What is an adrenaline autoinjector?

Adrenaline autoinjectors are used to treat severe allergic reactions (anaphylaxis) in an emergency. They are designed to administer a single, fixed dose of adrenaline and can be given by anyone, including people who are not medically trained.

What types of adrenaline autoinjector are available in Australia?

There are two different brands of adrenaline autoinjector available in Australia called EpiPen^™ and Anapen^™. Both brands have an autoinjector for adults and one for children who weigh between 7.5kg and 20kg. The children’s version contains a lower dose of adrenaline. Anapen^™ also makes a larger dose version that can be used by people who weigh over 50kg.

Why is adrenaline important when treating a severe allergic reaction?

Adrenaline treats the very low blood pressure and poor circulation that occur when someone is having a severe allergic reaction. It also relaxes the lungs to help breathing, and reduces swelling, skin rashes and itching.

How do I use an EpiPen^™ adrenaline autoinjector?

If you can, use the EpiPen yourself.

1. If the person cannot use the autoinjector themselves, lay the person flat on the ground. If breathing is difficult, they can sit on the ground.
2. Remove the autoinjector from the carry tube. Keep your fingers and thumb away from the orange tip.
3. With the orange tip facing down, hold the adrenaline autoinjector firmly in your fist and pull off the blue safety release.
4. Hold the leg still and place the orange end against the outer mid-thigh. Hold the autoinjector at a right-angle to the outer part of the thigh.
5. You can give the injection through clothing but avoid pockets or seams.
6. Push down firmly until you hear or feel a click.
7. Hold for 3 seconds.
8. Remove the adrenaline autoinjector.
9. Record the time the injection was given.
10. Call an ambulance and continue to follow anaphylaxis first aid.

Further adrenaline doses may be given if there is no response 5 minutes after giving the first dose.

Watch this video from Allergy & Anaphylaxis Australia for a demonstration on how to use the EpiPen^™ and EpiPen Jr^™.

Video not working? View it here.

How do I use an Anapen^™ adrenaline autoinjector?

If you can, use the Anapen^™ yourself.

1. If the person cannot use the autoinjector themselves, lay the person flat on the ground. If breathing is difficult, they can sit on the ground.
2. Remove the black needle shield by pulling hard.
3. Remove the grey safety cap from the red firing button.
4. Hold the open end (needle end) against the outer part of thigh.
5. You can give the injection through clothing but avoid pockets or seams.
6. Press the red firing button so that it clicks.
7. Hold for 10 seconds.
8. Slowly remove the adrenaline autoinjector.
9. Record the time the injection was given.
10. Call an ambulance and continue to follow anaphylaxis first aid.

Further adrenaline doses may be given if there is no response 5 minutes after giving the first dose.

Watch this video from Allergy & Anaphylaxis Australia for a demonstration on how to use the Anapen^™ autoinjector.

Video not working? View it here.

When should I use an adrenaline autoinjector?

You should use the adrenaline autoinjector immediately if someone shows any of the following signs of a severe allergic reaction:

• difficult or noisy breathing
• swelling of the tongue
• swelling or tightness in the throat
• difficulty talking and/or hoarse voice
• wheeze or persistent cough
• persistent dizziness and/or collapse
• pale and floppy (in young children)

The most common triggers of a severe allergic reaction are:

• foods such as milk, eggs, peanuts, tree nuts, sesame, seafood, wheat and soy
• insect bites and stings
• medicines

If you aren’t sure if someone needs the adrenaline autoinjector, it is better to give it than not. Failing to treat anaphylaxis can be life threatening. Adrenaline does not have serious side effects if given unnecessarily, but it can be lifesaving.

If you aren’t sure whether the person is having an asthma attack or anaphylaxis, use the adrenaline autoinjector first, followed by asthma reliever medication. Call triple zero (000) and ask for an ambulance, and continue first aid for both asthma and anaphylaxis until the ambulance arrives.

What is an allergy action plan?

If you are at risk of having an allergic reaction, it is important to have an action plan. This is a short, easy to follow one-page document that sets out how to treat allergic reactions in an emergency. Your allergy action plan is filled out and signed by a health professional, such as a doctor or nurse.

You can find out more about allergy action plans on the Australasian Society of Clinical Immunology and Allergy (ASCIA) website.

How can I get an adrenaline autoinjector?

Adrenaline autoinjectors are available on the Pharmaceutical Benefits Scheme (PBS) for people diagnosed as being at high risk of anaphylaxis. Ask your doctor if you need a prescription.

Adrenaline autoinjectors last for 1 to 2 years and must be stored at room temperature. Check your device regularly and remember to replace it before the expiry date. Do not use it if the adrenaline looks cloudy.

Resources and support

• Step by step instructions for giving EpiPen, available in English and other languages.
• Step by step instructions for giving Anapen.
• Contact Allergy & Anaphylaxis Australia on 1300 728 000.
• Consumer medicines information leaflets: Epipen^™, Epipen Jr^™, Adrenaline Mylan^™, Adrenaline Jr Mylan^™, Anapen^™ and Anapen Junior^™.