Epinephrine: A medication that saves lives

What is epinephrine?

Epinephrine is the synthetic equivalent to adrenaline, a hormone the body secretes in stressful situations. This medication is used to stop a serious allergic reaction that could lead to anaphylactic shock. It is therefore an emergency treatment.

How do you get an epinephrine auto-injector?

Epinephrine auto-injectors are sold in pharmacies. Although generally prescribed by a doctor, they can be bought without a prescription. Ask your pharmacist.

Two concentrations of epinephrine

Epinephrine auto-injectors come in two different concentrations:

• 0.15 mg of epinephrine for children, 15–30 kg (e.g. EpiPen Jr)
• 0.3 mg of epinephrine for children and adults, 30+ kg (e.g. EpiPen)

When your child’s weight passes the 20-kg mark, it is important to weigh him or her regularly so you start using an adult auto-injector as soon as needed. Your doctor may recommend your child transition from the junior to the adult auto-injector before he or she reaches 30 kg.

Auto-injector: A device that’s easy to use

Epinephrine is a liquid that is injected. For easy administration, either by the person with the allergies or a family member, the medication is sold in a device that contains the exact dose and requires very little manipulation.

Even if the device is designed to be very easy to use, it’s still a good idea to practice on a training device. By practicing without the medication or needle, you’ll be ready if ever an emergency does occur.

Your pharmacist will be happy to show you how to use an auto-injector. To practice at home, you can also order a starter kit (with a training device) on the manufacturer’s website.

For the Epipen© auto-injector, the injection occurs in two steps:

1. Hold the device vertically with the blue cap pointing up. Remove the blue cap.
    
2. Bring your hand to the thigh and firmly push the device’s orange tip into the outer thigh until you hear a “click.” Wait at least five seconds before removing the auto-injector. The thigh doesn’t need to be undressed: the needle will go through clothing.

The device is designed to hide the needle after injection to avoid accidental puncture.

Conservation and expiry date

Injectable medication, like epinephrine, are sensitive to variations in temperature. It should therefore be protected from freezing and extreme heat, as these are likely to affect the medication’s efficacy. For example, don’t leave your auto-injector in the car in summer or winter.

It is also important to check the auto-injector’s expiration date and replace it when necessary. This date is generally just a month and a year (for example, JN/19 for June 2019), and the medication is considered stable until the last day of the month. Of course, the medication does not become inactive overnight, but the longer the time from the expiration date, the greater the risk the medication is less effective.  

Important advice

• Inject the epinephrine at the first signs of a serious allergic reaction, and then call 911 immediately (or ask someone to call while you perform the injection).
• Use the epinephrine even if you aren’t completely sure if it is, in fact, an allergic reaction. It’s better to inject needlessly than wait and put a life in danger.  
• Don’t wait for the first responders to arrive before you use the auto-injector. The more the symptoms progress, the greater the risk the medication won’t be able to stop the reaction.
• Even if the epinephrine was effective and the symptoms have disappeared, you must go to the hospital for observation. This is because symptoms can reappear and require another injection of epinephrine.  
• Anyone with allergies should have an auto-injector on him or her at all times or in an easily accessible place. Never leave home without it.
• If you live in an area where first response services are more than 15 minutes away, or you must travel to such an area (like when camping, for example), it may be a good idea to have more than one device on hand. Your pharmacist can help you decide if this is necessary for you.

Services at your pharmacy

If you have questions or concerns about using the epinephrine auto-injector, or about its availability, please consult your family pharmacist. He or she can provide you with the information you need and answer your questions.