Epinephrine Injection for Severe Allergic Reactions
Epinephrine Injection
(generic EpiPen®)
What is this medication?
EpiPen is an emergency epinephrine auto-injector used to treat severe allergic reactions, also called anaphylaxis. Epinephrine is a naturally occurring hormone (adrenaline) that works quickly in the body to reverse dangerous allergic symptoms.
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 a life-saving emergency treatment, but it is not a cure. You must still receive emergency medical care after using it.
SOLO: Not Included
DUO: Not Included
QUAD: 2 EpiPens; optional
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 or shortness of breath
wheezing or chest tightness
swelling of the face, lips, tongue, or throat
hives, itching, or widespread rash
dizziness, fainting, or feeling like you may pass out
fast or weak pulse
nausea, vomiting, or diarrhea during an allergic reaction
Because anaphylaxis can become life-threatening within minutes, EpiPen should be used right away when a severe allergic reaction is suspected.
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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
Injection safety:
do not inject into hands, feet, fingers, or buttocks
accidental injection can cause reduced blood flow and requires urgent care
monitor for signs of infection at the injection site
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):
Call 911 and/or 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
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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.
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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.
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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.
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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
Important Safety Information
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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.
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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
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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.
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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.
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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.
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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.
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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
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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.
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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.