Generic Name: epinephrine (Injection route)
Commonly used brand name(s)
In the U.S.
- Adrenalin Chloride
- Epipen Jr
Available Dosage Forms:
Therapeutic Class: Anaphylaxis Agent
Pharmacologic Class: Adrenergic
Chemical Class: Alkylarylamine
Uses For Twinject
Epinephrine injection is used for emergency treatment of severe allergic reactions (including anaphylaxis) to insect bites or stings, medicines, foods, or other substances. It is also used to treat anaphylaxis caused by unknown substances or triggered by exercise.
This medicine is available only with your doctor's prescription.
Before Using Twinject
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of epinephrine injection in children.
No information is available on the relationship of age to the effects of epinephrine injection in geriatric patients. However, elderly patients are more likely to have age-related heart disease which may require caution in patients receiving epinephrine injection.
|All Trimesters||C||Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.|
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with Medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
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Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Interactions with Food/Tobacco/Alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Angina pectoris (severe chest pain) or
- Asthma or
- Blood vessel problems or
- Depression, history of or
- Diabetes or
- Heart attack or
- Heart disease (eg, coronary artery disease, organic heart disease) or
- Heart rhythm problems (eg, arrhythmia) or
- Hypertension (high blood pressure) or
- Hyperthyroidism (overactive thyroid) or
- Parkinson's disease—Use with caution. May make these conditions worse.
Proper Use of epinephrine
This section provides information on the proper use of a number of products that contain epinephrine. It may not be specific to Twinject. Please read with care.
Use this medicine only as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.
If you are using this medicine at home, make sure you or any of your family members understand exactly how to give them. Also, tell your doctor if you or your caregiver has severe arthritis of the hands. If you have any questions about this, check with your doctor.
This medicine is injected into the muscle of your outer thigh only. Do not inject this medicine into a vein or into the muscle of your buttocks. To do so, may increase the chance of having serious side effects.
This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions.
This medicine comes in an autoinjector syringe and needle kit that contains the correct dose of medicine your doctor has prescribed.
This medicine comes with an autoinjector trainer and a separate trainer instructions for use. Be sure to practice first with your autoinjector trainer before an allergy emergency happens to make sure you are ready to use the real Adrenaclick®, EpiPen®, or EpiPen Jr® autoinjector in an actual emergency. The autoinjector trainer has a grey color (for EpiPen® or EpiPen Jr®) or beige color (for Adrenaclick®) and does not contain any medicine or needle.
Do not remove the blue safety release (EpiPen® or EpiPen Jr®) or the gray end caps (Adrenaclick®) on the autoinjector until you are ready to use it. Do not put your thumb, fingers, or hand over the orange (EpiPen® or EpiPen Jr®) or red tip (Adrenaclick®). This is to avoid an accidental injection.
You may need to use more than one injection if your allergic reaction does not get better after the first shot. If more than 2 injections are needed for 1 reaction, however, those should be given only under medical supervision
If you are using the epinephrine injection in a child, make sure to hold his leg firmly in place and limit movement before and during an injection.
Carry this medicine with you at all times for emergency use in case you have a severe allergic reaction.
Check the injection kits regularly to make sure that the liquid has not changed its color. Do not use this medicine if the liquid has changed its color, or if there are solids in the liquid.
Do not reuse the remaining portion of the medicine that is left in the autoinjector. Throw away the autoinjector after you have used it.
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For injection dosage form:
- For allergic reactions:
- Adults and children weighing more than 30 kilograms (kg)—0.3 milligram (mg) injected under the skin or into the muscle of your thigh.
- Children weighing 15 to 30 kg—0.15 mg injected under the skin or into the muscle of your thigh.
- Children weighing less than 15 kg—Use and dose must be determined by your doctor.
- For allergic reactions:
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Store the injection kits at room temperature, away from heat, moisture, and direct light. Do not store the medicine in the refrigerator or freezer, or into your vehicle's glove box.
Keep the autoinjector in its case or carrier tube to protect from damage. However, this tube is not waterproof. If you accidentally drop it, check for damage or leakage.
Precautions While Using Twinject
Anaphylaxis is a life-threatening reaction and requires immediate medical attention. Check with your doctor right away, or go to an emergency room as soon as possible, even if you feel better after using this medicine.
Tell your doctor if you develop symptoms of an infection (such as redness that does not go away, swelling, warmth, or tenderness) at the injection site.
This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.
Do not inject this medicine into your hands or feet. There is already less blood flow to the hands and feet, and epinephrine could make that worse and cause damage to these tissues. If you accidentally inject epinephrine into your hands or feet, check with your doctor or go to the hospital emergency room right away.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Twinject Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:Incidence not known
- Abnormal or decreased touch sensation
- arm, back, or jaw pain
- bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
- blurred vision
- chest pain or discomfort
- chest tightness or heaviness
- fast, irregular, pounding, or racing heartbeat or pulse
- fear or nervousness
- nausea or vomiting
- paleness of the skin
- pounding in the ears
- shakiness in the legs, arms, hands, or feet
- slow or fast heartbeat
- trembling or shaking of the hands or feet
- troubled breathing
- unusual tiredness or weakness
Get emergency help immediately if any of the following symptoms of overdose occur:Symptoms of overdose
- coldness of the skin
- decreased urine output
- lightheadedness, dizziness, or fainting
- muscle twitching
- pounding, slow heartbeat
- rapid weight gain
- rapid, deep breathing
- stomach cramps
- swelling of the face, ankles, or hands
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
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More about Twinject (epinephrine)
- Side Effects
- During Pregnancy or Breastfeeding
- Dosage Information
- Drug Interactions
- Support Group
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