The best way to learn is to ask questions. Click the questions below for answers to some of the most common questions about anaphylaxis, epinephrine, EpiPen® and EpiPen Jr® (epinephrine injection) Auto‑Injector. Be sure to talk with your doctor if your questions aren’t answered here.
Life‑Threatening Allergies and Anaphylaxis
What is anaphylaxis?
Anaphylaxis is a potentially life‑threatening allergic reaction that can occur quickly (as fast as within a couple of minutes of exposure to the allergen). Anaphylaxis can be caused by a number of allergens, or triggers, which commonly include certain foods, insect stinging and biting, medications and latex.
What are the symptoms of anaphylaxis?
Symptoms of anaphylaxis vary, but those involving the skin (hives, itching, skin redness) are most common. A majority of cases also involve swelling of the lips and tongue as well as of the airways (tightness in the throat, shortness of breath). Anaphylaxis may also involve the gastrointestinal system (nausea, stomach pain, vomiting, diarrhea, coughing), the cardiovascular system (fast heartbeat, chest pain, low blood pressure) or the central nervous system (headache, confusion).
What factors put one at increased risk for anaphylaxis?
Life‑threatening allergies can happen at any time, but certain factors may make some individuals susceptible to having a life‑threatening allergic reaction (anaphylaxis). Remember that by being careful to avoid your allergens, you can help prevent a life‑threatening allergic reaction. The factors that make some individuals susceptible can be divided into two categories:
- General factors that increase the risk of having a life‑threatening allergic reaction include:
- Exposure to certain allergens (triggers) such as food (e.g., peanuts, tree nuts, fish, shellfish, eggs and milk), biting or stinging insects (e.g., bees, ants and ticks), latex and medications (e.g., penicillin) for those who are allergic to them
- Exercise, in susceptible individuals
- Exposure to cold, heat or sunlight
- Factors that may increase the severity of a life‑threatening allergic reaction include:
- Adolescents and young adults may be at an increased risk of anaphylaxis because of inconsistent behaviors in avoiding known allergic triggers
- The elderly may be at an increased risk of having a more severe life‑threatening allergic reaction because of accompanying disorders and medications used to treat those disorders, such as heart disease. In addition, the elderly may be at an increased risk of having a more severe life‑threatening allergic reaction if they are exposed to biting or stinging insects
- Disorders that make the symptoms of anaphylaxis difficult to recognize, such as impaired vision, seizures or depression
- Medications or chemicals that make the symptoms of anaphylaxis difficult to recognize, such as antidepressants, sedatives or alcohol
- Disorders such as asthma (especially if severe or not controlled with medication), heart disease, high blood pressure and cerebrovascular disease, such as stroke
- Certain medications used in the treatment of heart disease, such as beta‑blockers, that may block the medicinal benefits of epinephrine
Talk to your healthcare professional to determine if you may be at increased risk for anaphylaxis—and if you or your child should be prescribed EpiPen® or EpiPen Jr® Auto‑Injector. It’s important that those at increased risk for anaphylaxis are careful to avoid known allergy‑causing triggers and always have access to two EpiPen® or EpiPen Jr® Auto‑Injectors.
I’ve had a life‑threatening allergic reaction (anaphylaxis). Can I have another one, or have I built up a tolerance to the allergic trigger?
If you have had anaphylaxis, you may be at an even higher risk for another life‑threatening allergic reaction. It is not possible to predict who will or will not have another episode. It is possible to become less sensitive to an allergic trigger, but this usually happens after a treatment like allergy shots. You may sometimes even outgrow your reaction to some food triggers. However, you may also experience a more serious episode than you did the first time.
What foods typically cause anaphylaxis?
About 2.5% of Americans have some type of food allergy, and the problem is more prevalent among kids—about 1 in 13 children has a food allergy. Peanuts, tree nuts (such as walnuts and pecans), shellfish, fish, cow’s milk, eggs, wheat and soy account for the majority of life‑threatening food allergies.
How does epinephrine work?
The drug in EpiPen® and EpiPen Jr® Auto‑Injector is epinephrine. It constricts blood vessels to increase blood pressure, relaxes smooth muscles in the lungs to reduce wheezing and improve breathing, stimulates the heart (increases heart rate) and works to reduce hives and swelling that may occur around the face and lips.
Is one dose of epinephrine always enough? When might I need two?
Approximately 20% of patients—about 1 in 5—who receive an initial dose of epinephrine for treatment of anaphylaxis require a second dose. Why? Sometimes an allergic reaction can be so severe, a second dose of epinephrine is required. In other cases, a second allergic reaction can occur 1 to 72 hours (usually within 8 hours) after the initial reaction—even with no further exposure to the allergic trigger. Therefore, it is important that patients at increased risk for anaphylaxis have two doses of epinephrine available.
For your convenience, both EpiPen® and EpiPen Jr® Auto‑Injectors are available in EpiPen 2‑Pak® and EpiPen Jr 2-Pak® cartons. It’s important that you keep both EpiPen® Auto‑Injectors together at all times. That way, an extra dose is available if it’s needed. More than two sequential doses of EpiPen® Auto‑Injector should be administered only under direct medical supervision.
Make sure you speak with your healthcare professional about how to identify the signs and symptoms of a life‑threatening allergic reaction (anaphylaxis). If you, your child or someone you're caring for shows signs or symptoms of anaphylaxis, administer EpiPen® or EpiPen Jr® Auto‑Injector immediately as prescribed and seek emergency medical care. Take the used EpiPen® or EpiPen Jr® Auto‑Injector with you to the emergency room for inspection and disposal. Please read the full Prescribing Information.
Your EpiPen® Auto-Injector
To download the Prescribing Information, including Patient Information and complete instructions for use, please click here.
How long has EpiPen® been available?
EpiPen® Auto‑Injector has been available for more than 25 years. Over 60 million EpiPen® Auto‑Injectors have been dispensed.* Many patients, caregivers and school nurses are already familiar with EpiPen® Auto‑Injector.
*Based on IMS Data from 1987‑2014
Where’s the best place to keep EpiPen® and EpiPen Jr® Auto‑Injectors?
You should take your EpiPen® or EpiPen Jr® Auto‑Injectors everywhere you go, but they should be kept at room temperature (25°C, 77°F) until the marked expiration date, when they should be replaced. Your EpiPen® or EpiPen Jr® Auto‑Injector should not be refrigerated or exposed to extreme heat or light. Keep these temperature requirements in mind if you’re thinking of putting your auto‑injectors in your car’s glove compartment, for example. Learn how to receive a complimentary carrying case for your EpiPen® or EpiPen Jr® Auto‑Injectors.
Do EpiPen® and EpiPen Jr® Auto‑Injectors expire? If so, what should I do when one expires?
Like any medication, EpiPen® and EpiPen Jr® Auto‑Injector has an expiration date, which is printed on the side of the auto‑injector. Because the effectiveness of epinephrine may decrease after the expiration date, you should promptly refill your prescription before the expiration date. You can register your EpiPen® or EpiPen Jr® Auto‑Injectors online through the My EpiPen® program and we’ll send you reminders before your devices expire.
Can I get more than two EpiPen® or EpiPen Jr® Auto‑Injectors to have on hand?
Talk to your doctor if you need additional EpiPen® or EpiPen Jr® Auto‑Injectors to keep at work, school or any other location. The EpiPen® co‑pay savings offer could help you save on up to three EpiPen 2‑Pak® or EpiPen Jr 2-Pak® cartons per prescription fill, now through December 31, 2015. (Eligibility restrictions apply. See Terms and Conditions.)
Where should children with potentially life-threatening (severe) allergies keep EpiPen® or EpiPen Jr® Auto‑Injector while at school?
Make sure your child or appropriate school personnel have immediate access to his/her EpiPen® or EpiPen Jr® Auto‑Injectors. School regulations for carrying epinephrine auto‑injectors vary and should be discussed with school personnel. School personnel should also be informed of your child’s history of anaphylaxis and your child’s specific allergy trigger(s).
Is there one EpiPen® Auto‑Injector for all ages?
EpiPen® Auto‑Injector contains a single dose of 0.3 mg of epinephrine, appropriate for people weighing 66 pounds or more. EpiPen Jr® Auto‑Injector contains 0.15 mg of epinephrine for children with severe allergies weighing 33 to 66 pounds. Your healthcare professional will carefully determine the appropriate dose of epinephrine for you or your child.
Can I use EpiPen® or EpiPen Jr® Auto‑Injector on a different body part besides the thigh?
No. EpiPen® and EpiPen Jr® Auto‑Injectors should only be injected into the middle of the outer thigh (upper leg). DO NOT INJECT INTO YOUR VEIN, BUTTOCK, FINGERS, TOES, HANDS OR FEET. In case of accidental epinephrine injection, please seek immediate medical treatment.
The liquid inside my EpiPen® or EpiPen Jr® Auto‑Injector appears discolored. What should I do?
Examine the contents (the epinephrine solution) in the clear window of your EpiPen® or EpiPen Jr® Auto‑Injector periodically. The epinephrine solution should be clear. If the epinephrine solution is discolored (pinkish or brown color) or contains solid particles, speak with your healthcare professional immediately and replace your EpiPen® or EpiPen Jr® Auto‑Injector.
Can I reuse my EpiPen® or EpiPen Jr® Auto‑Injector?
No. Although some of the liquid (epinephrine solution) remains in the EpiPen® and EpiPen Jr® Auto‑Injector after an injection, it cannot be reused. Take your used EpiPen® or EpiPen Jr® Auto‑Injector with you to the emergency room or your healthcare professional’s office for proper disposal and obtain a replacement EpiPen® or EpiPen Jr® Auto‑Injector.
Is the EpiPen® and EpiPen Jr® Auto‑Injector carrier tube waterproof?
No. The carrier tube has no rubber seal, and it is not waterproof. If your EpiPen® or EpiPen Jr® Auto‑Injector is ever submerged in water or another liquid, contact your healthcare professional immediately to obtain a new EpiPen® or EpiPen Jr® Auto‑Injector prescription.
What should I do with EpiPen® or EpiPen Jr® Auto‑Injector after it has been used?
Take used EpiPen® or EpiPen Jr® Auto-Injectors to the emergency room or healthcare professional’s office for proper disposal, and ask for a new EpiPen® or EpiPen Jr® Auto-Injector prescription.