Dosage

Selection of the appropriate dose of epinephrine is determined according to patient body weight and is described in Table 1. Each EpiPen® or EpiPen Jr® (epinephrine injection) Auto-Injector contains a single dose of epinephrine. Since the doses of epinephrine delivered from EpiPen® and EpiPen Jr® Auto-Injector are fixed, consider using other forms of injectable epinephrine if doses lower than 0.15 mg are deemed necessary. The prescriber should carefully assess each patient to determine the most appropriate dose of epinephrine.1

Table 1. EpiPen® Auto-Injector dosing1

Auto-Injector Epinephrine Concentration Patient Weight
EpiPen® Auto-Injector 0.3 mg (0.3 mL, 1:1000) ≥30 kg (≥66 pounds)
EpiPen Jr® Auto-Injector 0.15 mg (0.3 mL, 1:2000) 15-30 kg (33-66 pounds)

How to use EpiPen® Auto-Injector

It is important to counsel a patient on the correct administration technique for EpiPen® Auto-Injector.2-4 (View a step-by-step video and share it with your patients.) It is also important to counsel the patient that other epinephrine auto-injectors look and operate differently from EpiPen® Auto-Injector.5 Dispensing a different auto-injector than what patients are prescribed and trained on could lead to patient confusion, according to Ram et al.6

Order complimentary EpiPen® Trainer Units to keep in your office or exam room to help train your patients.

To download the full Prescribing & Patient Information, including complete directions for use, please click here.

When should epinephrine be administered?

The immediate administration of epinephrine is critical for all patients meeting any of the three criteria outlined in the “Anaphylaxis Diagnosis Criteria” section.7,8 Any delay in treatment increases the risk of a fatal anaphylactic reaction or a biphasic reaction in these patients.8,9 Some patients not meeting these criteria may still need an immediate injection.7 For example, patients who have had a previous near-fatal anaphylactic reaction and who are exhibiting signs of even a mild allergic reaction after exposure to a known allergen should receive emergency treatment.7 There are no absolute contraindications to epinephrine administration for an anaphylactic reaction.1,4 It is important to administer epinephrine immediately.8-10

When a second dose of epinephrine may be warranted

If the initial response to epinephrine is less than optimal or if the attack is severe, epinephrine can be repeated every 5-15 minutes.2,9 More than two sequential doses of epinephrine should be administered only under direct medical supervision.1

Up to 20% of patients may need additional doses due to a biphasic reaction or continuing symptoms (see “The Continuum of Anaphylaxis” section).8 For this reason it is important that patients at increased risk for anaphylaxis have two doses of epinephrine available.2,11

It is important to communicate to your patients that if they, their child or someone they’re caring for shows signs or symptoms of an anaphylactic reaction, they should inject EpiPen® or EpiPen Jr® Auto-Injector immediately and seek emergency medical attention.8,9