EpiPen

EpiPen | Epinephrine Injection for Severe Allergic Reactions

What is this medication?

EpiPen is an emergency epinephrine auto-injector used to treat severe allergic reactions, also called anaphylaxis. It is a fast-acting medication that helps open the airways, raise low blood pressure, and reduce swelling and other dangerous allergic symptoms.

It is intended for immediate emergency use in people who are at risk for serious allergic reactions from:

  • foods

  • insect stings or bites

  • medications

  • allergy shots

  • exercise

  • or unknown causes.

EpiPen is emergency supportive treatment only and does not replace emergency medical care. 

    • Keep your EpiPen in your carry-on bag, not checked luggage

    • Keep it in original labeled packaging while traveling

    • Protect it from heat, sunlight, and freezing temperatures

    • Carry two devices with you at all times

    • Let travel companions know where it is kept and how to help in an emergency

    • Check the viewing window before trips to make sure the medicine is still clear and colorless and the device is not expired

When should this medication be used?

Your provider may recommend using this medication if you develop signs of a severe allergic reaction, especially if symptoms come on suddenly and involve breathing problems, swelling, or a whole-body reaction.

Symptoms of anaphylaxis may include:

  • trouble breathing

  • wheezing

  • hoarseness

  • hives, rash or severe itching

  • swelling of the face, lips, mouth, or tongue

  • fast heartbeat

  • fainting, dizziness or feeling like you may pass out.

  • stomach pain

  • vomiting

  • diarrhea

Because anaphylaxis can become life-threatening within minutes, EpiPen should be used right away when a severe allergic reaction is suspected. 

  • Before an emergency happens:

    • make sure you and anyone who may help you knows how to use the auto-injector

    • practice with the trainer device if one is included

    • check the medicine through the viewing window regularly

    • only use the device if the solution is clear and colorless

    • replace the device if the liquid looks pink, brown, cloudy, or has particles

    • do not use the device if the blue safety top is raised before use

    • keep 2 auto-injectors available at all times

    • tell family, friends, coworkers, teachers, or travel companions where you keep it and how to use it

    Follow the directions on your prescription label and the device instructions.

    • Use EpiPen right away when a severe allergic reaction happens

    • Inject it into the middle of the outer thigh

    • It may be injected through clothing if needed

    • Hold the auto-injector firmly in place for at least 3 full seconds

    • Do not inject into a vein, buttock, fingers, toes, hands, or feet

    • Each device is single-use only

    • After using it, get emergency medical help right away

    • Always carry 2 EpiPen auto-injectors with you in case a second dose is needed before help arrives

    Some patients may need a second auto-injector if symptoms continue, return, or if the first device is activated before the dose can be given. More than 2 doses for the same allergic emergency should only be given under direct medical supervision.

    After using EpiPen (critical precautions):

    • you must go to the emergency room immediately, even if symptoms improve

    • effects of epinephrine can wear off and symptoms may return (biphasic reaction)

    • bring the used auto-injector with you so healthcare providers know what was given

    • you may feel rapid heartbeat, anxiety, shakiness, or dizziness after use

    • try to remain lying down or seated unless instructed otherwise, especially if feeling faint

    • avoid standing or walking suddenly, as blood pressure changes can cause fainting

    • a second dose may be needed if symptoms return before emergency care is available

    • do not delay seeking care while waiting to see if symptoms improve

  • EpiPen is not taken on a schedule and does not have a routine dosing schedule. It is only used during an allergic emergency.

    If you experience symptoms of a severe allergic reaction:

    • use EpiPen right away

    • do not delay treatment

    • seek emergency medical care immediately after use

    If you are unsure whether your symptoms require use, it is generally safer to use epinephrine and seek medical care than to delay treatment. Early use is critical in severe allergic reactions.

  • Injection site precautions:

    • do not inject into hands, fingers, feet, or buttocks

    • accidental injection into these areas can reduce blood flow and requires immediate medical care

    • monitor the injection site for redness, swelling, warmth, or pain

    • seek care if signs of infection develop, as rare but serious skin infections can occur

    Device and safety awareness:

    • each auto-injector is single-use only and cannot be reused

    • do not attempt to reinsert the needle or reuse the device

    • always replace your EpiPen after use or if expired

    • check expiration dates regularly and refill before travel or high-risk exposure

    Special precautions:

    • movement during injection can cause cuts, bent needles, or incomplete dosing

    Even though epinephrine is life-saving, it is a temporary emergency treatment. Ongoing monitoring by medical professionals is always required after use. 

  • Epinephrine may interact with certain medications and may increase the risk of side effects, especially related to the heart and blood pressure.

    Tell your healthcare provider about all medications you take, including prescription, over-the-counter, supplements, and herbal products.

    Examples of potential interactions include:

    • beta-blockers: may reduce the effectiveness of epinephrine or worsen blood pressure responses

    • alpha-blockers: may interfere with how epinephrine affects blood vessels

    • antidepressants (such as tricyclic antidepressants or MAO inhibitors): may increase the effects of epinephrine and raise the risk of side effects

    • cardiac medications (such as digoxin): may increase the risk of abnormal heart rhythms

    • diuretics (“water pills”): may increase the risk of heart rhythm disturbances

    • thyroid medications: may increase sensitivity to epinephrine

    • certain antihistamines: may increase side effects

    Even if you take these medications, you should still use EpiPen in a life-threatening allergic emergency and seek immediate medical care.

Important Safety Information

  • EpiPen is used for the emergency treatment of severe allergic reactions and is not a substitute for medical care. You must seek immediate emergency medical attention after use, even if symptoms improve, as additional treatment and monitoring may be required.

    Most serious warnings may include:

    • Anaphylaxis requires emergency care: EpiPen provides temporary, life-saving treatment, but symptoms may return or continue. Always go to the emergency room after use.

    • Accidental injection into hands, fingers, feet, or toes: Injection into these areas can reduce blood flow and may cause pain, numbness, or tissue injury. Immediate medical attention is required if this occurs.

    • Injection into the buttock: Do not inject into the buttock, as this may result in reduced effectiveness and has been associated with serious infections, including rare cases of severe soft tissue infection.

    • Serious skin and soft tissue infections: Although uncommon, infections such as necrotizing fasciitis have been reported at the injection site. Seek medical care if you notice increasing redness, swelling, warmth, or severe pain after injection.

    • Heart-related complications: Epinephrine can place stress on the heart and may cause chest pain, irregular heartbeat, or worsening of underlying heart conditions, particularly in patients with cardiovascular disease.

    • Effects from repeated dosing or overdose: Multiple doses may be necessary in severe reactions, but excessive dosing can increase the risk of serious side effects, including dangerous changes in heart rhythm and blood pressure.

    • Choking hazard (safety cap): The blue safety release cap is small and may pose a choking risk, especially in young children. Keep out of reach and supervise handling.

    • Device integrity and medication quality: Do not use the auto-injector if the solution appears discolored, cloudy, or contains particles, or if the device appears damaged or the safety cap is already raised. Use of a compromised device may result in ineffective treatment.

  • Stop and seek emergency medical care immediately if you experience:

    • trouble breathing that does not improve or gets worse

    • fainting, severe weakness, or collapse

    • swelling of the face, lips, tongue, or throat

    • chest pain, irregular heartbeat, or severe palpitations

    • signs of accidental injection into fingers, hands, or feet such as pallor, numbness, coldness, or pain

    • redness, warmth, swelling, or tenderness at the injection site that suggests infection

  • There are no absolute contraindications to using epinephrine in a life-threatening allergic emergency.

    However, tell your healthcare provider if you have:

    • heart disease or history of heart attack

    • high blood pressure

    • irregular heart rhythms

    • diabetes

    • thyroid disorders

    • Parkinson’s disease

    • known sensitivity to sulfites

    These conditions may increase the risk of side effects, but they do not prevent the use of epinephrine in an emergency.

    In a severe allergic reaction, the benefits of using EpiPen outweigh the risks.

  • Tell your provider if you:

    • have heart disease, high blood pressure, irregular heartbeat, or coronary artery disease

    • have diabetes

    • have thyroid problems or hyperthyroidism

    • have asthma

    • have Parkinson’s disease

    • are pregnant, planning to become pregnant, or breastfeeding

    • take prescription or over-the-counter medications, vitamins, or herbal supplements

    • take cardiac glycosides, diuretics, anti-arrhythmics, antidepressants, monoamine oxidase inhibitors, levothyroxine, certain antihistamines, beta-blockers, alpha-blockers, or ergot alkaloids

    • have a known sulfite sensitivity

    There are no listed contraindications, but some patients may be at greater risk for side effects and should still use epinephrine in a life-threatening allergic emergency as directed. The presence of sulfite in the product should not prevent its use in an emergency.

  • Common side effects may include:

    • fast, pounding, or irregular heartbeat

    • sweating

    • shakiness or tremor

    • nervousness, anxiety, or feeling overexcited

    • dizziness

    • headache

    • weakness

    • paleness

    • nausea or vomiting

    • breathing discomfort or respiratory difficulty 

    These side effects often lessen with rest, but some people may have stronger or longer-lasting effects. 

    You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch or call 1-800-FDA-1088.

  • Using more epinephrine than prescribed or repeated doses may increase the risk of serious side effects.

    Symptoms of overdose may include:

    • severe or persistent rapid heartbeat

    • chest pain or pressure

    • irregular heart rhythm

    • severe headache

    • high blood pressure

    • anxiety, panic, or agitation

    • tremors or shaking

    • nausea or vomiting

    • difficulty breathing not related to the allergic reaction

    In severe cases, overdose may lead to:

    • heart complications

    • fluid buildup in the lungs

    • stroke

    • cardiac arrest

    If an overdose is suspected, seek emergency medical care immediately.

  • EpiPen is a single-use auto-injector and must be disposed of properly after use or when expired.

    • do not throw the auto-injector directly into household trash

    • place used or expired devices in an FDA-cleared sharps disposal container

    • if a sharps container is not available, use a sturdy, puncture-resistant container with a secure lid

    • follow local guidelines for sharps disposal or medication take-back programs

    • do not recycle the device

    • keep out of reach of children and pets

    Always replace your EpiPen after use or before the expiration date to ensure you are prepared for future emergencies.

Disclaimers

  • This prescription may have been issued through a telemedicine consultation with a licensed healthcare provider. If you experience severe symptoms, worsening illness, or any concerning reactions while using this medication, contact your prescribing clinician immediately or seek emergency medical care.

  • This medication guide summarizes important safety information derived from pharmacy labeling, medication manufacturers, and prescribing references. It is intended to help patients understand the safe use of medications included in the Superior Health & Wellness Travel Medical Kit.

    This guide does not contain the complete prescribing information for EpiPen. Always follow the directions provided by your healthcare provider and the instructions on the pharmacy label that accompanies your prescription.

    Medications included in travel medical kits are prescribed only after a clinical evaluation by a licensed healthcare provider. Prescriptions are issued based on your medical history, current medications, allergies, and overall health needs. Not all patients will qualify for every medication or kit configuration, and the contents of each kit may vary based on provider discretion and patient suitability.

    Some medications included in travel medical kits are commercially manufactured medications dispensed through licensed pharmacies. In certain cases, a medication may be provided as a compounded formulation prepared by a licensed compounding pharmacy when a provider determines that a compounded version is medically appropriate for a patient. Compounded medications are not reviewed or approved by the U.S. Food and Drug Administration (FDA) for safety or effectiveness but are prepared by licensed pharmacies in accordance with applicable pharmacy regulations.

    Travel Medical Kits are intended to provide limited medication support during travel when timely access to medical care may be difficult. These kits are not a substitute for routine medical care, primary care services, or emergency medical treatment. Purchasing a Travel Medical Kit does not establish a primary care relationship with Superior Health & Wellness and does not include ongoing medical supervision beyond the initial provider evaluation used to determine eligibility for the kit.

    Patients experiencing severe illness, worsening symptoms, medication reactions, or medical emergencies should seek immediate medical care or contact a licensed healthcare professional.

    Medical services and prescriptions offered through Superior Health & Wellness are provided by licensed healthcare professionals in accordance with applicable state and federal laws. Prescription medications are dispensed by licensed pharmacies following a valid provider prescription.

    Patients are encouraged to report negative side effects of prescription medications to the U.S. Food and Drug Administration (FDA). Visit MedWatch or call 1-800-FDA-1088.

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