Important safety information
If used correctly, significant injury with EpiPen® (adrenaline) auto-injector is unlikely. Patients should not remove the safety cap until they are ready to inject, always ensure that they point the end with the black tip towards the thigh and never put their thumbs or fingers over the black tip. Directions for use are in the package insert and can also be downloaded from the Supporting patients section of this website.
Auto-injectors should only be injected into the anterolateral aspect of the thigh, not any other part of the thigh or buttock. The outer thigh is the safest site for intramuscular injection as there is minimal risk of injection into major blood vessels or nerves in this area. Intravascular injection (which is possible on the front of the thigh) could lead to acute cardiovascular compromise. Injection into a major nerve (which could occur on the posterior thigh or buttock) can cause significant damage; also, injection into the buttock may not be effective for a severe allergic reaction. Accidental injection into the hand, particularly the digits, can cause serious injury and possibly gangrene. This injury needs to be urgently assessed and treated in an emergency room.41
Potential side effects include an increase in heart rate, a stronger or irregular heartbeat, sweating, nausea and vomiting, difficulty breathing, paleness, dizziness, weakness or shakiness, headache, apprehension, nervousness, or anxiety. However, these side effects usually subside quickly, especially if the patient rests.41
EpiPen® (adrenaline) auto-injector should be used with caution in patients with high blood pressure and thyroid conditions (as side effects can last longer) and in pregnancy; furthermore, sensitisation of the heart to catecholamines may occur in patients with uncontrolled hyperthyroidism or those using cocaine.41, 51 Blood sugar may increase in patients with diabetes and symptoms can temporarily get worse in patients with Parkinson's disease.41, 51
Overdose of adrenaline is unlikely with EpiPen® (adrenaline) auto-injector. However, symptoms of overdose are elevated arterial pressure, pulmonary oedema and cardiac arrhythmias. If necessary, pressor effects may be counteracted by rapidly acting vasodilators or alpha-adrenergic blocking drugs.41
It is important to remember that in practice there are no known contraindications to IM adrenaline use in a life-threatening allergic reaction.41
If you have any concerns/questions about the safety aspects of EpiPen® (adrenaline) auto-injector, please contact the MEDA customer support line on 0845 460 0000.
- 41 - EpiPen Summary of Product Characteristics, MEDA Pharmaceutical Ltd, April 2011
- 51 - EpiPen US Prescribing Information, Dey, LP, October 2009.