Epipen and Epipen Jr are injectable forms of epinephrine used to treat anaphylaxis, which is a severe form of an allergic reaction. Anaphylaxis is a potentially life threatening reaction that can happen rapidly. It can be triggered by reactions to foods, medications (including allergy shots), stinging/biting insects, exercise, or other causes. Epipen (0.3mg) is used for patients who weigh 66 pounds (30 kg) or more and Epipen Jr (0.15mg) is for patients who weigh approximately 33 to 66 pounds (15-30 kg).

Epipen should be used when signs of a severe reaction are present. Symptoms of anaphylaxis can affect different parts of the body and include:

Skin: itching, hives or swelling, redness of the skin
Head and Neck: itching or tingling of the mouth, swelling of the lips/tongue, an itchy throat, throat tightness or swelling, hoarseness
Respiratory system: coughing, shortness of breath, wheezing, trouble breathing,
GI Tract: nausea, vomiting, diarrhea, abdominal cramps, losing control of urine or bowel movements
Cardiovascular system: a weak pulse, increased heart rate, shock, or loss of consciousness.
Nervous system: dizziness, confusion

It is very important to recognize these symptoms when they occur as the symptoms can progress rapidly and be life threatening if not treated quickly. If anaphylaxis is suspected, the patient should be treated immediately with use of Epipen. It should be injected into the middle of the upper thigh muscle and can be used without removing the clothing if needed. When administering it to a child hold the leg firmly in place during injection. Do not inject it into other areas like fingers as it can potentially have increased side effects if not used properly. You should seek immediate medical attention if it is used accidentally or improperly. You may need to use a second dose if the symptoms do not improve or return. Once Epipen has been used you should seek immediate medical attention for further evaluation and monitoring.

Possible side effects of Epipen include an increased heart rate, an anxious feeling, sweating, nausea, vomiting, dizziness, paleness, tremor or shaking, headache, or weakness. These side effects are usually only temporary and resolve when the medication wears off. Make sure your doctor is aware of any medical conditions you have especially including heart problems, high blood pressure, thyroid problems, or if you are pregnant. Keep Epipen out of reach of children to prevent accidental injection. Store your Epipen away from extreme cold or heat. Do not allow it to freeze. The solution in the clear window should be not appear discolored and should be clear with any solid particles.

Strictly avoiding known allergens is the best way to prevent anaphylaxis. If you or your child have food allergies carefully read all labels, ask and plan ahead at restaurants or when traveling, and make sure your family members, school, babysitters/caregivers, friends, and anyone who takes care of a child with allergies knows which foods or allergens need to avoided and how to use the emergency medications. Always carry or keep your Epipen with you so it can be administered quickly if needed. Allergic reactions can vary in severity and symptoms. Usually other medications, like Benadryl, are also advised for use during allergic reactions. Ask your doctor about your particular individual risks and plan of action for any reactions.
Sources of information used: Epipen prescribing insert (Mylan Inc.) and National Food Allergy Guidelines

Laura Dougherty, MD
Allergy Partners of the Midlands

How to use your EpiPen
Dr. William McCann
Allergy Partners of Western North Carolina