenaline during a severe allergic reaction. Adrenaline is the first-line treatment for anaphylaxis and should be administered as soon as possible when a severe allergic reaction is suspected.

The 2mg formulation is indicated for adults and children weighing at least 30kg. The UK product information states that a second dose can be administered after five minutes if there is no clinical improvement, deterioration occurs or symptoms return. Patients are advised to seek emergency medical assistance immediately following administration.

Potential barriers to emergency treatment

The Welsh assessment highlighted practical factors that could affect whether people carry and use emergency adrenaline.

Nasal administration removes the need for a needle and may be relevant for people who are reluctant to carry or use adrenaline auto-injectors. The assessment also considered potential advantages for some adolescents, people with needle phobia, people with neurodivergence or additional learning needs, and parents, carers or school staff who may need to administer emergency treatment.

Amena Warner, Head of Clinical Services at Allergy UK, said: “Living with the risk of anaphylaxis can have a profound impact on everyday life. Many people and their families live with the knowledge that a severe allergic reaction can happen without warning, making it essential to always carry emergency medication and be prepared to act quickly. We welcome the availability of a needle-free adrenaline option in Wales, which provides people with greater choice in how they prepare for and manage an allergic emergency.”

Expanding treatment options in Wales

ALK said the recommendation will give eligible people in Wales access to a needle-free adrenaline option through NHS Wales.

Emil Stage Olsen, general manager UK & Republic of Ireland at ALK, said: “We are proud that eligible people in Wales will now have access to the first and only needle-free nasal adrenaline spray through NHS Wales. By expanding treatment choice and offering the prospect of reduced costs compared with adrenaline auto-injectors, EURneffy offers NHS Wales an important patient-focused innovation. We look forward to working with healthcare professionals to support its introduction across Wales.”

The AWMSG recommendation applies specifically to the 2mg formulation for people weighing 30kg or more. AWTTC notes that the EURneffy licence was extended in July 2026 to include a 1mg formulation for children aged four years and over weighing 15kg to less than 30kg. Health boards in Wales are advised to make the lower-dose product available in line with the AWMSG policy on paediatric licence extensions.

The recommendation adds to access to emergency adrenaline for people at risk of anaphylaxis and provides an alternative delivery method to adrenaline auto-injectors.