Epipen & Epipen Jr Auto-Injectors

How To Use For Acute Allergic Emergencies (Anaphylaxis)

The EpiPen auto-injector is a disposable drug delivery system featuring spring activation and a concealed needle. It is designed for self-administration of epinephrine in acute allergic emergencies (anaphylaxis). It provides a rapid, convenient dose of epinephrine for individuals needing protection from potentially fatal allergic reactions.

What is the drug in the EpiPen & EpiPen Jr. auto-injector?

The drug product is epinephrine. Epinephrine by injection is the treatment of choice for allergic emergencies (anaphylactic reactions) because it quickly begins working to reverse symptoms of an anaphylactic reaction. It constricts blood vessels, relaxes smooth muscles in the lungs to improve breathing, stimulates the heart, and works to reverse hives and swelling around the face and lips (angioedema). The effects of epinephrine usually last 10 to 20 minutes.

Does the EpiPen & EpiPen Jr auto-injector come in different strengths?

Yes. Epinephrine dosing is based on body weight. Your doctor will prescribe what is right for you.

• The EpiPen auto-injector (0.3 mg of epinephrine) is for individuals weighing 66 lbs. or more.
• The EpiPen Jr. auto-injector (0.15 mg of epinephrine) is for individuals weighing between 33 and 66 lbs.

Both strengths deliver a single dose. Sometimes a single dose of epinephrine may not be enough to completely reverse the effects of an anaphylactic reaction. The dose can be repeated in 15 minutes if there has been no improvement after the first dose. For that reason, your physician may prescribe more than one auto-injector.

Why might I need an EpiPen & EpiPen Jr. auto-injector?

The EpiPen auto-injector is commonly prescribed for individuals who are anaphylactic - that is, who have had prior severe allergic reactions or those who may be at high risk (e.g., a family history of severe reactions or a highly allergic individual). These reactions can be caused by a number of things:

• severe allergic reactions to food additives or foods -nuts, shellfish, eggs, etc..
• severe allergic reactions to drugs such as penicillin.
• severe allergic reactions to a sting from insects - bees, wasps, hornets, yellow jackets.
• severe allergic reactions to a reaction from exercise.
• severe allergic reactions to items containing latex -balloons, elastic, or other rubber items.

An allergic reaction to any of these may be so severe that it can be life-threatening very quickly and could occur when no physician or hospital is nearby. With an EpiPen auto-injector, an emergency injection of epinephrine is immediately available. The EpiPen injection can help stabilize you temporarily until you can reach the emergency room for follow-up by a physician.

How do I know that I am going into anaphylactic shock and need to use an EpiPen & EpiPen Jr. auto-injector?

Symptoms of anaphylactic shock can include hives, swelling (especially of the lips and face), difficulty breathing, vomiting, diarrhea, cramping, and a fall in blood pressure.

If you experience any of these symptoms and think you may be having an anaphylactic reaction, use an EpiPen auto-injector immediately and go to the hospital emergency room immediately.

Take your used auto-injector with you for proper disposal. To aid in the transport of your EpiPen to the hospital for disposal, carefully reinsert the fired unit (without replacing the safety cap) -NEEDLE FIRST - into the amber carrying tube. Re-cap the amber tube.

How do I use the EpiPen & EpiPen Jr. auto-injector?

The instructions for the EpiPen auto-injector are easy to follow. You should read the instructions included in each package when you first get your Epipen so you will be familiar with the EpiPen before an emergency occurs. In addition, your physician can provide you with a demonstration using a training device that simulates the actual auto-injector. As a reminder, instructions are printed on each Epi Pen auto-injector.

1. Form a fist around the auto-injector with the black tip facing down.
2. Pull off the gray safety cap.
3. Do not remove the safety cap until you are ready to use the auto-injector. Once the safety cap is removed, the auto-injector is ready for use and can be activated.
4. Never put your fingers over the black tip when removing the safety cap or after the safety cap has been removed.
5. It is not necessary to remove your clothing first. The EpiPen auto-injector is designed to work through your clothing.
6. Place the black tip against your outer thigh.
7. Do not put your thumb over the end of the unit.
8. With a quick motion, push the auto-injector firmly against your thigh. This will release a spring-activated mechanism that injects a dose of epinephrine.
9. Hold the auto-injector in place for a few seconds after activation.
10. Remove the auto-injector from your thigh.
11. Take your used auto-injector with you to the hospital emergency room for proper disposal.
12. To aid in the transport of your EpiPen to the hospital for disposal, carefully re-insert the fired unit (without replacing the safety cap) - NEEDLE FIRST - into the amber carrying tube. Re-cap the amber tube.

Where should I inject myself with the EpiPen & EpiPen Jr. auto-injector?

The EpiPen auto-injector should only be used on the fleshy outer portion of the thigh, about half way down the thigh from the hip. DO NOT ATTEMPT INJECTION INTO A VEIN OR INTO THE BUTTOCKS.

How do I know if my child received a dose of the medication?

Your child may not feel the medication being injected. However, it is released automatically when you activate the unit by pressing the auto-injector against the thigh. If the needle is exposed when you remove the auto-injector from the thigh, the medication has been released. A small amount of medication will remain in the auto-injector. This is normal and is necessary for product stability. It does not affect delivery of the dose.

Can the EpiPen & EpiPen Jr auto-injector be used through clothing?

Yes. The whole purpose of the Epi Pen auto-injector is to ensure that your child get an emergency dose of epinephrine quickly when needed. Therefore, it was designed to work through clothing if necessary.

Can I reuse the EpiPen & EpiPen Jr. auto-injector?

Each EpiPen auto-injector delivers a single dose of epinephrine. Even though a small amount of liquid remains inside an auto-injector after use, the unit cannot be used again. See the next question for information on proper disposal.

How do I dispose of my EpiPen & EpiPen Jr auto-injector after I have used it?

Take the EpiPen auto-injector with you to the hospital emergency room and ask the doctor or nurse to dispose of it for you. This will ensure that the doctor knows you have had a shot of epinephrine and what amount you received. To aid in the transport of your EpiPen to the hospital for disposal, carefully re-insert the fired unit (without replacing the safety cap) -NEEDLE FIRST- into the amber carrying tube. Re-cap the amber tube.

What will I feel when I use the EpiPen & EpiPen Jr. auto-injector?

The injection itself is relatively painless and the beneficial effects of the drug will be felt soon after injection.

The most common changes you may feel are a more rapid heart beat and a slight nervousness, "like a shot of adrenaline." As with any epinephrine product, you may also experience palpitations, sweating, dizziness, and headache.

After using an EpiPen & EpiPen Jr. auto-injector, what else should I do?

The EpiPen auto-injector is intended for emergency use only. After use, you should seek further medical help immediately. At the same time, try to keep warm and avoid unnecessary exertion.

The effects of the injection begin to wear off after 10 to 20 minutes; therefore, it is important to seek further medical assistance. If you cannot go to an emergency room, call 911 for assistance. Make certain you inform the health professionals who will treat you that you have given yourself an injection of epinephrine.

Where does the EpiPen & EpiPen Jr auto-injector technology come from?

Auto-injectors were initially developed for the military to deliver antidotes in the event of poison gas attack. They are ideal for this because of the need for a fast and easy method of providing life-saving medication in a high-stress situation. Similar auto-injector systems were also used with other drugs as part of the NASA Manned Space Flight Program. The EpiPen auto-injector was designed to provide a simple, quick self-injection of epinephrine during an acute allergic reaction.

Does the EpiPen & EpiPen Jr auto-injector expire and what do I do if it does?

As with any medication, the EpiPen auto-injector does have an expiration date, which is printed directly on the unit. When you first get your Epi Pen auto-injector, be sure to register it in the EpiPen Replacement Reminder Program. An enrollment form is included in each package. When you enroll in the EpiPen Replacement Reminder Program, we will notify you one month before the expiration date so that you can get a prescription for a new auto-injector.

The registration card also gives you the opportunity to receive free educational information from patient support groups such as The Food Allergy Network (F.A.N.), Medic-Alert, and ELASTIC (latex allergy).

Are there any special tips or precautions I should know?

• Keep your EpiPen auto-injector at room temperature until the marked expiration date, at which point your unit should be replaced.
• It should not be refrigerated; refrigeration for extended periods may cause the unit to malfunction. Neither should the EpiPen auto-injector be exposed to extreme heat, such as in the glove compartment or trunk of a car during the summer.
• Do not expose your auto-injector to direct sunlight; light and heat can cause epinephrine to degrade, turning brown. This shortens the usable life of the product. The best way to protect your auto-injector is to keep it in the plastic tube it comes in.
• Check your EpiPen auto-injector periodically through the viewing window of the unit to make sure the solution is clear and colorless.
• If the solution appears brown, replace the unit immediately.
• Regardless of the color of the epinephrine, always replace your auto-injector with a fresh unit prior to the expiration date.