New developments in the treatment of anaphylaxis: alternative forms of administration of adrenaline other than by injection. Given barriers to the use of adrenaline auto-injectors, alternative forms of adrenaline are desirable. Several devices using adrenaline by intranasal, sublingual or transcutaneous route are currently under investigation. An adrenaline intranasal spray for anaphylaxis treatment is now approved in the United States and Europe.