Patient education: Epinephrine autoinjectors (The Basics)

What is an epinephrine autoinjector? — An epinephrine autoinjector (sample brand names: EpiPen, Auvi-Q) is a device that gives a person a shot of a medicine called "epinephrine." Epinephrine is used to treat a severe allergic reaction, also called "anaphylaxis." A severe allergic reaction can happen after a person eats a food, takes a medicine, or is stung by an insect that they are allergic to.

What are the symptoms of an allergic reaction? — Symptoms of an allergic reaction can include:

●Hives – These are raised patches of skin that are very itchy (picture 1).

●Puffiness of the face, eyelids, ears, mouth, hands, or feet

●Redness or itching of the skin (without hives)

●Runny nose or swelling of the tongue

●Wheezing or trouble breathing

●Vomiting or diarrhea

●Feeling dizzy or passing out

●Death (although this is rare)

When should I use my epinephrine autoinjector? — Your doctor or nurse will tell you when you should use your autoinjector. Most doctors recommend that you use one right away when you have an allergic reaction and:

●Have trouble breathing or feel like your throat is tight

●Feel dizzy or like you are going to pass out

If your doctor prescribed an autoinjector for your child, use it right away when your child has an allergic reaction and:

●Seems groggy or passes out

●Vomits a lot

●Coughs a lot

●Has hives all over their body

How do I use an epinephrine autoinjector? — Your autoinjector will have directions that come with it. It's important to read the directions so you will know what to do before you actually need to use it.

These are the general steps:

●Take the autoinjector out of its case.

●Hold the autoinjector in your hand. Make sure your fingers aren't covering either end.

●Take off the safety cap (or caps).

●If you're giving the injection to a child or someone who might have trouble staying still, hold their leg so they can't move.

●Press the tip firmly into the outer thigh – The needle in the autoinjector can go through clothes (picture 2).

●Hold it in place for at least 2 to 3 seconds.

After you use an autoinjector, call for an ambulance (in the US and Canada, call 9-1-1) or have someone drive you to the emergency department. This is because epinephrine doesn't last very long in the body, and symptoms can sometimes come back as it wears off. In the hospital, doctors can watch you and give you more medicine if needed.

What if the autoinjector doesn't stop my symptoms? — The medicine in the autoinjector should stop your symptoms within a few minutes. But if your symptoms don't improve, get worse, or return before you reach the hospital, you will need another dose.

Some autoinjectors have 2 doses of medicine in them, but most have only 1 dose. If your autoinjector has only 1 dose of medicine, you will need to use a second autoinjector.

Can I use an expired autoinjector? — It is best to use an autoinjector that has not expired. Over time, the epinephrine might not work as well. Check the dates on all of your autoinjectors regularly. Call your doctor, nurse, or pharmacist if they have expired and you need a new prescription.

In an emergency, using an expired autoinjector is better than not using one at all.

Where should I keep my autoinjector? — Keep your autoinjector at room temperature. Do not leave it in places that could get too hot or cold, like your car. You can buy small cases, bags, or belts meant for carrying autoinjectors.

You should carry at least 1 autoinjector with you at all times, because you never know when you'll need it. Let your family members know where you keep your autoinjector. That way, if you have an allergic reaction but can't get your autoinjector, another person can get it and use it on you.

If your child has an autoinjector, be sure to bring it wherever they go. You should also keep at least 1 at your child's school, day care, or with other regular caregivers.

What are the side effects of epinephrine? — Epinephrine can cause short-term side effects, such as:

●Fast or pounding heartbeat

●Feeling nervous, shaky, or dizzy

●Headache

Is epinephrine dangerous? — Epinephrine is the same as the hormone adrenaline. Your body makes its own adrenaline when you are scared, stressed, or having an allergic reaction. Using an autoinjector just gives you more adrenaline than your body can make on its own. It can make your heart race or, very rarely, cause abnormal heartbeats. But letting a serious allergic reaction go untreated is much more dangerous than using an autoinjector.

What if I am worried about cost? — Some brands of autoinjectors can be expensive. The amount you will have to pay depends on where you live, which autoinjector you have, and your health insurance. If you are worried about the cost, talk to your doctor or nurse. You might be able to get a different type of autoinjector that is less expensive.

More on this topic

Patient education: Anaphylaxis (The Basics)
Patient education: Food allergy (The Basics)
Patient education: Insect bites and stings (The Basics)
Patient education: Peanut allergy (The Basics)

Patient education: Using an epinephrine autoinjector (Beyond the Basics)
Patient education: Anaphylaxis symptoms and diagnosis (Beyond the Basics)
Patient education: Anaphylaxis treatment and prevention of recurrences (Beyond the Basics)