MHRA Consults on Adrenaline Nasal Sprays in Schools

Schools across the UK could keep spare adrenaline nasal sprays for pupils’ emergency use under a proposal from the Medicines and Healthcare products Regulatory Agency (MHRA). The regulator is consulting on changes to the Human Medicines Regulations 2012 that would allow schools to buy the sprays without an individual prescription.

According to the consultation, adoption would give schools in England, Scotland, Wales and Northern Ireland a choice of adrenaline product type and brand. They would not have to hold both nasal sprays and auto-injectors. The MHRA says these emergency supplies would supplement, rather than replace, the medicine prescribed to each pupil.

The proposed rules would preserve restrictions on who could receive and administer a school’s supply. Only pupils attending that school and known to be at risk of anaphylaxis would be eligible. Staff administering the medicine would need training in the particular product the school keeps.

The MHRA says the proposal would permit either product type to be used for a pupil prescribed the other. A school-held spray could therefore be used for a pupil prescribed an auto-injector, or an auto-injector for someone prescribed a spray. This would include emergencies in which a pupil had not responded to their own prescribed adrenaline.

Proposed guidance would specify use for pupils with an adrenaline prescription for anaphylaxis. It would also recommend obtaining consent from a parent or guardian as good practice, while stating that such consent is not legally required.

The consultation describes an exemption dating from 2017 that already allows schools to purchase and hold spare auto-injectors without a pupil-specific prescription. Under that exemption, trained staff may administer a spare device during an emergency to a pupil known to be at risk of anaphylaxis. Nasal sprays are not covered by the current exemption.

The MHRA says its authorisation of a non-injectable adrenaline spray for anaphylaxis dates to July 2025. The consultation lists a 1 mg version for children aged at least four who weigh 15–30 kg. For children and adults above 30 kg, it identifies a 2 mg version.

Views from throughout the UK are being sought through an eight-week consultation opened jointly by the MHRA and Northern Ireland’s Department of Health on 19 October 2026. The consultation document was published that day, with responses due by 14 December 2026.

In its accompanying release, the MHRA puts the share of serious food-allergic reactions occurring at school at approximately 20%. The release also states that September 2026 brought new allergy-safety requirements into effect for English schools under the first phase of Benedict’s Law.

* This article is based on publicly available information at the time of writing.