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Learn how to
use EpiPen®

Review the simple 2-step administration process.

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Frequently asked questions

Review these frequently asked questions to find out more about the EpiPen® Auto-Injector.

QWhat are the differences between the re-designed EpiPen® and the original EpiPen®?

It is important to understand that the re-designed EpiPen® and EpiPen® Jr have the same reliable Auto-Injector mechanical properties and contain the same dose and formulation of epinephrine. The needle gauge (bore or diameter) and length are exactly the same as the preceding version of EpiPen®. Importantly, the administration of EpiPen® is exactly the same, only the colours of the safety release (formerly gray now blue) and the injection tip (formerly black now orange) has been changed. The colours of the ends or tips of EpiPen® were changed to make them more distinguishable, especially among users who may be colour blind and may have difficulty distinguishing colours.

There has been a change to the shape of the injector from round to a larger oval shape:

  • 1. The oval shape allows for the mechanics of the automatic needle protection device. This has been added to prevent accidental needle sticks.
    • Once the dose is administered and the EpiPen® is released from the injection site, the orange needle cover automatically extends and immediately locks in place encasing the needle to prevent accidental needle sticks.
    • Further, the way the orange needle cover is designed the patient never actually sees the needle either prior to or after administration of the dose.
  • 2. The oval shape also allows for more surface area for the labelling information and administration instructions on the EpiPen® which has been revised to be more visual in order to aid in accurate use of the EpiPen®.
  • 3. Lastly, the oval shape makes the EpiPen® easy to grip in your hand and it also makes it more recognizable as a medical product, differentiating it from an item of a comparable shape or appearance (e.g., ink pen, lipstick or lip balm container, cigar, etc.).

Q When should I inject EpiPen®?

Epinephrine should be administered as early as possible after the onset of symptoms of a severe allergic response. People requiring epinephrine will not always have predictable reactions. Adequate warning signs are not always present before serious reactions occur.

It is recommended that epinephrine be given at the start of any reaction associated with a known or suspected allergen contact. For people with a history of a severe cardiovascular collapse on exposure to an allergen, the physician may advise that epinephrine be administered immediately after exposure to that allergen, and before any reaction
has begun.

Epinephrine, when used as directed immediately following exposure to a known allergen, may prove life-saving.

Q How do I administer EpiPen®?

EpiPen® is administered in a simple 2-step process:

1. Remove blue safety
cap by pulling straight
up. Do not bend or
twist.

2. Swing and push orange tip firmly
into mid-outer thigh until you hear
a ‘click’. Hold on thigh for several
seconds.

Seek medical attention immediately.

When the dose is administered and EpiPen® is released from the injection site, the orange needle cover will automatically extend and immediately locks in place.

Give any used EpiPen® Auto-Injectors to emergency responders or emergency room personnel to discard.

These instructions are found on the barrel of EpiPen® as well as in the
prescribing information.

To see a demonstration, click here.

If you would like to order your FREE EpiPen® Starter Kit, click here.

Q Why should I swing my arm to inject?

It is recommended that you swing your arm to inject EpiPen®. You do not need to apply excessive force to the swing, just enough to gain sufficient momentum to ensure the Auto-Injector deploys. Swinging your arm helps provide enough load on the tip of the EpiPen® to deliver an intramuscular (IM) injection. Administering the EpiPen® in this manner also helps facilitate the ideal angle for the IM injection into the anterolateral aspect of the thigh, which is perpendicular or at 90 degrees to the injection site.

Q How many seconds should I hold EpiPen® in place when I inject?

The instructions on the EpiPen® cartridge state you should swing the arm and push the orange tip firmly into the mid-outer thigh so it “clicks” and hold it on the thigh for several seconds. By holding the EpiPen® in place at the injection site for several seconds, it helps assure that the dose of epinephrine has been delivered satisfactorily.

Q How do I know if EpiPen® has been activated?

The extended orange needle cover and obscured window indicates that the EpiPen® has delivered the drug.

Q How do I know if I have received my injection?

There is a viewing window on the barrel of the EpiPen® which prior to delivery is clear and after delivery is obscured or shaded. Also, once the dose is administered and the EpiPen® is released from the injection site, the orange needle cover extends and immediately locks in place encasing the needle to prevent accidental needle sticks. Both of these things serve as a visual indicator that the dose of epinephrine has been delivered.

Further, after the orange needle cover is extended the EpiPen® will not fit back into the carrier tube.

Q Can I inject EpiPen® through my clothes?

Yes. If necessary, you can inject EpiPen® through clothing.

Q What do I do in the event of an accidental injection into hands or feet, etc?

Accidental injection into the hand or feet may result in loss of blood flow to the affected areas and should be avoided. If there is an accidental injection into these areas, go immediately to the nearest emergency room for treatment.

Q What do I do after I have used EpiPen®?

After using EpiPen®, seek medical attention immediately. Take the used EpiPen® with you to the nearest Emergency Department and give it to the Emergency Department staff for proper disposal. You can also bring any used EpiPen® Auto-Injectors to your pharmacy.

Q How should I dispose of a used EpiPen®?

After using EpiPen® medical attention should be sought. The used EpiPen® should be taken to the nearest Emergency Room for proper disposal and this will also show the medical personnel what medication has already been administered.

For an expired EpiPen®, contact your local pharmacy, they should be able to assist in disposal of the product according to regulations.

Q What should I do if I accidentally remove the safety release from EpiPen®?

If the unit has not been activated, then the safety release can be carefully replaced. Because removing the safety release prepares the unit for activation, you should gently place the unit in its needle-safe storage tube. Make sure the safety release end faces towards the opening and secure the blue safety release in place. Be very careful to keep your fingers clear of each end.

Q Does EpiPen® come with needle protection?

EpiPen® has a needle protection device (orange needle cover or sheath) built-in within the unit. This device automatically deploys or extends when the dose is administered and the EpiPen® is removed from the injection site.

The extended needle protection sheath will prevent the EpiPen® from fitting back into the carrier tube.

Q Do you have to be certified to administer EpiPen® to someone else who is in need
of the medication but unable to administer it themselves?

Emergency administration of EpiPen® in the case of a suspected severe allergic reaction does not require certification. The patient’s physician or pharmacist should review the package insert in detail with the patient or caregiver to ensure that he/she understands the indications and use of the EpiPen®.

Actual demonstration of the injection technique by a physician or pharmacist is recommended. A training device for patient instruction purposes is also available and can be ordered at EpiPen.ca.

It is important that people at risk of a severe allergic reaction educate others on how to
use EpiPen®.

EpiPen® and EpiPen® Jr are designed as emergency supportive therapy only and not as a replacement or substitute for subsequent medical or hospital care. After administration, patients should seek medical attention immediately or go to the emergency room. For the next 48 hours, patients must stay within close proximity to a healthcare facility or where they can call 911.

Q What are the dosing guidelines for EpiPen®?

Dosage in any specific patient should be based on body weight.

  • EpiPen®: EpiPen® delivers a dose of 0.3 mg in 0.3 mL of 1:1000 dilution of epinephrine injection, USP. EpiPen® is intended for adults and children who weigh
    30 kg or more.
  • EpiPen® Jr: EpiPen® Jr delivers a dose of 0.15 mg in 0.3 mL of 1:2000 dilution of epinephrine injection, USP. EpiPen® Jr is intended for children who weigh between 15 kg and 30 kg.
  • Dosing in children <15 kg: Since the dose of epinephrine delivered from EpiPen® Jr is fixed at 0.15 mg, the physician can consider other forms of injectable epinephrine if doses lower than 0.15 mg are felt to be necessary (e.g., for children weighing less than 15 kg).

Dosage adjustments are at the discretion of a healthcare professional.

Q How many doses of EpiPen® can be administered?

A severe allergic reaction is a serious, acute, allergic reaction that may cause death. It has a sudden onset and generally lasts less than 24 hours. Because a severe allergic reaction is a generalized reaction, a wide variety of clinical signs and symptoms may be observed.

Physicians may determine that a single dose of epinephrine may not be enough to reverse the symptoms of a severe allergic reaction. As such, your healthcare professional may prescribe more than one EpiPen® to have on hand. Epinephrine can be re-injected every 5 to 15 minutes until there is resolution of the severe allergic reaction or signs of adrenaline excess (such as palpitations, tremor, uncomfortable apprehension, and anxiety).

In most cases, epinephrine is effective after 1 injection. However, symptoms may recur and further injections may be required. After receiving epinephrine, you must be transported to hospital, for evaluation and a period of observation of no less than 4 hours. This is because of the possibility of either a “biphasic” reaction (a second reaction) or a prolonged reaction. The attending physician will consider such factors as the severity of the reaction, your history and response, and the distance from the hospital to your home.

Severe allergic reactions typically follow a uniphasic course; however, 20% will be biphasic in nature. The second phase usually occurs after an asymptomatic period of 1 to 8 hours, but may occur up to 38 hours (mean 10 hours) after the initial reaction. About 1/3 of the second-phase reactions are more severe, 1/3 are as severe, and 1/3 are less severe. The second-phase reactions can occur even following administration of corticosteroids. After administration, you should seek medical attention immediately or go to the emergency room. For the next 48 hours, you must stay within close proximity to a healthcare facility or where you can call 911.

Protracted anaphylaxis, which is frequently associated with profound hypotension and sometimes lasts longer than 24 hours, is minimally responsive to aggressive therapy, and has a poor prognosis.

Q What length of expiry should I expect when purchasing EpiPen®?

We strive to provide our patients with a minimum of 12 months of expiry when they purchase an EpiPen® or EpiPen® Jr. If you have recently bought an EpiPen® or EpiPen® Jr that has a shorter expiry date, please talk to your pharmacist.

Q How do I read the expiry date on EpiPen®?

The expiration date is expressed as the month and the last 2 digits of the year. For example, an expiration designation of “Exp: JA 12” indicates that the EpiPen® expires the last day (31st) of January 2012, thus the expiration date in this example would be January 31, 2012.

Further, expiration dates on EpiPen® (Canada) are different than product from the U.S. The Canadian product is designed to be "bilingual friendly," e.g. JA = Jan, JN = June, JL = July, MA = May, MR = March.

Q If the EpiPen® is expired, can it still be used?

We cannot recommend use of an expired product. To help ensure your
EpiPen® Auto-Injectors are replaced before they expire, you can register here for the Expiration Reminder Service.

Q How do I store EpiPen® and under what conditions should I consider the
Auto-Injector compromised?

It’s important to properly store EpiPen® to help ensure it’s ready to use in the event of a severe allergic reaction.

  • Always store EpiPen® in the carrier tube with the safety release on until you need to use it.
  • Keep EpiPen® at room temperature. Do not refrigerate.
  • EpiPen® can be exposed to temperatures between 15°C to 30°C.
  • Do not keep EpiPen® in a vehicle during extremely hot or cold weather.
  • Protect your EpiPen® from light.
  • Submerging EpiPen® in water can compromise the delivery mechanism.

Occasionally look through the viewing window on your EpiPen® to make sure the solution in the Auto-Injector is not brown in colour. Replace your EpiPen® if the solution is discoloured or cloudy.

If EpiPen® has not been stored according to the above storage recommendations, using the Auto-Injector cannot be recommended.

EpiPen® is a medical device that contains glass and should be handled with care.

Q What do I do if the liquid in the EpiPen® is discoloured?

Discoloured EpiPen® Auto-Injectors should not be used. Discoloration is extremely rare and usually signifies that the drug has come in contact with oxygen, extreme temperatures, light, or some foreign element such as a piece of metal. When the EpiPen® discolours, it will turn to a dark coffee colour.

For disposal of EpiPen® Auto-Injectors, contact your local pharmacy, they should be able to assist in disposal of the product according to regulations.

Q Can you use EpiPen® if you have a sensitivity to sulfites?

This product contains sodium metabisulphite, a substance which may cause allergic-type reactions including anaphylactic symptoms or mild to severe asthmatic episodes in certain susceptible persons.

Epinephrine is the drug of choice for serious allergic reactions and the presence of a sulfite in this product should not deter administration of the drug for treatment of serious allergic or other emergency situations, even if the patient is sulfite-sensitive.

Q Does EpiPen® contain latex?

No. EpiPen® is latex-free.

Q Can you purchase EpiPen® without a prescription?

In Canada, EpiPen® can be purchased with or without a prescription.

Q Is there an EpiPen® carrier bag or belt available?

Belt carriers and clip holders for EpiPen® can be ordered from the following patient organization websites:

Q Does EpiPen® fit in most commercial carrying cases?

It is recommended to always carry an EpiPen® in the case provided when it is dispensed at the pharmacy. This carrying case is designed specifically for the EpiPen® and protects the device from UVB, accidental discharge and damage. However, EpiPen® will fit in most commercially-available carrying cases. Please check with manufacturers for updates.

Q Can I travel with EpiPen®?

If travelling by air, always inform security that you are carrying an EpiPen® or EpiPen® Jr and keep it in your hand luggage. The baggage compartment of the aircraft is not temperature controlled, so temperatures may not be ideal (25°C/77°F) or within the permitted range of 15°C–30°C (59°F–86°F).

Be sure to carry your EpiPen® or EpiPen® Jr in its original packaging. You may also require a pharmacy label that includes the name of the person the pen was prescribed for and the name of the prescribing physician.

When travelling cross-border, please consult Canada Border Services at 1-800-461-9999 for the latest information, or click here.

Q Where can I find patient information on severe allergic reactions?

The following links may offer additional resources and information on severe allergic reactions and treatment for patients with allergies:

Q Who should I contact if I have concerns or product complaints?

Contact Pfizer at 1-877-EPIPEN1 (1-877-374-7361).