FDA WARNING ABOUT EPIPEN MALFUNCTIONS

In March 2020, the Food and Drug Administration (FDA) released a safety alert to warn the public that epinephrine auto-injectors (EpiPen, EpiPen Jr, and generic forms) may malfunction. This could prevent you from receiving potentially lifesaving treatment during an emergency. If you’re prescribed an epinephrine auto-injector, see recommendations from the manufacturer here and talk with your healthcare provider about safe usage.

An epinephrine auto-injector is a way to deliver medication quickly and effectively to someone who’s experiencing anaphylaxis, a severe and potentially life threatening consequence of an allergic reaction.

You may also see auto-injectors referred to as adrenaline auto-injectors.

Because anaphylaxis can be life threatening, it’s very important that someone experiencing symptoms receives treatment as quickly as possible.

The epinephrine present in an auto-injector works to reverse the symptoms of what could be a severe acute allergic reaction.

Read on to learn how to use an auto-injector as well as what else to do in the event that you or someone else is experiencing anaphylaxis.

Before you use an epinephrine auto-injector, you should check that the blue safety release isn’t raised and that the device isn’t difficult to slide out of its carrying case.

Don’t use the auto-injector if it has either of these issues. Contact your healthcare provider as well as the manufacturer instead.

The video below walks you through how to administer an epinephrine auto-injector to yourself.

In summary, follow the steps below to administer an epinephrine auto-injector to yourself:

  1. Carefully remove the auto-injector from its clear carrier tube.
  2. Grip the barrel of the auto-injector in your dominant hand so the orange tip points downward. Make sure your fingers aren’t close to either end of the auto-injector.
  3. Use your other hand to pull straight up on (not sideways) and remove the blue safety release. Don’t twist or bend it.
  4. Firmly inject the orange tip of the auto-injector into the middle part of your upper thigh, pushing until it makes a clicking noise. This lets you know that the epinephrine injection is underway.
  5. Hold the auto-injector in place for at least 3 seconds, counting off slowly, before removing it from your thigh.
  6. Use your fingers to gently massage the area of the injection for about 10 seconds.
  7. Call 911 to seek emergency care or tell someone close to you to call.

An epinephrine auto-injector can be administered through clothes if necessary.

Sometimes the person may need a second dose (requiring an additional auto-injector) should they not respond effectively to the first dose.

If you need to administer an epinephrine auto-injector to another adult, follow the steps above and administer the injection into the upper thigh.

It may help to administer the auto-injector while the person is lying down or sitting.

Don’t use an epinephrine auto-injector on a child if the blue safety release is raised or if the auto-injector doesn’t slide out of its carrying case easily.

Contact their healthcare provider as well as the manufacturer instead.

Follow the steps below to administer an epinephrine auto-injector to a child:

  1. Remove the auto-injector from its clear carrier tube.
  2. Form a fist, gripping the auto-injector in your dominant hand so the orange tip points downward. Make sure your fingers aren’t covering either end.
  3. Use your other hand to pull straight up on (not sideways) and remove the blue safety release. Don’t twist or bend it.
  4. Position the child to receive the injection. Older children can sit or lie down. Smaller children may need to be held in your lap. Be sure to hold their leg gently yet firmly in place.
  5. Inject the orange tip of the epinephrine auto-injector firmly into the middle part of the child’s upper thigh. Push until it clicks.
  6. Be sure to hold the auto-injector in place for at least 3 seconds before you remove it from the child’s thigh.
  7. Carefully massage the injection area for about 10 seconds.
  8. Call 911 to seek emergency care.

The symptoms of anaphylaxis come on quickly and can rapidly worsen.

Anaphylaxis is an emergency situation. If you or someone else is experiencing symptoms, don’t hesitate to administer an epinephrine auto-injector and seek emergency care.

Symptoms to look out for include:

Antihistamine medications, such as diphenhydramine (Benadryl) or loratadine (Claritin), can be used to either prevent or ease allergy symptoms.

It’s appropriate to use these medications to relieve mild allergy symptoms such as sneezing, itchy or watery eyes, and hives.

However, never use antihistamines alone to treat anaphylaxis.

Not only do they not act as quickly as epinephrine, but they also can’t effectively prevent or reduce some of the more serious effects of anaphylaxis, such as airway obstruction and low blood pressure.

If you or someone else is experiencing anaphylaxis, epinephrine should be administered immediately. You should then get emergency medical attention.

What should you do in the event that someone is experiencing anaphylaxis? Follow the steps below in an emergency situation.

  1. Call 911 immediately.
  2. Ask the person if they’re carrying an epinephrine auto-injector on them. If so, ask them if they need your help administering the injection.
  3. Administer the epinephrine auto-injector.
  4. Loosen any tight-fitting clothing.
  5. Help the person lie on their back. If they’re feeling nauseous or have vomited, gently turn them on their side. Also, turn them on their side if they’re unconscious, pregnant, or having trouble breathing.
  6. Remove any allergy triggers if possible.
  7. Cover the person with a blanket if available.
  8. Avoid giving them any food or drink.
  9. If a second epinephrine auto-injector is available, give another injection if symptoms haven’t improved in about 5 to 15 minutes. However, more than two injections shouldn’t be given without the supervision of a medical professional.
  10. If there are no signs of breathing, administer CPR.
  11. Stay with the person and continue to reassure them until help arrives.

To help prevent an anaphylactic reaction, or to be prepared in case you experience one, follow the safety tips below:

  • Always carry your epinephrine auto-injector with you. Try to carry the double pack just in case you have a reaction and one dose doesn’t alleviate your symptoms or your symptoms come back before help arrives.
  • Check your auto-injector regularly. Note the expiration date as well as the color of the liquid in the injector, which should be clear. Replace your auto-injector if it’s close to its expiration date or the liquid is discolored.
  • Always store your epinephrine auto-injector at room temperature. Extremes in temperature may make the medication less effective.
  • Know the signs of an anaphylactic reaction. Knowing this information can allow you to promptly administer your auto-injector.
  • Know how to administer an epinephrine auto-injector. Be sure your family, friends, and caregivers know as well. Many manufacturers include a practice injector (trainer) so you can practice administering an injection.
  • Let others know about your allergy. This helps them know what to do in case you have a reaction. Consider wearing a medical ID that lets people know about your allergy.
  • Always seek emergency medical treatment if you experience anaphylaxis. Don’t just wait for your symptoms to improve.

It’s very important to go to the ER for anaphylaxis, even if you’ve used an epinephrine auto-injector.

This is because the symptoms can potentially come back. People who’ve experienced anaphylaxis should be monitored in a hospital for several hours.

Anaphylaxis is a serious allergic reaction and an emergency medical situation. Using an auto-injector to administer epinephrine can reverse the symptoms of anaphylaxis and stabilize your condition until help arrives.

If you have an allergy, it’s important that you carry an auto-injector at all times in case of a reaction. The injection is quick and is given in the upper part of your thigh.

Both you and those close to you should also be able to identify the symptoms of anaphylaxis and know how to properly administer an epinephrine auto-injector.

Recognizing anaphylaxis and promptly giving an epinephrine injection can save lives.