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Innovations to administer adrenaline via alternative routes may potentially improve usage rates and treatment effectiveness. Here, we describe the known limitations and barriers to AAI use in anaphylaxis. We then summarise current data for adrenaline devices which use alternative routes of administration for treating anaphylaxis. Several novel devices are in development, which deliver adrenaline via nasal, sublingual or transcutaneous routes. Pharmacokinetic, pharmacodynamic and safety studies have compared these treatments with AAI or intramuscular adrenaline via needle and syringe. The first non\u2010injectable adrenaline delivery device for emergency treatment of anaphylaxis was approved in Europe and the United States. Neffy, an adrenaline nasal spray, is licensed for use in adult and paediatric patients who weigh at least 30\u2009kg. In the near future, multiple alternatives to injectable adrenaline may be available for managing anaphylaxis, overcoming some, but not all of the limitations of AAIs.<\/jats:p>","DOI":"10.1111\/cea.14598","type":"journal-article","created":{"date-parts":[[2024,11,24]],"date-time":"2024-11-24T23:49:56Z","timestamp":1732492196000},"page":"36-51","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Alternatives to Injectable Adrenaline for Treating Anaphylaxis"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4118-6385","authenticated-orcid":false,"given":"Guillaume","family":"Pouessel","sequence":"first","affiliation":[{"name":"Service de P\u00e9diatrie, Pavillon M\u00e9dicochirurgical de P\u00e9diatrie Boulevard Lacordaire  Roubaix France"},{"name":"Unit\u00e9 de Pneumologie et Allergologie P\u00e9diatriques, H\u00f4pital Jeanne de Flandre CHRU Lille et Universit\u00e9  Lille France"},{"name":"ULR 2694: Metrics Univ. 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