Generic Name: epinephrine (EP-i-NEF-rin)
Brand Name: Examples include EpiPen and Twinject
Twinject auto-injector is used for:
Treating severe allergic reactions (eg, difficulty breathing; rash; hives; itching; tightness in the chest; severe dizziness; 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.
Twinject auto-injector is a sympathomimetic. It works on blood vessels to improve blood pressure and on the smooth muscle of the lungs to help breathing. It also works by decreasing rash, hives, and swelling.
Do NOT use Twinject auto-injector if:
- you are allergic to any ingredient in Twinject auto-injector, unless your doctor tells you otherwise
Contact your doctor or health care provider right away if any of these apply to you.
Before using Twinject auto-injector:
Some medical conditions may interact with Twinject 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 (eg, sulfites)
- if you have glaucoma, heart disease, chest pain, high blood pressure, blood vessel problems, diabetes, Parkinson disease, thyroid problems, mood or mental disorders (eg, depression), asthma, or an irregular heartbeat
Some MEDICINES MAY INTERACT with Twinject auto-injector. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Bromocriptine, furazolidone, or linezolid because the risk of side effects, such as headache, high temperature, and high blood pressure, may be increased
- Antiarrhythmics (eg, quinidine), digoxin, diuretics (eg, furosemide, hydrochlorothiazide), or droxidopa because the risk of irregular heartbeat may be increased
- Alpha-blockers (eg, prazosin), beta-blockers (eg, propranolol), 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
- Antihistamines (eg, chlorpheniramine), catechol-O-methyltransferase (COMT) inhibitors (eg, entacapone), levothyroxine, monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), or tricyclic antidepressants (eg, amitriptyline) because they may increase the risk of Twinject auto-injector's side effects
- Guanethidine because its effectiveness may be decreased by Twinject auto-injector
This may not be a complete list of all interactions that may occur. Ask your health care provider if Twinject 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 Twinject auto-injector:
Use Twinject auto-injector as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- An extra patient leaflet is available with Twinject auto-injector. Talk to your pharmacist if you have questions about this information.
- Twinject auto-injector may be given as an injection at your doctor's office, hospital, or clinic. If you will be using Twinject auto-injector at home, a health care provider will teach you how to use it. Be sure you understand how to use Twinject auto-injector. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
- Check Twinject auto-injector regularly. Replace Twinject auto-injector if the expiration date has passed, if it contains particles or is discolored (pink or darker than slightly yellow), or if it is cracked or damaged in any way. If Twinject auto-injector has been dropped, inspect it for damage or leakage and replace it if necessary.
- Inject Twinject auto-injector only into the outer thigh, as directed by your health care provider. Do not inject into the buttocks or into a vein.
- Go to the nearest hospital emergency room immediately after use. 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 away from 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.
- Twinject auto-injector is usually given in an emergency situation. If you are unable to use Twinject auto-injector, seek medical attention immediately.
- If you miss a dose of Twinject auto-injector, seek immediate medical attention.
Ask your health care provider any questions you may have about how to use Twinject auto-injector.
Important safety information:
- Never put your thumb, fingers, or hand over the tip of the auto-injector. Do NOT remove the cap until you are ready to use Twinject auto-injector.
- Only inject Twinject auto-injector into the outer thigh. Never inject Twinject 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 Twinject auto-injector, seek immediate emergency medical attention.
- It may be helpful to train others how to give Twinject auto-injector in case you are unable to give it to yourself during a reaction.
- Diabetes patients - Twinject auto-injector may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur or persist, tell your doctor right away.
- Patients with Parkinson disease may notice a temporary worsening of symptoms (eg, uncontrolled muscle movements). If these symptoms persist, contact your doctor.
- Use Twinject auto-injector with caution in the ELDERLY; they may be more sensitive to its effects.
- PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Twinject auto-injector while you are pregnant. It is not known if Twinject auto-injector is found in breast milk. If you are or will be breast-feeding while you use Twinject auto-injector, check with your doctor. Discuss any possible risks to your baby.
Possible side effects of Twinject 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:
Seek medical attention right away if any of these SEVERE side effects occur:
Dizziness; feeling anxious, nervous, or fearful; headache; nausea; paleness; restlessness; shakiness or weakness; sweating; vomiting.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; fast or 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. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include chest pain; confusion; extreme paleness or coldness of the skin; fast or irregular heartbeat; one-sided weakness; severe headache or dizziness; slurred speech; trouble breathing; vision problems.Proper storage of Twinject auto-injector:
Store Twinject auto-injector at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store in the carrying case provided. Do not refrigerate or freeze. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Twinject auto-injector out of the reach of children and away from pets.
- If you have any questions about Twinject auto-injector, please talk with your doctor, pharmacist, or other health care provider.
- Twinject 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.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take Twinject auto-injector or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Twinject auto-injector. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Twinject auto-injector. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Twinject auto-injector.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.
More Twinject auto-injector resources
- Adrenaclick Prescribing Information (FDA)
- Adrenaclick Advanced Consumer (Micromedex) - Includes Dosage Information
- Auvi-Q Consumer Overview
- Auvi-Q Prescribing Information (FDA)
- Epinephrine Professional Patient Advice (Wolters Kluwer)
- Epinephrine Monograph (AHFS DI)
- Epinephrine (Mydriatic) eent Monograph (AHFS DI)
- Medihaler-Epi Prescribing Information (FDA)
- Twinject Auto-Injector Prescribing Information (FDA)