EpiPen, Anapen, Jext or neffy? Adrenaline Devices in Australia

Anaphylaxis & Asthma

EpiPen, Anapen, Jext or neffy? Adrenaline Devices in Australia Explained (2026)

Australia now has more adrenaline options than ever, including a needle-free nasal spray. Here is what each device is, how they differ, and the one first aid rule that never changes.

For years, most Australians only ever saw one adrenaline device: the EpiPen. That has changed. In late 2025 the Therapeutic Goods Administration (TGA) registered two new options, the neffy adrenaline nasal spray and the Jext adrenaline injector, joining EpiPen and Anapen.

More choice is good news for people living with severe allergies. But it also means parents, teachers, childcare educators, coaches and workplace first aiders may now come across a device they have never held before, in the middle of an emergency.

This guide explains the adrenaline devices available in Australia in 2026, how to recognise anaphylaxis, and why adrenaline must always come first, whichever device you are holding.

Quick answer

Which adrenaline devices are available in Australia? As of 2026, the TGA-registered devices are EpiPen and EpiPen Jr, Anapen 500, Jext and Jext Jr autoinjectors, and neffy adrenaline nasal spray (2 mg and 1 mg). They all deliver adrenaline, the first-line treatment for anaphylaxis. Whichever device is available, give it without delay at the first signs of a severe allergic reaction, lay the person down and call 000.

1. What Is Anaphylaxis?

Anaphylaxis is the most severe form of allergic reaction. It can become life threatening within minutes. The body's immune system overreacts to a trigger and releases a flood of chemicals that affect several body systems at once, including the airways, the heart and blood vessels, the skin and the gut.

Common triggers include:

• Foods such as peanuts, tree nuts, sesame, fish, shellfish, egg, cow's milk, soy and wheat

• Insect stings and bites, including bees, wasps and jack jumper ants

• Medicines, including some antibiotics and anti-inflammatory drugs

• Latex

• Occasionally exercise, especially when combined with certain foods

Anyone can have anaphylaxis, including people who have never had a serious reaction before. Around one in five people who have anaphylaxis do not have a prior diagnosis. That is why every first aider, not just those caring for someone with a known allergy, needs to recognise it.

2. How to Recognise Anaphylaxis

Anaphylaxis can develop within seconds, or may take up to 30 minutes or more to appear after exposure to a trigger. Symptoms often involve more than one body system.

Signs of anaphylaxis (any one of these)

• Difficult or noisy breathing

• Swelling of the tongue

• Swelling or tightness in the throat

• Wheeze or persistent cough

• Difficulty talking or a hoarse voice

• Persistent dizziness or collapse

• Pale and floppy (in young children)

• Sudden sleepiness, abdominal pain or vomiting after an insect sting

Milder allergic signs, such as hives, welts, swelling of the lips, face or eyes, tingling in the mouth, and abdominal pain or vomiting, can be the start of anaphylaxis. Stay with the person and watch closely for any of the signs above.

No rash does not mean no anaphylaxis

Not every anaphylaxis reaction involves hives or a visible skin change. Some of the most dangerous reactions show up mainly as breathing difficulty or collapse. If breathing or circulation is affected after contact with a likely trigger, treat it as anaphylaxis.

Anaphylaxis can look like asthma

For people with both asthma and allergies, anaphylaxis can look almost identical to a severe asthma attack. The coronial findings from several Australian deaths show how easily this confusion happens. Read our articles on why adrenaline comes before the inhaler and lessons from Max McKenzie's inquest for the full picture.

3. Why Adrenaline Always Comes First

Adrenaline, also called epinephrine, is the only first-line treatment for anaphylaxis. Nothing else can do what it does in the first minutes of a severe reaction.

Adrenaline works by:

• Relaxing the muscles around the airways to improve breathing

• Reducing swelling in the throat and airways

• Tightening blood vessels to raise dangerously low blood pressure

• Supporting the heart during cardiovascular collapse

• Reducing the release of more allergic chemicals

Antihistamines do not treat the serious symptoms of anaphylaxis. They act too slowly and do not reverse airway swelling or low blood pressure. Asthma relievers help the airways but do nothing for circulation. Using either as a first response wastes critical time.

If in doubt, give adrenaline.

Adrenaline is safe for most people when given in an emergency. The risk of giving it when it turns out not to be needed is far lower than the risk of giving it too late.

4. The Adrenaline Devices Available in Australia

Here is a side-by-side overview of the devices registered in Australia as of 2026. Doses and weight ranges are summarised from information published by ASCIA, the Australasian Society of Clinical Immunology and Allergy. Always follow the instructions on the device, the person's ASCIA Action Plan and their doctor's advice.

Pricing, availability and PBS subsidy differ between devices and can change. Your doctor or pharmacist can tell you which options are right for you and what they will cost.

5. EpiPen: The Device Most People Know

EpiPen has been the most widely used adrenaline autoinjector in Australia for many years. Most first aid courses, schools and workplaces train with EpiPen trainers, and many people know the simple rhyme: "Blue to the sky, orange to the thigh."

How to give an EpiPen

1. Form a fist around the EpiPen and pull off the blue safety release.

2. Hold the leg still and place the orange end against the outer mid-thigh. It can go through clothing.

3. Push down hard until you hear or feel a click, and hold it in place for 3 seconds.

4. Remove the EpiPen.

Then lay the person flat, call 000 and follow the rest of the anaphylaxis first aid steps below. Give the used device to the paramedics and tell them the time it was given.

6. Anapen 500: A Higher-Dose Autoinjector

Anapen is another adrenaline autoinjector available in Australia. The current Anapen device listed by ASCIA is Anapen 500, which delivers 500 micrograms of adrenaline. Your doctor may prescribe it based on body weight and individual needs.

Anapen looks and works differently from EpiPen. The caps, the colours and the way you activate it are not the same. That is exactly why it matters to practise with the right trainer. If you care for someone who carries Anapen, ask for a trainer device and run through the steps printed on it and on the ASCIA instructions until they feel automatic.

7. Jext: A New Autoinjector Option

Jext is an adrenaline autoinjector that has been used overseas for many years and was registered by the TGA in November 2025. It comes in two doses, Jext 300 micrograms and Jext Jr 150 micrograms, with similar weight ranges to EpiPen and EpiPen Jr.

Like every autoinjector, Jext is given into the outer mid-thigh and can go through clothing. The exact steps, including how you remove it from its case and how the safety cap works, are specific to the device. ASCIA has published step-by-step instructions for each device on its how to give adrenaline devices page.

8. neffy: Australia's First Needle-Free Adrenaline

Neffy is an adrenaline nasal spray. Instead of an injection into the thigh, it delivers adrenaline through the lining of the nose. It was approved in the United States and Europe before being registered in Australia in December 2025, and became available here from February 2026.

Why Neffy matters

Fear of needles is one of the reasons people, and especially parents and children, delay giving adrenaline. Every minute of delay matters in anaphylaxis. A needle-free option may help some people give adrenaline sooner, which is the whole point.

How Neffy is used

Neffy is a single-use spray. You do not prime or test it. It is placed in one nostril and the plunger is pressed firmly to give the full dose. If symptoms do not improve after 5 minutes, ASCIA guidance says to give a second dose with a new Neffy device, ideally in the same nostril. A second dose of injectable adrenaline can be used instead if that is what is available.

Doses

• Neffy 2 mg for adults and children weighing 30 kg and over

• Neffy 1 mg for children aged 4 years and older who weigh 15 to 30 kg

Neffy is not suitable for every person or every situation. It is a prescription decision between the person and their doctor. For first aiders, the key message is simple: if the person's action plan names neffy and that is the device they have, use it at the first signs of anaphylaxis, exactly as you would an autoinjector.

Questions to ask your doctor about devices

If you or your child is at risk of anaphylaxis, the new options are worth discussing at your next review. Useful questions include:

• Which device and dose suit my weight, age and lifestyle?

• Is a needle-free option appropriate for me or my child?

• How many devices should I carry, and where should I keep a spare?

• What does each device cost, and is it subsidised?

• Can I get a trainer device to practise with, and to share with school, childcare or my workplace?

• Does my ASCIA Action Plan need updating to show the device I now carry?

Whatever you choose, make sure everyone around you knows which device you carry and how to use it.

9. Anaphylaxis First Aid: Step by Step

The device may change. The first aid does not. These steps follow the ASCIA first aid approach for anaphylaxis.

1. Lay the person flat. Do not let them stand or walk. If they are having trouble breathing, let them sit with their legs out straight. If they are pregnant, lay them on their left side. Hold young children flat, not upright.

2. Give adrenaline. Use their prescribed device, or a general use device if theirs is not available, following the instructions on the device.

3. Call 000 for an ambulance. Every person who has had anaphylaxis needs to go to hospital, even if they seem to recover.

4. Phone a family member or emergency contact.

5. Give a further dose of adrenaline if there is no response after 5 minutes.

6. If breathing stops or the person becomes unresponsive and is not breathing normally, start CPR.

7. Stay with them and keep them lying down until paramedics take over. Give the used device to the paramedics and tell them the time it was given.

What happens at hospital

Hospital staff will assess the person, give further treatment if needed and usually observe them for several hours, because symptoms can come back. Before they go home, the person should have a current ASCIA Action Plan, a prescription to replace any device that was used, and a referral or follow-up plan with their doctor or an allergy specialist. If this was a first reaction, working out the trigger is an important next step.

For the first aider, a used device, the time it was given and a short note of symptoms and actions are the most helpful things to hand over.

Asthma and allergy together

If someone with a known allergy and asthma has sudden breathing difficulty, including wheeze, persistent cough or a hoarse voice, give adrenaline first, then asthma reliever medication. Do not wait to see whether the puffer works.

After anaphylaxis, the person should be observed in hospital. Symptoms can return after the first dose wears off, which is known as a biphasic reaction. That is one of the key lessons from the James Tsindos coronial inquest.

10. Laying Flat Matters More Than People Think

One of the most important parts of anaphylaxis first aid is also one of the easiest to forget: keep the person lying down.

During anaphylaxis, blood vessels relax and blood pressure can drop suddenly. If a person stands up, walks or is held upright, blood can pool in the legs and there may not be enough returning to the heart. This can cause sudden collapse and cardiac arrest.

That means:

• Do not walk the person to the first aid room, sick bay, car or ambulance. Bring help to them.

• Do not let them stand up, even if they feel better after adrenaline.

• Do not hold a young child upright on your shoulder. Hold them lying flat on your lap or on the floor.

• If they are struggling to breathe lying down, let them sit with legs out straight.

11. Common Mistakes With Adrenaline Devices

In our training rooms and in Australian coronial findings, the same errors come up again and again. Knowing them helps you avoid them.

• Waiting too long. Hoping symptoms will settle, or waiting for a second opinion, loses precious minutes.

• Giving antihistamine or a puffer first. Neither treats anaphylaxis. Adrenaline comes first.

• Injecting into the thumb. This happens when someone holds an autoinjector the wrong way round. Practise with a trainer so your grip is automatic.

• Not holding it long enough. Autoinjectors need to be held in place for the time stated on the device.

• Letting the person walk. Standing and walking can trigger collapse.

• Not calling 000. Everyone who has adrenaline for anaphylaxis needs to go to hospital.

• Expired or overheated devices. Devices kept in hot cars, sheds or glove boxes may not work properly.

• Leaving the device at home. A device only works if it is with the person.

Our article on the 7 anaphylaxis first aid mistakes that cost time in WA goes into more detail.

12. Storing and Checking Adrenaline Devices

An adrenaline device is only useful if it works when needed. Good storage and regular checks matter, especially in WA's heat.

• Keep devices at room temperature. Follow the storage instructions on the packaging. Do not refrigerate them and do not leave them in a hot car, ute, shed or in direct sun.

• Check expiry dates. Set a reminder in your phone a month before each device expires.

• Check the window. For autoinjectors with a viewing window, check the liquid is clear. Replace it if it is cloudy or discoloured.

• Keep the action plan with the device. An ASCIA Action Plan tells others exactly what to do.

• Carry it everywhere. Many people are advised to carry two devices, in case a second dose is needed.

For remote workers and travellers in the north of WA, plan ahead for heat. An insulated pouch can help keep devices in a safe temperature range during long days in the field.

13. What Schools, Childcare and Workplaces Need to Know

With four device types now registered, organisations that care for people with allergies need to update their thinking.

Know the devices your people carry

Ask families and staff which device they carry and make sure it is written on their action plan and individual health care plan. If a child carries neffy or Jext, staff should know how that specific device works.

Train with the right trainers

Trainer devices do not contain adrenaline or a needle, and they are the best way to build confidence. If your team only ever practises with one brand, add the others to your refreshers.

General use devices

Many schools, childcare services and workplaces keep an adrenaline device for general use, for people who do not have their own or whose device fails or is not available. Check your policies and make sure the general use device is stored correctly, checked regularly and easy to find.

Update plans and policies

Review your anaphylaxis management policy, risk minimisation plans and emergency response procedures to reflect the new devices. ASCIA updated its action plans and device instructions in December 2025, so make sure you are using current versions.

Education and care staff should hold current training. HLTAID012 Provide First Aid in an Education and Care Setting covers anaphylaxis and asthma management for children, and our article on why every WA school, club and workplace needs annual anaphylaxis training explains the case for regular refreshers.

14. Anaphylaxis in the Workplace

Anaphylaxis is not only a school and childcare issue. Adults have severe allergic reactions at work every day, in offices, kitchens, construction sites, farms and mine sites.

• Shared food. Morning teas, catered meetings, work functions and shared kitchens create risk for people with food allergies. Clear labelling and a culture of asking before sharing help.

• Insect stings outdoors. Gardeners, farm workers, rangers, road crews and anyone working outside may be stung. Some will not know they are allergic until it happens.

• Medications and latex. Health and care workers may be exposed to allergens through their work.

• Remote sites. On a remote site, a second dose of adrenaline may be needed long before help arrives. Carrying two devices and having a general use device in the site kit are important.

Employers should include anaphylaxis in first aid risk assessments, make sure first aiders are trained, and encourage workers with known allergies to share their action plan with their team. Workers do not have to disclose health conditions, but many find that telling a few trusted colleagues where their device is kept is a simple, powerful safety step.

15. Travelling With an Adrenaline Device

Whether you are heading to Broome for a holiday, flying FIFO to the Pilbara or travelling overseas, a little planning keeps you safe.

• Carry devices in your hand luggage, never in checked baggage, where they could be lost or exposed to extreme temperatures.

• Bring your ASCIA Action Plan and consider a letter from your doctor, especially for international travel.

• Protect devices from heat in cars, on boats and at the beach. An insulated pouch helps.

• Check expiry dates before you leave so you are not caught out while away.

• Research medical help at your destination, including how far the nearest hospital is.

• Tell travel companions where your device is and how to use it.

If you are travelling overseas, check whether your device type is available at your destination in case you need a replacement.

16. Talking to Children About Their Device

Children who carry adrenaline devices benefit from understanding them in age-appropriate ways. Confident kids are more likely to speak up early when something feels wrong.

• Explain that the device is "medicine that helps your breathing and your heart when you have a bad allergy".

• Let them hold and practise with a trainer device.

• Teach them to tell an adult straight away if their mouth feels funny, their throat feels tight or they feel sick after eating.

• As they get older, teach them to recognise their own symptoms and, when ready, to give their own device.

• Make sure friends' parents, coaches and grandparents know where the device is and how to use it.

For some children with a strong fear of needles, a needle-free option such as neffy may be something to discuss with their doctor.

17. A Real-World Scenario: A New Device on Camp

A Year 6 school camp is running at a coastal campsite in the South West. On the second night, Ava, who has a peanut allergy, eats a biscuit from a friend's snack pack. Within minutes she is coughing and says her throat feels tight.

The teacher, Sam, remembers Ava's action plan. It names neffy, not an EpiPen. Sam has only ever practised with EpiPen trainers, but at a refresher course last term the trainer passed around the new devices and walked the group through each one.

• Sam lays Ava flat on the floor of the cabin and asks another teacher to call 000.

• Sam takes the neffy from Ava's medical kit, places it in one nostril and presses the plunger firmly, following the steps on the device.

• A third adult calls Ava's parents.

• Ava's cough settles slightly but she is still wheezy after 5 minutes. Sam gives the second neffy in the same nostril.

• Sam keeps Ava lying down, talks to her calmly and watches her breathing until paramedics arrive.

Ava is taken to hospital, observed overnight and goes home the next day. Sam later says the refresher made all the difference. Holding an unfamiliar device in an emergency is stressful. Having held it before made it manageable.

18. Why Hands-On Training Matters More Than Ever

When there was mainly one device, most people could get by with one set of instructions. Now, first aiders may face different shapes, caps and methods, including a nasal spray. Reading about them helps. Holding and practising with them builds the automatic confidence you need under pressure.

In REACHAU courses, you:

• Practise recognising anaphylaxis through realistic scenarios, including reactions without a rash

• Handle trainer devices and rehearse the steps until they are second nature

• Practise laying a casualty flat, calling for help and managing the scene

• Learn the link between asthma and anaphylaxis, and why adrenaline comes first

• Practise CPR in case the person stops breathing

Anaphylaxis is covered in HLTAID011 Provide First Aid, HLTAID012 for education and care, and HLTAID014 Provide Advanced First Aid. We deliver across Perth and regional WA and can train your whole team on site.

The device may change. The rule does not.

Recognise the signs, lay them flat, give adrenaline, call 000. Practise it until your hands know what to do.

Frequently Asked Questions About Adrenaline Devices in Australia

Is neffy available in Australia?

Yes. neffy adrenaline nasal spray was registered by the TGA in December 2025 and became available in Australia from February 2026. It requires a prescription, so talk to your doctor about whether it suits you.

Is neffy as good as an EpiPen?

Both deliver adrenaline to treat anaphylaxis. Which device is right depends on the person and their doctor's advice. For first aiders, the rule is the same: give whichever device is available straight away.

How do you use a effy nasal spray?

Do not prime or test it. Place it in one nostril and press the plunger firmly. If symptoms do not improve after 5 minutes, give a second dose with a new device, ideally in the same nostril.

What is the difference between EpiPen and EpiPen Jr?

EpiPen delivers 300 micrograms of adrenaline for adults and children over 20 kg. EpiPen Jr delivers 150 micrograms for children weighing 7.5 to 20 kg.

What is Jext?

Jext is an adrenaline autoinjector registered by the TGA in November 2025. It comes as Jext 300 micrograms and Jext Jr 150 micrograms and is given into the outer mid-thigh.

Should I give an antihistamine for anaphylaxis?

Not as the first treatment. Antihistamines do not treat airway swelling or low blood pressure. Give adrenaline first, lay the person flat and call 000.

Can an adrenaline autoinjector go through clothing?

Yes. Autoinjectors can be given through clothing into the outer mid-thigh. Avoid seams, pockets and thick items that could get in the way.

What if I am not sure it is anaphylaxis?

If in doubt, give adrenaline. The risk of giving it when it was not needed is much lower than the risk of giving it too late. Then call 000.

Why must a person with anaphylaxis lie down?

Anaphylaxis can cause a sudden drop in blood pressure. Standing or walking can lead to collapse. Keep them lying flat, or sitting with legs outstretched if breathing is difficult.

Does everyone need to go to hospital after using adrenaline?

Yes. Call 000 after giving adrenaline. Symptoms can return after the first dose wears off, so the person needs to be observed in hospital.

How should adrenaline devices be stored?

Store devices at room temperature, following the packaging instructions. Do not refrigerate them or leave them in hot cars, and check expiry dates regularly so you can replace them in time.

Can I use someone else's adrenaline device in an emergency?

In a life-threatening emergency, giving any available adrenaline device is far better than giving none. Many schools and workplaces keep a general use device for exactly this reason. Call 000 as well.

Get Confident With Every Device

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Training and Assessment is delivered by Britt at Regional Education and Career Help Australia on behalf of ABC First Aid RTO 3399.

Written by Britt Brennan

Empowerment-Focused First Aid Trainer and Employment Coach, and founder of REACHAU. Britt has a special focus on anaphylaxis and asthma education, drawing on Australian coronial findings to help people act faster.

This article is general first aid information based on ASCIA and ANZCOR guidance current at the time of writing. It does not replace medical advice, an ASCIA Action Plan or a first aid course. Always follow the instructions for the specific device. In an emergency, call 000.