An adrenaline autoinjector can save the life of someone who is having a severe allergic reaction (anaphylaxis). If you think you or someone you know is experiencing an anaphylaxis, use the adrenaline autoinjector immediately then call an ambulance on triple zero (000).

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.

There are two different brands of adrenaline autoinjector available in Australia; EpiPen and Anapen. Both brands have an autoinjector for adults and one, which contains a lower dose of adrenaline, for children who weigh between 15kg and 30kg.

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 to use an EpiPen adrenaline autoinjector.

If you can, use the EpiPen yourself.

1. 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.

How to use an Anapen adrenaline autoinjector

If you can, use the Anapen yourself.

1. 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.

When to 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, fish, shellfish, wheat and soy, insect bites and stings, or medications.

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.

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 an ambulance on triple zero (000) and continue first aid for both asthma and anaphylaxis until the ambulance arrives.

Have an action plan for anaphylaxis

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 anaphylaxis in an emergency. Your anaphylaxis action plan is filled out and signed by a health professional, such as a doctor or nurse.

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

How to get an adrenaline autoinjector

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

Adrenaline autoinjectors last for 1 to 2 years and must be stored at room temperature. Make sure your device has not passed its expiry date before you use it. Do not use it if the adrenaline looks cloudy.

More information

• Step by step instructions for giving EpiPen, available in English and other languages
• Contact Allergy & Anaphylaxis Australia, 1300 728 000 or email coordinator@allergyfacts.org.au
• Consumer medicines information leaflets: Epipen, Epipen Jr, Adrenaline Mylan, Adrenaline Jr Mylan, Anapen and Anapen Junior.

Not sure what to do next? Visit healthdirect’s Symptom Checker, an online tool that will help you check your symptoms and get advice on what to do.