Frequently Asked Questions

Frequently Asked Questions

When should I prescribe an EpiPen Auto-Injector?

An EpiPen Auto-Injector should be prescribed for any patient with a history of anaphylaxis as well as for patients at risk for anaphylaxis (see ‘Identifying at-risk patients’ section).1

How should the EpiPen Auto-Injector be administered?

EpiPen and EpiPen Jr Auto-Injectors should be injected intramuscularly or subcutaneously into the anterolateral aspect of the thigh, through clothing if necessary.2 The detailed steps are as follows and are also described in the ‘About EpiPen Auto-Injector’ section3:

  1. Pull off blue safety release cap.
  2. Swing and firmly push orange tip against outer thigh so it ‘clicks.’ HOLD on thigh approximately 10 seconds to deliver drug.
  3. Instruct your patients to seek immediate medical attention by calling 911 and going to the closest medical facility. Also, instruct the patient to take the used EpiPen Auto-Injector(s) with them.

How should my patients dispose of a used EpiPen Auto-Injector?

It is important to communicate to your patients that expired and used auto injectors must be disposed of properly. They should be taken to a doctor’s office or to a hospital for proper disposal.3 Also, remind your patients to obtain a replacement for any EpiPen Auto-Injector(s) used or disposed of.

When should a second dose of epinephrine be given?

With severe persistent anaphylaxis, repeated injections with additional EpiPen Auto-Injectors may be necessary.2 Up to 20% of patients who receive an initial first dose of epinephrine require a second dose, because of either a biphasic reaction or ongoing symptoms.4 In such cases, the epinephrine dose can be repeated every 5-15 minutes, as needed.1 Remind your patients that more than two doses of EpiPen Auto-Injector should only be administered under direct medical supervision.2

How chemically stable is epinephrine?

Epinephrine solution deteriorates rapidly on exposure to air or light, turning pink from oxidation to adrenochrome and brown from the formation of melanin. Patients should be instructed to visually inspect the epinephrine solution periodically for particulate matter and discoloration. Patients should also be advised to replace their EpiPen and EpiPen Jr Auto-Injectors if the epinephrine solution contains particulate matter or develops a pinkish color or becomes darker than slightly yellow, because these changes indicate that the effectiveness of the drug product may have decreased or been affected.2

How should the EpiPen Auto-Injector be carried?

Until the EpiPen Auto-Injector needs to be used, it should be carried in the carrier tube with the blue safety release cap on.3

How should the EpiPen Auto-Injector be stored?

EpiPen and EpiPen Jr Auto-Injectors should be stored in the carrier tube provided at a temperature of 25ºC (77ºF); however, temperature excursions between 15ºC and 30ºC (59ºF to 86ºF) are permitted. EpiPen and EpiPen Jr Auto-Injectors should not be stored in refrigerators or in a vehicle’s glove box. The auto-injectors should not be exposed to extreme heat or cold.2,3

My patient accidentally injected himself/herself with an EpiPen Auto-Injector. What should I do?

Because epinephrine is a strong vasoconstrictor, accidental injection into fingers, hands or feet may result in decrease or loss of blood flow to these areas. Treatment should be directed at vasodilation in addition to further treatment of anaphylaxis. The patient should be advised to go immediately to the nearest emergency room and to inform the health care professional in the emergency room of the location of the accidental injection.2,3