Generic Name: epinephrine injection (EP i NEF rin)
Brand Names: Adrenaclick, Adrenalin, Auvi-Q, EpiPen, Twinject

What is EpiPen?

EpiPen is an injection containing epinephrine, a chemical that narrows blood vessels and opens airways in the lungs. These effects can reverse severe low blood pressure, wheezing, severe skin itching, hives, and other symptoms of an allergic reaction.

EpiPen is used to treat severe allergic reactions (anaphylaxis) to insect stings or bites, foods, drugs, and other allergens. Epinephrine is also used to treat exercise-induced anaphylaxis.

Epinephrine auto-injectors such as EpiPen and EpiPen Jr. may be kept on hand for self-injection by a person with a history of an severe allergic reaction.

EpiPen may also be used for purposes not listed in this medication guide.

Important information

EpiPen is used to treat severe allergic reactions (anaphylaxis).

Seek emergency medical attention even after you use EpiPen to treat a severe allergic reaction. The effects of EpiPen may wear off after 10 or 20 minutes. You will need to receive further treatment and observation.

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Before using EpiPen a second time, tell your doctor if your first injection caused a serious side effect such as increased breathing difficulty, or dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Before using EpiPen

To make sure EpiPen is safe for you, tell your doctor if you have:

  • heart disease or high blood pressure;

  • a heart rhythm disorder;

  • coronary artery disease;

  • Parkinson's disease;

  • diabetes; or

  • a thyroid disorder.

FDA pregnancy category C. It is not known whether EpiPen will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

See also: Pregnancy and breastfeeding warnings (in more detail)

It is not known whether epinephrine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

In an emergency situation it may not be possible to tell your caregivers if you are pregnant or breast feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received a dose of EpiPen.

How should I use EpiPen?

Use EpiPen exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

EpiPen is injected into the muscle of your outer thigh. In an emergency, this injection can be given through your clothing.

Your medicine may also come with a "trainer pen." The trainer pen contains no medicine and no needle. It is only for non-emergency use to practice giving yourself an EpiPen injection. Do not use a trainer pen to treat an allergic reaction.

The auto-injector device is a disposable single-use system that comes with patient instructions for safe and effective use. Do not self inject this medicine if you do not understand these instructions.

Do not remove the safety cap until you are ready to use the auto-injector. Never put your fingers over the tip when removing the safety cap or after the safety cap has been removed.

To use an EpiPen auto-injector:

  • Form a fist around the auto-injector with the black tip pointing down. Pull off the safety cap.

  • Place the black tip against the fleshy portion of your outer thigh. You may give the injection directly through your clothing. Do not put your thumb over the end of the unit.

  • With a quick motion, push the auto-injector firmly against your thigh. This will release the spring-loaded needle that injects the dose of EpiPen. Hold the auto-injector in place for a few seconds after activation.

  • Remove the auto-injector from your thigh. Carefully re-insert the used device needle-first into the carrying tube. Re-cap the tube and take it with you to the emergency room so that anyone who treats you will know how much EpiPen you have received.

Seek emergency medical attention after any use of epinephrine to treat a severe allergic reaction. The effects of epinephrine may wear off after 10 or 20 minutes. You will need to receive further treatment and observation.

Use an auto-injector only once, then throw away in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Do not use the EpiPen if it has changed colors or has any particles in it, or if the expiration date on the label has passed. Call your doctor for a new prescription.

Store EpiPen at room temperature away from moisture, heat, and light. Do not refrigerate this medication, and do not store it in a car.

What happens if I miss a dose?

Since EpiPen is normally used only as needed in an emergency, you are not likely to be on a dosing schedule. Do not use repeat doses of EpiPen without a doctor's advice.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid?

Do not inject EpiPen into a vein or into the muscles of your buttocks, or it may not work as well. Inject it only into the fleshy outer portion of the thigh.

Accidentally injecting EpiPen into your hands or feet may result in a loss of blood flow to those areas, and resulting numbness. If this occurs, seek emergency medical attention.

EpiPen side effects

Before using EpiPen a second time, call your doctor if your first injection caused a side effect such as increased breathing difficulty, or dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Common EpiPen side effects may include:

  • sweating;

  • nausea and vomiting;

  • pale skin;

  • feeling short of breath;

  • dizziness;

  • weakness or tremors;

  • headache; or

  • feeling nervous or anxious.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect EpiPen?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with EpiPen, especially:

  • digoxin;

  • a diuretic or "water pill";

  • levothyroxine, Synthroid;

  • an antidepressant--amitriptyline, doxepin, imipramine, nortriptyline, and others;

  • a beta-blocker--atenolol, carvedilol, labetalol, metoprolol, nadolol, propranolol, sotalol, and others;

  • cold or allergy medicine that contains an antihistamine;

  • ergot medicine--ergotamine, dihydroergotamine, ergonovine, methylergonovine (Methergine);

  • heart rhythm medication such as quinidine (Quin-G); or

  • an MAO inhibitor--isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine.

This list is not complete. Other drugs may interact with EpiPen, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about EpiPen.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2014 Cerner Multum, Inc. Version: 8.02. Revision Date: 2014-03-12,4:27:31 PMM.

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