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Anaphylaxis is unpredictable and while a person may have a mild reaction one time, a serious or even life-threatening reaction can occur the next time. In addition, allergic reactions can begin with mild symptoms and then progress to a full anaphylactic episode.
A person who is having an allergic reaction should use their EpiPen® immediately if they experience ANY of the following serious symptoms of anaphylaxis following contact with their allergen:
- Feeling light-headed or faint
- Breathing difficulties, such as fast, shallow breathing
- A fast heartbeat
- Clammy skin
- Confusion and anxiety
- Collapsing or losing consciousness
Other allergy symptoms may include hives, feeling or being sick, angioedema or stomach pain.
Patients experiencing the following mild to moderate symptoms of anaphylaxis should take an anti-histamine and have their EpiPen® ready in case of worsening symptoms:
- Red, raised, itchy rash
- Swelling of face, lips or eyelids
- Abdominal pain, nausea and/or vomiting
It is vital that patients carry 2 EpiPen® at all times. A second EpiPen® should be administered after 5 minutes if symptoms persist.1,2
If used correctly, significant injury with EpiPen® is unlikely. Patients should not remove the blue safety cap until they are ready to inject. They should always ensure that they point the end with the orange tip towards the thigh and never put their thumbs or fingers over the orange tip. Directions for use are in the package insert.
EpiPen® 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 (IM) 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.
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.
EpiPen® should be used with caution in patients with high blood pressure and thyroid conditions (as side effects can last longer) and in pregnancy. Blood sugar may increase in patients with diabetes and symptoms can temporarily get worse in patients with Parkinson’s disease.
Overdose of adrenaline is unlikely with EpiPen®. 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.
It is important to remember that in practice there are no known contraindications to IM adrenaline use in a life-threatening allergic reaction.
If you have any concerns/questions about the safety aspects of EpiPen®, please contact the Viatris Medical Information Department on +44 (0)1707 853000 (option 1) or email: firstname.lastname@example.org