A Nasal Spray May Redefine How Europe Treats Anaphylaxis

UK approval of nasal adrenaline hints at a wider European shift toward simpler, needle-free emergency treatments

21 Jul 2025

A routine feature of emergency care in the UK is beginning to change after the medicines regulator approved an adrenaline nasal spray for the treatment of severe allergic reactions, a move that could shape wider European thinking on needle-free therapies.

The decision by the Medicines and Healthcare products Regulatory Agency marks the first approval of a nasal form of adrenaline for anaphylaxis in the UK. Adrenaline auto-injectors have long been the standard treatment and are considered clinically effective, but concerns over usability have persisted, particularly in high-pressure situations outside clinical settings.

The nasal spray delivers the same active medicine through the nose, removing the need for injection. Supporters say this may reduce hesitation, simplify administration by patients or caregivers, and lower the risk of handling errors. Regulators reviewed data indicating the product could deliver adrenaline quickly and reliably, meeting clinical requirements while addressing practical concerns around use.

Industry analysts describe the approval as a signal rather than a fundamental shift in regulation. Across Europe, health authorities have shown rising interest in patient-friendly drug delivery, especially for acute and emergency care where speed and ease of use can influence outcomes. Nasal delivery is already used in some urgent treatments and is attracting renewed attention for its portability and suitability in community settings.

The UK decision also reflects a broader regulatory focus on real-world effectiveness alongside traditional clinical measures. Ease of administration is increasingly viewed as relevant when treatments depend on rapid action by non-professionals, such as teachers, family members or bystanders.

For pharmaceutical companies, the move highlights a strategic change in how delivery methods are considered. Drug delivery is no longer seen solely as a technical choice late in development, but as a factor that can affect uptake, patient confidence and market positioning. Some analysts expect this to shape future investment, though the impact will vary across therapy areas and health systems.

Obstacles remain before nasal adrenaline becomes widely used. Clinicians will require training, treatment guidelines may need revision, and reimbursement decisions will influence adoption. Health groups have expressed cautious optimism that simpler formats could improve response times, particularly in schools and public venues.

The MHRA approval is widely viewed as a reference point rather than a conclusion. As European healthcare systems place greater emphasis on access, safety and use outside hospitals, needle-free delivery is likely to play a larger role in how emergency medicines are assessed and introduced.