Anaphylaxis

Additional information

Anaphylaxis

Anaphylaxis is a severe, rapid-onset allergic reaction that can become life-threatening within minutes. If you live with a serious allergy, or care for someone who does, your single most important job is being ready: knowing the triggers, recognising the early signs, and having two in-date adrenaline devices within arm’s reach at all times. At Courier Pharmacy, we help you build that readiness into your daily routine, with prescriber-led adrenaline supply (including injectable auto-injectors and the new needle-free nasal spray Eurneffy), antihistamine and emergency-kit support, and a real team to talk to when allergy life gets complicated.

If you’ve been recently diagnosed with a serious allergy, or you’re the parent of a child who’s just been prescribed an adrenaline device for the first time, the word anaphylaxis can feel enormous. The good news is that anaphylaxis is recognisable, treatable, and almost always survivable when adrenaline is given quickly. The harder news is that being prepared isn’t a one-off event; it’s a routine you build into the rest of your life. This page is here to make that routine feel manageable rather than overwhelming, with calm, evidence-led guidance grounded in NHS and NICE recommendations, and a real Courier Pharmacy team to talk to when you need us.

Five key takeaways

• • Anaphylaxis is a severe, rapid-onset allergic reaction affecting multiple body systems at once, and is a medical emergency that requires immediate adrenaline, as the NHS makes clear.

• • Common triggers include foods (peanuts, tree nuts, milk, egg, shellfish, sesame), insect stings (wasps, bees), medicines (penicillin, NSAIDs, contrast agents), and latex, with NICE noting that around 30% of severe reactions have no clearly identified trigger.

• • The cornerstone of anaphylaxis treatment is rapid adrenaline delivery. UK options include intramuscular auto-injectors (EpiPen, Jext, Emerade) and, as of 2025, Eurneffy, the first needle-free adrenaline nasal spray licensed in the UK and EU.

• • Everyone at risk of anaphylaxis should carry two in-date adrenaline devices at all times, have a written allergy action plan, and review their kit regularly with a pharmacist or prescriber.

• • At Courier Pharmacy, adrenaline auto-injectors, Eurneffy nasal spray, antihistamines, and supporting medicines are available after a quick online consultation reviewed by a UK-qualified prescriber, with optional free pharmacist support to help you build your emergency kit, train your circle, and stay ready.

Service highlights

• • Online consultation reviewed by a UK-qualified prescriber for adrenaline auto-injector prescriptions (EpiPen, Jext, Emerade) and Eurneffy nasal spray

• • Quick-access supply of antihistamines (cetirizine, fexofenadine, loratadine, chlorphenamine) and steroid courses where prescribed

• • Expiry tracking and adrenaline device replacement reminders so your kit doesn’t quietly lapse

• • Personalised allergy emergency-kit guidance, including how to brief family, friends, schools, and colleagues

• • Excipient-aware prescribing for people living with MCAS or multiple drug sensitivities

• • Free pharmacist support before and after you order, including a review of your written allergy action plan

• • Free fortnightly community talks at Insomnia in Derby for anyone navigating allergy, MCAS, or another long-term condition

What you should know about anaphylaxis treatments

Anaphylaxis treatment rests on a small number of essential building blocks, and the rest is detail. The first is recognising a reaction early, which usually means knowing your own pattern (foods, insect stings, medicines, latex) and the telltale combination of symptoms that mark a true anaphylactic episode rather than a milder allergic reaction. The second is having immediate access to adrenaline, which is the only medicine that reliably reverses anaphylaxis. The third is supportive treatment after adrenaline, including positioning, oxygen, antihistamines, and steroids in hospital. The fourth is review and personalisation, working with a prescriber to understand your triggers, refine your action plan, and make sure your kit stays in date.

That four-part framework is the one NICE Clinical Knowledge Summaries and the NHS both recommend, and it’s the structure we use during every consultation at Courier Pharmacy. The goal isn’t just to dispatch an auto-injector or a nasal spray; it’s to make sure you, and the people who care about you, know exactly what to do if a reaction starts.

Anaphylaxis overview

Anaphylaxis is one of the few medical conditions where minutes genuinely matter. The NHS describes it as a severe, life-threatening allergic reaction that can develop within minutes of contact with a trigger, and where the difference between a good and a bad outcome often comes down to how quickly adrenaline is given. According to NICE Clinical Knowledge Summaries, the UK rate of anaphylaxis hospital admissions has risen significantly over the past two decades, particularly in children, although deaths remain rare.

That mismatch (more reactions, very few deaths) is largely a story of better recognition, better adrenaline supply, and better community awareness. Schools train staff. Restaurants flag allergens. Parents carry auto-injectors. The system is far from perfect, but the trajectory is encouraging, and the central lesson of the last decade is consistent. People who carry two in-date adrenaline devices and use them early do well. People who delay using adrenaline or rely on antihistamines alone are the group who fare worst.

The arrival of Eurneffy in 2025, the first needle-free adrenaline nasal spray, has added a meaningful option to that picture. For people with a fear of needles, for adolescents and adults who find auto-injectors difficult to use under stress, and for caregivers who worry about administering an injection in an emergency, a nasal spray format removes a real barrier without compromising on the active medicine. Adrenaline is adrenaline, regardless of how it’s delivered.

Despite that progress, living with the risk of anaphylaxis can be exhausting. Allergy UK and other patient organisations consistently report that the emotional load (the constant label-checking, the anxiety about new foods or new environments, the worry about being away from your kit) is one of the most under-discussed parts of allergy life. The medical condition is treatable. The lifestyle adjustment is harder to talk about. We try to address both during our consultations.

This page covers what anaphylaxis is, what causes it, how it’s diagnosed, what treatment looks like, and how Courier Pharmacy can help you build a plan that actually fits your life, your household, and your wider medical picture.

What is anaphylaxis?

Anaphylaxis is the most severe form of allergic reaction. It develops rapidly (usually within minutes to a couple of hours of exposure to the trigger) and affects multiple body systems at once, as the NHS explains. It’s distinct from a milder allergic reaction, which might involve a localised rash or mild itching only.

Symptoms typically include some combination of the following:

• • Skin: widespread hives, intense itching, flushing, sudden facial or lip swelling

• • Airways and breathing: throat tightness or swelling, hoarseness, difficulty swallowing, wheezing, persistent cough, breathing difficulty

• • Circulation: feeling faint, dizziness, rapid or weak pulse, collapse, loss of consciousness

• • Gut: severe abdominal pain, nausea, vomiting, diarrhoea

• • General: a sense of impending doom, sudden severe anxiety, confusion

A key point: anaphylaxis isn’t always dramatic from the first minute. It can start with mild symptoms (an itchy mouth, a few hives) and escalate over 5 to 30 minutes. That’s why prompt adrenaline at the first sign of a serious reaction is so important. Waiting to see how bad it gets is the single most common mistake.

How common is anaphylaxis?

Anaphylaxis is increasingly common, particularly in children. The NHS reports that food allergies affect around 8% of children and 2% of adults in the UK, and a meaningful subset of those people are at risk of anaphylactic reactions. Hospital admissions for anaphylaxis in the UK have approximately tripled over the past two decades, according to UK-wide audit data referenced in NICE Clinical Knowledge Summaries.

That said, severe outcomes remain rare. Allergy UK and the Anaphylaxis Campaign both report that fatal anaphylaxis affects fewer than 1 in 1 million people in the UK each year. The vast majority of reactions, even severe ones, are survived without long-term harm when adrenaline is given promptly. The combination of “common enough to take seriously, rare enough to live with” is the reality most people with allergies adapt to over time.

Adult-onset food allergies are also rising, particularly to shellfish, tree nuts, and sesame. Many adults with new-onset allergies feel particularly unprepared, because the cultural conversation around anaphylaxis has historically focused on children. Anaphylaxis can develop at any age, and a first reaction in your 30s or 50s is not unusual.

What causes anaphylaxis?

Anaphylaxis is triggered when the immune system overreacts to a substance it has decided (rightly or wrongly) is dangerous. The underlying mechanism is the same regardless of trigger, but the triggers themselves vary widely. NICE Clinical Knowledge Summaries group the main causes into the following categories.

Food triggers

Food is the most common cause of anaphylaxis, particularly in children. The most frequent triggers in the UK are peanuts, tree nuts (almonds, cashews, walnuts, hazelnuts, pistachios), milk, egg, fish, shellfish, sesame, soy, and wheat. New regulations require pre-packed-for-direct-sale foods to label all 14 major allergens, which has improved safety for people eating out and on the go.

Insect stings

Bee and wasp stings are the most common insect triggers in the UK, although hornet and ant stings can also cause severe reactions. Most people who have a severe reaction to an insect sting can be referred for venom immunotherapy, which can substantially reduce future reaction risk.

Medicine triggers

Penicillin and other antibiotics, NSAIDs (including ibuprofen and aspirin), opioid analgesics, contrast agents used in scans, neuromuscular blocking agents used during anaesthesia, and certain biologic medicines can all trigger anaphylaxis. NICE notes that medicine-triggered anaphylaxis is more common in older adults than food-triggered anaphylaxis.

Latex

Latex allergy can cause anaphylactic reactions in some. Most UK healthcare settings now use latex-free gloves and equipment as standard.

Exercise-induced and food-dependent exercise-induced

Some people only develop anaphylactic reactions when exercising after eating a particular food (often wheat). The food alone is fine; exercise alone is fine; but the combination triggers a reaction. This is a recognised but unusual pattern.

Idiopathic anaphylaxis

Around 30% of severe reactions have no clearly identified trigger after thorough investigation, according to NICE. This is called idiopathic anaphylaxis and can be frustrating, but the treatment approach (adrenaline device availability, action plan, antihistamine prophylaxis where appropriate) is essentially the same.

MCAS and overlap conditions

For some people, episodes that look like anaphylaxis are actually part of a wider mast cell activation syndrome (MCAS) picture, where mast cell degranulation happens unpredictably. MCAS care that takes you seriously means understanding the overlap, ensuring excipient sensitivities are addressed, and working with a prescriber who recognises that one-size-fits-all allergy advice doesn’t always fit. Our team can talk this through with you during the consultation.

What happens in the body with anaphylaxis?

Anaphylaxis is, at its core, a chemical chain reaction. When the immune system encounters a trigger (food, sting, medicine), specific antibodies called IgE bind to the trigger and signal mast cells and basophils throughout the body to release their contents. Those contents include histamine, tryptase, leukotrienes, prostaglandins, and other inflammatory mediators.

These mediators do several things at once. They widen blood vessels (causing flushing and a sudden drop in blood pressure), they make blood vessels leaky (causing swelling of the lips, tongue, throat, and face), they constrict the airways in the lungs (causing wheezing and breathing difficulty), they irritate the gut (causing pain, nausea, and vomiting), and they sensitise the skin (causing widespread itching and hives). Because all of these effects happen at once across multiple body systems, anaphylaxis is by definition a multi-system reaction, not a localised one.

Adrenaline reverses essentially all of these effects. It constricts the widened blood vessels (restoring blood pressure), it reduces vascular leak (reducing swelling), it relaxes airway smooth muscle (easing breathing), and it stabilises mast cells (slowing further mediator release). That’s why adrenaline is the only medicine that reliably treats anaphylaxis, and why antihistamines and steroids alone are not sufficient. Antihistamines treat the itch and the hives. They don’t treat the airway, the circulation, or the falling blood pressure.

Diagnosing anaphylaxis

Anaphylaxis diagnosis is almost entirely clinical, based on the pattern of symptoms during a reaction. The NHS and NICE Clinical Knowledge Summaries both recommend treating a suspected reaction with adrenaline first and asking diagnostic questions later. Waiting for confirmation is not an option in the acute setting.

After a reaction, formal diagnosis usually involves referral to an NHS allergy specialist (typically an immunologist or allergist), who will take a detailed history of what was eaten, used, or encountered before the reaction, and arrange one or more of the following:

• • Specific IgE blood tests (also called ImmunoCAP or RAST tests) for suspected food, insect, or medicine triggers

• • Skin prick testing under specialist supervision, where small amounts of suspected allergens are introduced into the skin and the reaction observed

• • Serum tryptase measurement during or shortly after the reaction, to confirm mast cell activation

• • Oral food challenges under hospital supervision in some cases, where the suspected trigger is reintroduced in a controlled setting

For patients consulting Courier Pharmacy, our online consultation captures your reaction history, your current allergy status, your medicines, and your existing care arrangements. Where blood tests would help guide care (for example, specific IgE panels for suspected food allergens, or a baseline tryptase to investigate possible MCAS), we can arrange them as part of the consultation. Tests that answer the question, not just tick a box.

Managing anaphylaxis: current treatments

Anaphylaxis management has two arms: emergency treatment of an acute reaction, and ongoing preparation between reactions. Both matter equally.

Adrenaline auto-injectors

Intramuscular adrenaline delivered by auto-injector remains the first-line emergency treatment for anaphylaxis. In the UK, three branded auto-injectors are available: EpiPen, Jext, and Emerade. All deliver a fixed dose of adrenaline (0.3mg for adults and children over 30kg, 0.15mg for children 7.5 to 30kg, with smaller doses for younger children where appropriate). The Electronic Medicines Compendium lists the full prescribing information for each device.

The crucial point is that everyone at risk of anaphylaxis should carry two in-date adrenaline devices at all times, in line with NICE guidance. A second dose may be needed if symptoms continue after 5 minutes, and a second dose is also needed if the first device misfires. One device is not enough.

Eurneffy: the first adrenaline nasal spray

Eurneffy, manufactured by ARS Pharmaceuticals and partnered with Stallergenes Greer in Europe, is the first needle-free adrenaline nasal spray to be licensed in the UK and the European Union. It received Great Britain marketing authorisation from the MHRA in 2025 (following EMA approval in 2024) for the emergency treatment of allergic reactions, including anaphylaxis, in adults and children weighing 30kg or more. A lower-strength version for children weighing 15 to 30kg is in regulatory progress.

Each Eurneffy device delivers a single 2mg dose of adrenaline as a nasal spray, sprayed once into one nostril. If symptoms continue or recur after 10 minutes, a second dose can be given into the other nostril using a fresh device. Like injectable auto-injectors, the recommendation is to carry two Eurneffy devices at all times. The device is roughly the size of a pen and is designed to be used immediately by anyone, including people without medical training, with simple visual instructions on the casing.

The clinical case for Eurneffy is straightforward. For many patients (particularly adolescents, adults with needle phobia, and caregivers responsible for administering adrenaline to someone else), the prospect of using an injectable auto-injector is itself a barrier to prompt treatment. Pharmacokinetic studies have shown that adrenaline absorbed via the nasal mucosa reaches the bloodstream rapidly and reliably, with peak concentrations comparable to those achieved by intramuscular injection. The mechanism of action is identical; only the delivery route differs.

Eurneffy is now an option to discuss during your consultation, particularly if you or someone you care for has previously delayed using an auto-injector because of needle anxiety, or if you’ve struggled with the technique of injectable devices in the past.

MHRA approves first needle?free adrenaline nasal spray for anaphylaxis (UK)

The MHRA has approved a new adrenaline (epinephrine) nasal spray called EURneffy for the emergency treatment of anaphylaxis (a sudden, severe allergic reaction that can cause breathing problems and a dangerous drop in blood pressure).

Until now, people have mainly used adrenaline auto?injectors (like pens). This new option gives a needle?free way to deliver adrenaline in an emergency.

Key points (plain English)

• • What it’s for: emergency treatment of severe allergic reactions (anaphylaxis).

• • Who can use it: adults and children who weigh 30kg or more.

• • How it works: it’s a single?dose nasal spray that delivers 2mg when activated.

• • Important tip: don’t press the plunger until the spray is in the nostril, or you’ll waste the dose.

• • Blocked nose? It can still be used if you’re congested from a cold or allergies.

• • Carry two: people should carry two sprays in case a second dose is needed, and tell friends/family where they are.

• • Auto?injectors still matter: the MHRA says adrenaline auto?injectors remain vital and life?saving, and people should still know how to respond in an emergency.

• • Safety monitoring: the MHRA will keep monitoring safety, and side effects can be reported via the Yellow Card scheme.

The MHRA notes that Eurneffy does not replace existing auto-injectors as a first-line option but adds to the available choices, and NHS specialist allergy clinics are increasingly discussing it as part of personalised emergency planning.

Antihistamines

Oral antihistamines such as cetirizine, fexofenadine, loratadine, or chlorphenamine (Piriton) can help with the skin and itching components of an allergic reaction, but they do not treat the airway, blood pressure, or circulation. They are useful for milder allergic reactions and as supportive treatment alongside adrenaline, but they are never a substitute for an adrenaline device in suspected anaphylaxis.

Steroids

Oral or injectable steroids (typically prednisolone or hydrocortisone) are sometimes given in hospital after anaphylaxis, although recent guidance has moved away from routine steroid use because the evidence for preventing biphasic (delayed second-phase) reactions is weaker than once thought.

Inhaled bronchodilators

People with asthma who experience anaphylaxis may also benefit from their usual reliever inhaler (such as salbutamol) for the airway component, although again, this does not replace adrenaline.

Trigger avoidance and labelling

Trigger avoidance is the foundation of long-term safety. This includes reading every food label, asking detailed questions in restaurants, carrying clear written information about your allergens, and where appropriate, wearing a medical alert bracelet or necklace.

Allergy immunotherapy

For some triggers (particularly insect venom, and increasingly peanut), graded immunotherapy under specialist supervision can reduce the severity of future reactions. This is an NHS-specialist service and not something we provide directly, but our prescribers can discuss whether referral might be appropriate.

Written allergy action plans

A written allergy action plan (sometimes called an emergency action plan) sets out exactly what to do when symptoms start, who to call, and when to use which device. It’s a small but consistently helpful document, and we encourage every patient at risk of anaphylaxis to have one accessible to themselves, family, and schools or workplaces.

Patient experiences and challenges

The most common thing patients tell us is that the emotional load of anaphylaxis risk is often heavier than the medical reality. Living with the awareness that a misread label, a hidden ingredient, or a single sting could put you in hospital is genuinely exhausting, particularly for parents of children with serious allergies. The clinical guidance focuses (rightly) on the technical aspects of recognition and treatment, but the wider lifestyle adaptation deserves more space than it usually gets.

Three patterns come up regularly in our consultations. First, the “I haven’t replaced my auto-injector yet” patient: someone whose original prescription has lapsed, whose pens are out of date, or who has misplaced one of their two devices. Replacement is straightforward; our prescribers can issue replacement prescriptions quickly, and the arrival of Eurneffy as a needle-free option has given some patients new motivation to refresh a kit they’d been quietly avoiding. Second, the “I’m not sure I’d know when to use it” patient: someone with a recent diagnosis who feels uncertain about which symptoms warrant adrenaline. This is where written action plans, family training, and pharmacist conversations make the biggest difference. Third, the “MCAS overlap” patient: someone whose reactions don’t fit a simple IgE pattern and who has been bouncing between allergy clinics and immunology services. We take MCAS seriously, and we’ll work with you on excipient-aware prescribing where it’s needed.

There’s also a wider piece about stigma, particularly for adults with new-onset food allergies. Adult-onset allergy is sometimes treated as fussiness in social settings, particularly in workplaces and restaurants. We take patient self-report seriously; if you tell us you’ve had a reaction, we won’t be the second clinician to talk you out of carrying an adrenaline device.

 

Innovative and new treatments for anaphylaxis

The anaphylaxis field has shifted in genuinely useful ways over the past five years. The biggest shifts have been around four areas.

The first is Eurneffy, the needle-free adrenaline nasal spray licensed in the UK and EU in 2024–2025. It is the first major innovation in adrenaline delivery in decades and substantially expands what an emergency kit can look like, particularly for patients with needle anxiety, adolescents, and caregivers. The MHRA listing makes clear that Eurneffy is not a replacement for injectable auto-injectors as a category, but an addition to the available options that prescribers and patients can choose between based on individual circumstances.

The second is peanut oral immunotherapy. Palforzia, an oral peanut protein product, is licensed in the UK as a desensitisation treatment for peanut allergy in children, delivered under specialist supervision. It doesn’t cure peanut allergy, but it can substantially reduce the severity of reactions to accidental exposure.

The third is improvements in auto-injector design. Newer devices have better needle systems, clearer instructions, and audio prompts that walk users through the steps. The Jext and Emerade designs in particular are easier to use under stress than older designs.

The fourth is wider recognition of mast cell activation syndrome (MCAS) and its overlap with anaphylaxis-like episodes. MCAS isn’t classical IgE-mediated allergy, but the clinical picture can look similar, and the treatment approach often involves a similar emergency kit (auto-injector or Eurneffy, antihistamines, often a stable dose of an H1 and H2 antihistamine, and sometimes a leukotriene receptor antagonist). MCAS care that takes you seriously means recognising the overlap and tailoring the medicine list accordingly.

The fifth is around community access. The introduction of “spare” auto-injectors in UK schools (legislation introduced in 2017) means that schools can hold backup devices for use in emergencies, even if the affected child’s own device fails or is unavailable. As Eurneffy enters wider use, we expect similar policy thinking to evolve around nasal spray adrenaline in school and public settings.

Looking to the future: research and hope

The next decade is likely to see better evidence for oral immunotherapy across a wider range of food allergens, paediatric formulations of Eurneffy for younger children, improved auto-injector design with smaller form factors, and more sophisticated diagnostic panels for distinguishing classical allergy from MCAS and idiopathic anaphylaxis. The Anaphylaxis Campaign and Allergy UK both highlight prevention, accurate diagnosis, and community awareness as priority areas.

The bigger picture is encouraging. UK allergy care has become substantially better organised over the past decade, school-level awareness has improved meaningfully, the option of needle-free adrenaline removes a real barrier that has lingered for years, and patient organisations have done excellent work shifting the cultural conversation. The conditions for living well with serious allergies are better now than they have ever been.

How Courier Pharmacy helps with anaphylaxis

We treat allergy management the way we treat any long-term condition. People often come to us after a hospital discharge, a new diagnosis, or a near-miss reaction that has made them realise their kit needs updating. They aren’t the problem. The system can feel disjointed between GP, hospital, school, and pharmacy, and our job is to be the part that joins it up.

Our approach leans on personalisation and guidance. Every adrenaline prescription, whether for an injectable auto-injector or for Eurneffy nasal spray, is supplied after an online consultation reviewed by a UK-qualified prescriber. We can arrange replacement devices when yours are due to expire, supply antihistamines and supportive medicines in line with NICE recommendations, and help you review your written allergy action plan. For people with MCAS or multiple drug sensitivities, our team can work with you on excipient-aware prescribing and compounded options for everyday medicines. MCAS care that takes you seriously isn’t a marketing line; it’s how we approach the whole consultation.

This is also where our brand ambassador, Dr Ada Jex-Cori, comes in. She represents our whole ethos: listening, challenging one-size-fits-all care, and building healthcare that fits the person. Behind her is a real team of pharmacists who do this work every day, and a community of patients we genuinely enjoy hearing from. If a particular device, antihistamine, or kit configuration isn’t right for you, our team will say so honestly and suggest a better next step.

Frequently asked questions about anaphylaxis

What is anaphylaxis?

Anaphylaxis is the most severe form of allergic reaction, affecting multiple body systems at once and developing rapidly (usually within minutes to a couple of hours of exposure to a trigger). It is a medical emergency that requires immediate adrenaline and a 999 call, as the NHS makes clear.

What are the main symptoms of anaphylaxis?

Symptoms include throat tightness or swelling, breathing difficulty, hives or widespread rash, sudden lip or facial swelling, severe abdominal pain or vomiting, fast or weak pulse, dizziness or collapse, and a sense of impending doom. The combination of airway, breathing, or circulation symptoms with sudden skin or gut symptoms strongly suggests anaphylaxis, according to NICE Clinical Knowledge Summaries.

What should I do if I think someone is having an anaphylactic reaction?

Use an adrenaline device immediately. If using an auto-injector, inject into the outer mid-thigh. If using Eurneffy nasal spray, deliver a single dose into one nostril. Call 999 and say “anaphylaxis”, lie the person flat with their legs raised (or sit them up if breathing is the main problem), and stay with them. If symptoms haven’t improved after 5 to 10 minutes, give a second dose. The NHS provides clear step-by-step guidance.

How does an adrenaline auto-injector work?

An auto-injector delivers a fixed dose of intramuscular adrenaline (0.3mg for adults, 0.15mg for smaller children) into the outer mid-thigh. Adrenaline reverses the key effects of anaphylaxis by constricting blood vessels, reducing swelling, relaxing airways, and stabilising mast cells. It’s one of two licensed adrenaline delivery routes in the UK, as the Electronic Medicines Compendium notes for each device.

What is Eurneffy and how does it differ from an EpiPen?

Eurneffy is the first needle-free adrenaline nasal spray licensed in the UK and EU, manufactured by ARS Pharmaceuticals. It delivers a 2mg dose of adrenaline as a single spray into one nostril, with rapid absorption through the nasal mucosa producing blood concentrations comparable to intramuscular injection. The active medicine is the same as an EpiPen; only the delivery route differs. Eurneffy is particularly useful for people with needle anxiety or those who have struggled with injectable auto-injector technique.

Who can use Eurneffy?

Eurneffy is currently licensed in the UK for adults and children weighing 30kg or more. A lower-strength formulation for children weighing 15 to 30kg is in regulatory progress. As with auto-injectors, NICE recommends carrying two devices at all times. Our prescribers can discuss whether Eurneffy is the right fit for your situation, including alongside or instead of injectable auto-injectors.

Why do I need to carry two adrenaline devices?

Because a second dose may be needed if symptoms continue after 5 to 10 minutes, and because devices can occasionally misfire. NICE guidance recommends that everyone at risk of anaphylaxis carries two in-date adrenaline devices at all times. One device is not enough, whether it’s an auto-injector or a Eurneffy nasal spray.

Are antihistamines enough to treat anaphylaxis?

No. Antihistamines such as cetirizine, fexofenadine, or chlorphenamine treat the skin and itching components of allergy but do not treat the airway, blood pressure, or circulation. They are useful for milder allergic reactions and as supportive treatment alongside adrenaline, but never as a replacement, as the NHS makes clear.

What are the most common triggers of anaphylaxis in the UK?

Common triggers include foods (peanuts, tree nuts, milk, egg, fish, shellfish, sesame), insect stings (wasps, bees), medicines (penicillin, NSAIDs, contrast agents, neuromuscular blockers), and latex. Around 30% of severe reactions have no clearly identified trigger after investigation, according to NICE Clinical Knowledge Summaries.

Can I outgrow an allergy that has caused anaphylaxis?

Some childhood allergies (particularly egg and milk) are often outgrown. Peanut, tree nut, fish, and shellfish allergies are usually lifelong. Insect venom allergy can be substantially reduced through specialist immunotherapy. Adult-onset allergies are generally less likely to be outgrown. A specialist allergy clinic can review your specific situation.

What is MCAS and how does it relate to anaphylaxis?

Mast cell activation syndrome (MCAS) is a condition where mast cells release their contents inappropriately, sometimes producing reactions that look very similar to anaphylaxis without a classical IgE allergy trigger. The emergency treatment is similar (adrenaline device, antihistamines), but the long-term plan often differs. Our team can talk this through with you, including excipient-aware prescribing.

Can I get adrenaline auto-injectors or Eurneffy from Courier Pharmacy?

Yes. EpiPen, Jext, Emerade, and Eurneffy are all Prescription Only Medicines in the UK and can be supplied after an online consultation reviewed by a UK-qualified prescriber. We can also arrange replacement devices when yours are due to expire and provide expiry tracking reminders.

What if my adrenaline device is out of date?

An out-of-date adrenaline device may still be partially effective in an emergency (it’s better than nothing), but expired adrenaline degrades over time and the dose can be significantly reduced. Replace expired devices promptly. Our team can help with quick replacement prescriptions and track upcoming expiry dates for you.

How do I get adrenaline devices and allergy support from Courier Pharmacy?

Complete the online consultation at courierpharmacy.co.uk. A UK-qualified prescriber will review your answers, issue a prescription if appropriate, and our pharmacy team will dispense and deliver discreetly. Free pharmacist support is available before and after you order, including a review of your written allergy action plan.

Disclaimer: This article is for information only and isn’t a substitute for personal medical advice. Always speak to a qualified prescriber before starting or changing treatment.

More than a condition: our community

Healthcare shouldn’t only happen when you’re buying something. That’s why Courier Pharmacy runs free fortnightly drop-in talks and clinics at Insomnia in Derby, every fortnight from 10 am to 12 pm, open to anyone living with long-term or complex conditions, including allergy, anaphylaxis, MCAS, fibromyalgia, and CFS/ME. It’s a calm space to ask questions, compare notes, and meet others going through similar experiences. No cost, no pressure, and you’re welcome to bring a friend or family member. Allergy and anaphylaxis preparedness are topics we cover regularly. Learn more about our community talks on the courierpharmacy.co.uk community page.

How this content was created

Written by the Courier Pharmacy editorial team and reviewed by a GPhC-registered pharmacist. Grounded in the latest NHS, NICE, BNF and EMC guidance, peer-reviewed studies, and the real questions patients bring to our drop-in clinics in Derby.

References

[1] NHS (n.d.) Anaphylaxis.

[2] National Institute for Health and Care Excellence (NICE) (n.d.) Angio-oedema and anaphylaxis. NICE Clinical Knowledge Summaries (CKS).

[3] Electronic Medicines Compendium (n.d.) EpiPen 0.3mg adrenaline auto-injector — Summary of Product Characteristics.

[4] Electronic Medicines Compendium (n.d.) Jext 300 micrograms adrenaline auto-injector — Summary of Product Characteristics.

[5] European Medicines Agency (2024) Eurneffy (adrenaline nasal spray): summary of product information [EDITOR: insert verified EMA / MHRA URL once UK SmPC live].