What is an EpiPen (epinephrine)?

EpiPen is an injectable medication used to treat severe emergency allergic reactions (anaphylaxis) to food, insect bites or stings, and other allergens. It is also used to treat exercise-induced anaphylaxis

EpiPen belongs to the drug class alpha/beta-adrenergic agonists. It works by releasing epinephrine providing adrenaline to reverse anaphylaxis symptoms.

EpiPen & EpiPen JR

What is an EpiPen (epinephrine)?

EpiPen is an injectable medication used to treat severe emergency allergic reactions (anaphylaxis) to food, insect bites or stings and other allergens. EpiPen is also used to treat exercise-induced anaphylaxis

EpiPen belongs to the drug class alpha/beta-adrenergic agonists. EpiPen releases epinephrine providing adrenaline to reverse anaphylaxis symptoms.

An EpiPen is intended to be used immediately at the onset of a severe allergic reaction in patients with a history or risk of anaphylaxis. Symptoms can appear within minutes of the allergic interaction, which can be fatal without immediate treatment.

Anaphylactic symptoms may include:

  • Trouble breathing or wheezing
  • Hoarseness (changes in the way your voice sounds)
  • Hives or severe itching
  • Swelling of your face, lips, mouth, or tongue
  • Skin rash, redness, or swelling
  • Fast heartbeat
  • Weak pulse
  • Feeling very anxious and confusion
  • Stomach pain or cramps
  • Losing control of urine or bowel movements or diarrhea
  • Dizziness or fainting

Your EpiPen may be prescribed for other indications not listed.

How is an EpiPen used?

An EpiPen is a single-use injection tool preloaded with one dose of medication. If you have been prescribed an EpiPen, carry it with you at all times as anaphylaxis can happen at any moment.

The EpiPen package may come with a trainer pen to be used for practicing. The trainer pen is identified by the gray coloring and has no medication or needle. You are encouraged to practice with the trainer pen to ensure you can understand and use the pen safely and correctly in the event of an anaphylactic emergency.

Instructions

Follow the instruction pamphlet that comes with the EpiPen package. EpiPen should never be injected into a vein, the buttocks, hands, fingers, feet, or toes.

  1. Remove the blue safety release by pulling it straight up.
  2. For young patients, firmly hold the injection area to prevent cuts or broken needles.
  3. Swing and push the orange tip (needle) against the outer thigh firmly until you hear a “click.”
    1. Do not put your hand or fingers over the orange tip.
  4. Hold firmly for 3 seconds and remove.
    1. A second injection may be used if symptoms continue.
    2. Do not reuse the EpiPen that has already been injected.
  5. Seek emergency medical care.

Used or expired EpiPens must be disposed of in an FDA-cleared sharps container, not in the trash.

Dosage

EpiPen comes in two different packages with two pens each:

  • EpiPen Auto-Injector 0.3 mg – used for patients over 66 lbs (30 kg)
    • Yellow packaging
  • EpiPen Jr Auto-Injector 0.15 mg – used for patients between 33-66 lbs (15-30 kg)
    • Green packaging

Storage

EpiPen should be stored away from light and extreme temperature at room temperature between 68°F and 77°F (20°C and 25°C).

Periodically check your EpiPen for any particles or discoloration as the solution should be clear. Refill as needed to replace unclear solutions or when expired.

Keep out of reach of children.

Side Effects

It’s important to understand that although EpiPen is FDA approved, it comes with side effects that may or may not affect you.

Before starting EpiPen, you should discuss possible side effects with your doctor or pharmacist.

Common Side Effects

Tell your doctor if you experience the following symptoms, and they become severe or do not go away on their own:

  • Headaches
  • Weakness or shakiness
  • Sweating, nervousness, or anxious
  • Paleness or dizziness
  • Nausea or vomiting
  • Breathing problems
  • Fast or irregular heartbeat

Serious Side Effects

Severe adverse reactions while taking EpiPen can occur. Seek emergency medical care or call 911 if you experience any of the following symptoms:

  • Infection at the injection site: warmth, pain, swelling, or redness around the injection site
  • Cuts around the injection site or needle remain in the skin – more likely to occur in young children moving during the injection.

 The information above does not list all possible side effects. Contact your doctor or pharmacist if you experience any side effects not listed. You or your doctor may report side effects to the FDA by calling 1-800-FDA-1088.

Warnings & Precautions

Before using EpiPen, tell your doctor or pharmacist if you:

  • Have thyroid problems
  • Have asthma
  • Have or have had depression
  • Have heart problems or high blood pressure
  • Have diabetes
  • Have Parkinson’s disease
  • Are pregnant or planning to become pregnant
  • Are breastfeeding or planning to breastfeed

Heart Problems

If you have heart problems, the use of EpiPen may cause chest pain and produce rapid heartbeats. Your doctor will monitor your symptoms for follow-up.

Parkinson’s Disease

The use of EpiPen may temporarily worsen symptoms of Parkinson’s Disease.

Other Diseases

Your doctor may monitor your symptoms of current conditions such as thyroid disease and diabetes after using EpiPen.

Pregnant or planning to become pregnant

There is insufficient data to determine if epinephrine will affect pregnant patients or their unborn child.

Breastfeeding or planning to breastfeed

There is no data to determine if epinephrine will affect breast milk or pass it on to breastfed children.

Interactions & Contraindications

Before using EpiPen, tell your doctor or pharmacist if you take any medications, herbal supplements, or vitamins.

Cardigan Glycosides. Diuretics and Anti-arrhythmics

The use of cardiac glycosides, diuretics, or anti-arrhythmics medications while receiving an EpiPen dose may cause irregular heartbeats (cardiac arrhythmia).

Antidepressants, Levothyroxine, and Antihistamines

The use of tricyclic antidepressants, levothyroxine sodium, monoamine oxidase inhibitors, and certain antihistamines such as chlorpheniramine and diphenhydramine while receiving an EpiPen dose may increase the potency of epinephrine.

Ergot Alkaloids, Beta-Adrenergic and Alpha-Adrenergic Blockers

The use of ergot alkaloids beta-adrenergic and alpha-adrenergic blocker medications may interfere with the effectiveness of EpiPen. Your doctor will determine if these medications should be continued and what dose, as needed.

Frequently Asked Questions

EpiPen contains the active ingredient epinephrine.

EpiPen may contain the following inactive ingredients, sodium chloride, sodium metabisulfite, hydrochloric acid, and water.

EpiPen is only available in injection form. EpiPen comes in two different packages with two pens each:

  • EpiPen Auto-Injector 0.3 mg – used for patients over 66 lbs (30 kg)
    • Yellow packaging
  • EpiPen Jr Auto-Injector 0.15 mg – used for patients between 33-66 lbs (15-30 kg)
    • Green packaging

EpiPen is approved for the treatment of patients weighing 33 lbs (15 kg) or more with severe allergic reactions (anaphylaxis).

EpiPen is only recommended for severe allergic reactions. Follow your doctor’s guidance on treatment for mild allergic reactions such as taking an over-the-counter medication.

Follow the instruction pamphlet that comes with the EpiPen package. EpiPen should never be injected into a vein, the buttocks, hands, fingers, feet, or toes.

Used or expired EpiPens must be disposed of in an FDA-cleared sharps container, not in the trash.

An EpiPen should be stored away from light and extreme temperature at room temperature between 68°F and 77°F (20°C and 25°C). EpiPen should not be refrigerated.

Unused EpiPens can be stored at room temperature up to the expiration date on the package and device. Once the EpiPen has expired, dispose of it in an approved sharps container. Contact your pharmacist or doctor for a refill, as you should always have an active unexpired EpiPen with you unless your doctor states otherwise.

The medication will start to work within minutes, reversing the anaphylactic reaction symptoms.

If you inject EpiPen in areas other than the outer thigh, such as your hand, seek emergency medical care.

Yes, with a prescription, you can purchase EpiPen online. Buying medications online is convenient and often less expensive than purchasing at your local pharmacy.