UK children at risk of anaphylaxis could soon have another treatment option available at school, after the Medicines and Healthcare products Regulatory Agency (MHRA) said it would consider allowing schools to hold spare adrenaline nasal sprays for emergency use.
Around 8% of children and young people in the UK have a food allergy. Some are at risk of anaphylaxis, a severe and potentially life-threatening allergic reaction that requires immediate treatment with adrenaline. The hormone medication works by opening airways and increasing blood pressure, acting as the first-line treatment for the reaction.
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The MHRA is launching a consultation on proposals that would allow schools to purchase and keep spare adrenaline nasal sprays for emergency use in children with severe allergies. The consultation is being carried out UK-wide, jointly with the Department of Health in Northern Ireland.
While not specifically mentioning the brand name, ALK-Abelló’s EURneffy is the country’s first and only adrenaline nasal spray. The MHRA approved a 2mg dose for adults and children weighing at least 30kg in July 2025. Approval for a 1mg dose followed in June this year, expanding the medicine’s use to younger paediatric patients and widening the eligible weight range. The spray was originally developed by US-based ARS Pharmaceuticals, where it was marketed as neffy – generating $72.2m in sales in the US in 2025.
Schools can already hold spare adrenaline auto-injectors for emergencies. The most well-known brand of autoinjectors is Mylan’s EpiPen, though ALK-Abelló also markets Jext. Both products offer specific lower-strength formulations for children. The proposals will explore allowing schools to hold sprays in the same way as autoinjectors.
Given that around 20% of serious allergic reactions to food happen in a school setting, the MHRA’s executive director of operations, Julian Beach, said the availability of sprays would “provide an additional treatment option” for children at risk of anaphylaxis.
Anaphylaxis, a severe allergic reaction, typically occurs when the body’s immune system develops an immediate and unexpected response to a foreign substance, which can come from food, insect stings, or medications. Anaphylaxis affects up to an estimated 761 out of every 100,000 children in Europe each year, with food allergies responsible for more than two‑thirds of cases.
Under the proposals, schools could choose whether to hold auto-injectors, sprays, or both. In high doses, adrenaline can be dangerous, so the MHRA said it would maintain existing safeguards.
Beach added: “Our proposal is designed to ensure that medicines legislation keeps up with developments in healthcare while ensuring safeguards that support the safe use of emergency adrenaline in schools remain in place.
“We encourage everyone to share their views, including teachers, healthcare professionals, parents, carers and those at risk of anaphylaxis.”
EURNeffy’s approval marked a significant advancement for anaphylaxis options in the UK. Research shows that over half of children are anxious regarding medical needles, meaning a single-dose nasal spray is more convenient for many patients. Studies also showed that EURneffy is lighter and easier to carry in daily life compared to autoinjectors.
Amena Warner, head of clinical services at Allergy UK, said: “Storing a needle-free adrenaline device that is administered into the nose will offer parents – plus children and young people at risk of anaphylaxis – an easy-to-use device, more confidence to use it promptly and will give schools choice in how they prepare for and manage an allergic emergency.”
