Epinephrine Auto-Injector

Generic Name: Epinephrine Auto-Injector (Intramuscular or Subcutaneous) (EP-i-NEF-rin)
Brand Name: Twinject

Epinephrine Auto-Injector is used for:

Treating severe allergic reactions (eg, difficulty breathing; rash; hives; tightness in the chest; swelling of the mouth, lips, or tongue) caused by insect stings or bites, foods, drugs, or other causes. It may also be used for other conditions as determined by your doctor.

Epinephrine Auto-Injector is a sympathomimetic. It works on different receptors in the body to relax the smooth muscle of the lungs, which improves breathing. It also blocks histamine, which decreases rash, hives, and swelling.

Do NOT use Epinephrine Auto-Injector if:

• you are allergic to any ingredient in Epinephrine Auto-Injector

Contact your doctor or health care provider right away if any of these apply to you.

Before using Epinephrine Auto-Injector:

Some medical conditions may interact with Epinephrine Auto-Injector. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have angle-closure glaucoma, heart disease, chest pain, high blood pressure, diabetes, Parkinson disease, thyroid problems, mood or mental disorders, depression, asthma, or an irregular heartbeat

Some MEDICINES MAY INTERACT with Epinephrine Auto-Injector. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Beta-blockers (eg, propanolol), droxidopa, ergot alkaloids (eg, ergotamine), or phenothiazines (eg, chlorpromazine) because the risk of high or low blood pressure and fast or slow heartbeat may be increased
• Bromocriptine, furazolidone, or tricyclic antidepressants (eg, amitriptyline) because the risk of side effects, such as headache, high temperature, and high blood pressure, may be increased
• Catechol-O-methyltransferase (COMT) inhibitors (eg, entacapone), certain antihistamines, digoxin, diuretics (eg, furosemide, hydrochlorothiazide), levothyroxine, medicines for irregular heartbeat (eg, quinidine), or monoamine oxidase inhibitors (MAOIs) (eg, phenelzine) because they may increase the risk of Epinephrine Auto-Injector's side effects
• Guanethidine because its effectiveness may be decreased by Epinephrine Auto-Injector

This may not be a complete list of all interactions that may occur. Ask your health care provider if Epinephrine Auto-Injector may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Epinephrine Auto-Injector:

Use Epinephrine Auto-Injector as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• An extra patient leaflet is available with Epinephrine Auto-Injector. Talk to your pharmacist if you have questions about this information.
• Epinephrine Auto-Injector is an injection. If you will be using Epinephrine Auto-Injector at home, a health care provider will teach you how to use it. Be sure you understand how to use Epinephrine Auto-Injector. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
• Check Epinephrine Auto-Injector regularly. Replace the injector unit if it contains particles, is discolored (pink or brown), or is cracked or damaged in any way.
• Inject Epinephrine Auto-Injector only into the outer thigh. Do not inject into the buttocks or into a vein.
• Immediately after use, go to the nearest hospital emergency room. You may need further medical attention. Tell the doctor or health care provider that you have received an injection of epinephrine. Show the thigh where the injection was given to the doctor. Give your used auto-injector to the doctor for inspection and proper disposal.
• Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
• Epinephrine Auto-Injector is usually given as a one-time dose in an emergency situation. If you are unable to use Epinephrine Auto-Injector, seek medical attention immediately.
• If you miss a dose of Epinephrine Auto-Injector, contact your doctor right away.

Ask your health care provider any questions you may have about how to use Epinephrine Auto-Injector.

Important safety information:

• Never put thumb, fingers, or hand over the red tip of the auto-injector. Do NOT remove the green or red cap until ready to use.
• Only inject Epinephrine Auto-Injector into the outer thigh. Never inject Epinephrine Auto-Injector into hands, fingers, feet, or toes. Doing so may cause a loss of blood flow and result in tissue damage to these areas. If you accidentally inject Epinephrine Auto-Injector into any of these areas, seek immediate emergency medical attention.
• It may be helpful to train others how to give Epinephrine Auto-Injector in case you are unable to give it yourself during a reaction.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Epinephrine Auto-Injector while you are pregnant. It is not known if Epinephrine Auto-Injector is found in breast milk. If you are or will be breast-feeding while you use Epinephrine Auto-Injector, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of Epinephrine Auto-Injector:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Anxiety; difficulty sleeping; dizziness; fearfulness; headache; nausea; nervousness; paleness; sweating; tremors; vomiting; weakness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); fast heartbeat; irregular heartbeat; wheezing.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org), or emergency room immediately. Symptoms may include bleeding in the brain; fast or irregular heartbeat; fluid in the lungs; high blood pressure.

Proper storage of Epinephrine Auto-Injector:

Store Epinephrine Auto-Injector at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 F (15 and 30 degrees C) is permitted. Store in the carrying case provided. Store away from heat, moisture, and light. Keep Epinephrine Auto-Injector out of the reach of children and away from pets.

General information:

• If you have any questions about Epinephrine Auto-Injector, please talk with your doctor, pharmacist, or other health care provider.
• Epinephrine Auto-Injector is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Epinephrine Auto-Injector. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

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