EpiPen®

Also called adrenaline (epinephrine) auto-injector

Easy-to-read medicine information about EpiPen; what it is, how to use EpiPen safely and possible side effects.

What is an EpiPen?

An EpiPen is an auto-injector device that has a pre-filled syringe fitted with a needle and contains a single dose of adrenaline (also called epinephrine) for rapid injection into the muscle. It is used in an emergency to quickly treat anaphylaxis – see signs of anaphylaxis.

EpiPens are easy to use and can be given by non-medical people, such as parents, caregivers, passers-by or the allergic person themselves (if they are well and old enough). 
 
EpiPens are designed for emergency first-response therapy only and are not a replacement for emergency medical or hospital care. You must still call an ambulance (on 111) or be taken to hospital for observation, even if you feel much better.

Each EpiPen contains a pre-measured dose of adrenaline and can only be used once.

Epipen and Epipen Junior

In New Zealand, there are two strengths of EpiPen which have different amounts of adrenaline. 

EpiPen: 300 micrograms (for people weighing more than 30 kg)
EpiPen Junior: 150 micrograms (for children weighing 15 to 30 kg).  

Note: The Australian dosing guidelines below are slightly different and some New Zealand organisations use them:
    
EpiPen: 300 micrograms (for people weighing more than 20 kg)
EpiPen Junior: 150 micrograms (for children weighing 10 to 20 kg).

How do you get an EpiPen?

In New Zealand, an EpiPen may be prescribed by your doctor or you can buy it directly from a pharmacy, without a prescription. EpiPen is not funded by Pharmac. 

When to use an EpiPen

EpiPens are intended for use in people who have been assessed and advised by their doctor as needing an EpiPen to treat their severe allergic reaction caused by food, medicines, insects, latex or other allergens. Anaphylaxis is the most severe form of allergic reaction that can be life-threatening. It usually occurs almost immediately (20 minutes to 2 hours) after exposure to a food, medicine or insect to which a person is allergic. 

Anaphylaxis must be treated as a medical emergency requiring immediate treatment with adrenaline.

Signs of anaphylaxis:
  • mouth: swelling of the tongue
  • throat: swelling, tightness or closure
  • heart: weak pulse, dizziness, collapse, seizures or unconsciousness
  • stomach: nausea, vomiting, diarrhoea, severe stomach cramps
  • lungs: coughing, wheezing, difficult or noisy breathing
  • skin: flushing, itching, skin rash, hives.

How to use an EpiPen

Learn how to use an EpiPen BEFORE a severe allergic reaction causes a medical emergency. Ask your doctor or pharmacist for advice on how to use the EpiPen. 

EpiPen has a hidden needle, which helps people overcome any fear they may have. The needle is very fine so the injection doesn't usually hurt. It can be injected into the thigh muscle through clothes if necessary, even jeans, but its best to avoid seams and pockets.

EpiPen and EpiPen Junior work in exactly the same way. 

1. Form fist around EpiPen and PULL OFF BLUE SAFETY RELEASE
2. Hold leg still and PLACE ORANGE END against outer mid-thigh (with or without clothing)
3. PUSH DOWN HARD until a click is heard or felt and hold for 3 seconds
Images © 2018 ASCIA 


(Mylan NZ)

After you have used the EpiPen:

  • phone or ask someone to phone an ambulance on 111 (in New Zealand) and tell the operator you are having anaphylaxis and have given yourself adrenaline
  • don't sit upright if you feel lightheaded or dizzy 
  • lie down and wait for the ambulance
  • record the time the injection was given and take the used EpiPen with you to the emergency room.

Each EpiPen can only be used once. After it has been used, put it back in its container and give it to your doctor or hospital staff who will dispose of it for you.

Tips when using your EpiPen

Have an action plan: Ask your doctor about an action plan that tells you or others what to do if you are having a severe allergic reaction. For example, see Action plan for anaphylaxis

Be prepared: Make sure you and your close friends and family know in advance what symptoms to watch for, how to use your EpiPen and where your EpiPen is kept. Ask your pharmacist about EpiPen training kits or contact Epiclub for a training device.  

Check the expiry date of your EpiPen: An expired EpiPen will still work but may be less effective. The expiry date is printed on the side of the EpiPen device. Get a new EpiPen before your old one expires and record the expiry date on your calendar as a reminder or sign up to Epiclub reminder service to help remind you when your EpiPen is about to expire.  

Please note: In the event of a severe allergic reaction, it is better to use an out of date EpiPen than nothing at all.

Some people may need to carry two EpiPens: You may need two doses of EpiPen if you are very overweight, have had previous near-fatal anaphylaxis or have needed multiple doses for previous anaphylactic episodes. Check with your doctor. Also, if you are going to be quite a long way away from any medical help such as on a boat/ship or tramping/mountaineering, it is a good idea to carry more than one EpiPen.

Store your EpiPen at room temperature: Do not store it in sunlight, in the glove compartment of your car or anywhere it may get too hot or in the fridge which is too cold. 

Carry your EpiPen with you at all times: Pouches are available for men and women generally keep theirs in their handbag. When you are travelling by plane, carry your EpiPen on your person, or in your hand luggage. Read more travel plan anaphylaxis and travelling with allergy checklist.  

How to give EpiPen (english; other languages)

References

  1. EpiPen Auckland DHB Clinical Immunology and Allergy
  2. Patient information re adrenaline autoinjector ordering Starship Children’s Health Allergy and Clinical Immunology
  3. Adrenaline New Zealand Formulary
Credits: Sandra Ponen, pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 01 May 2019