Generic name: epinephrine injection [ EP-i-NEF-rin ]
Brand names: EpiPen 2-Pak, EpiPen JR 2-Pak
Drug classes: Adrenergic bronchodilators, Catecholamines, Vasopressors

Medically reviewed by Melisa Puckey, BPharm. Last updated on Oct 24, 2023.

What is EpiPen?

EpiPen and Epipen Jr are used to treat life-threatening allergic reactions (anaphylaxis) to insect stings or bites, foods, drugs, and other allergens, and also treat exercise-induced anaphylaxis. EpiPen Auto-Injectors reduce wheezing and improve low blood pressure, hives, severe low blood pressure, and other symptoms of an allergic reaction.

EpiPen contains epinephrine from a class of medications called sympathomimetic agents which works by relaxing the muscles in the airways and tightening the blood vessels. Epinephrine is also called adrenaline.

EpiPen Auto-Injectors are hand-held devices that automatically inject a measured dose of medicine. EpiPen Auto-Injectors make it easier to give epinephrine in an emergency when anaphylaxis occurs. Anaphylaxis can be life-threatening and can happen within minutes and, if untreated, can lead to death. Each EpiPen or EpiPen Jr auto-injector can be used only 1 time (single-use). 

Patients with a history of severe allergic reactions should keep EpiPen or EpiPen Jr Auto-injectors on hand for immediate self-injection if they have an allergic reaction. Epipens are for emergency supportive therapy only and do not take the place of emergency medical care. You should get emergency help right away after using your EpiPen or EpiPen Jr auto-injector.

EpiPen and EpiPen Jr auto-injectors have a Never-See-Needle® that covers the needle before and after you inject, so you should never see a needle. If you can see a needle, do not use the EpiPen or EpiPen Jr auto-injector.

What is anaphylaxis?

Anaphylaxis is a life-threatening allergic reaction to insect stings or bites, foods, drugs, exercise-induced anaphylaxis, and other allergens. Sometimes the cause of anaphylaxis is unknown. EpiPen and Epi-pen Jr Auto-Injectors reduce wheezing and improve low blood pressure, hives, severe low blood pressure, and other symptoms of an allergic reaction. Anaphylaxis can happen within minutes and, left untreated, can lead to death

Symptoms of anaphylaxis may include:

• trouble breathing
• wheezing
• hoarseness (changes in the way your voice sounds)
• hives (raised reddened rash that may itch)
• severe itching
• swelling of your face, lips, mouth, or tongue
• skin rash, redness, or swelling
• fast heartbeat
• weak pulse
• feeling very anxious
• confusion
• stomach pain
• losing control of urine or bowel movements (incontinence)
• diarrhea or stomach cramps
• dizziness, fainting, or “passing out” (unconsciousness).

Anaphylaxis is treated with epinephrine injections such as Epipen, but you must seek emergency medical treatment right away, even if you have used the EpiPen or EpiPen Jr auto-injector.

Warnings

EpiPen Auto-Injectors are used to treat severe allergic reactions (anaphylaxis).

Seek emergency medical attention even after you use EpiPen to treat a severe allergic reaction. You will need to receive further treatment and observation.

Before using EpiPen a second time, tell your doctor if your first injection caused a serious side effect such as increased breathing difficulty, or dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

It is recommended that patients at risk of anaphylaxis carry 2 auto-injectors in case the first auto-injector is activated before the dose can be given, or you need a second dose.

You may not know when anaphylaxis will happen. Talk to your healthcare provider if you need more auto-injectors to keep at work, school, or other locations. Make sure your family members, caregivers, and others where you keep your EpiPen or EpiPen Jr auto-injectors and they know how to use it before you need it. You may be unable to speak in an allergic emergency. 

A “trainer pen” is available to teach and practice giving an injection. The trainer pen contains no medicine and no needle. 

How should I use EpiPen?

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

The EpiPen Auto-Injector device is a disposable single-use system. An Auto-Injector can only be used one time. You may need to use a second EpiPen auto-injector if symptoms continue or come back while you wait for emergency help or if the first auto-injector is activated before the dose can be given.

Do not remove the safety cap until you are ready to use the Auto-Injector. Never put your fingers over the injector tip after the safety cap has been removed.

Do not give this medicine to a child without medical advice.

EpiPen is injected into the skin or muscle of your outer thigh. In an emergency, this injection can be given through your clothing. Do not inject into a vein or into the buttocks, fingers, toes, hands or feet.

To use an EpiPen Auto-Injector:

• Form a fist around the Auto-Injector with the orange end pointing down. Pull the blue safety top straight up and away from the auto-injector. Place the orange tip against the fleshy portion of the outer thigh. You may give the injection directly through your clothing. Do not put your thumb over the end of the unit. Hold the leg firmly when giving this injection to a child or infant.
• Push the Auto-Injector firmly against the outer thigh and hold the EpiPen or Epi-pen Jr auto-injector down firmly on the middle of the outer thigh (upper leg) for at least 3 full seconds. If you do not hold it in place long enough, the EpiPen or EpiPen Jr auto-injector might not have time to deliver the correct dose of medicine.
• Remove the Auto-Injector from the thigh. 
• The EpiPen or EpiPen Jr auto-injector has been activated when the blue safety top is removed and a “pop” is heard, the orange needle end of the auto-injector is extended, or the medicine viewing window is blocked.
• Carefully re-insert the used device needle-first into the carrying tube. Re-cap the tube and take it with you to the emergency room so that anyone who treats you will know how much epinephrine you have received.

If you accidentally inject yourself while giving EpiPen to another person you must seek medical attention.

Accidental injection into fingers, hands or feet may cause a loss of blood flow to these areas. If an accidental injection happens, go immediately to the nearest emergency room.

Use an Auto-Injector only once, then throw away in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Do not try to reuse the same Auto-Injector a second time. If the needle is bent from the first use, it may cause serious injury to your skin.

Do not use the EpiPen if it has changed colors or has any particles in it, or if the expiration date on the label has passed. Call your doctor for a new prescription.

Your medicine may also come with a "trainer pen." The trainer pen contains no medicine and no needle. It is only for non-emergency use to practice giving yourself an injection.

Dosing information

Usual Epipen dose patients over 30kg (66 lbs): EpiPen 0.3 mg. 

Usual Epipen dose patients 15 to 30 kg (33 lbs to 66 lbs): EpiPen Jr 0.15 mg.

Inject intramuscularly or subcutaneously into the outer thigh, through clothing if necessary. Each device is a single-dose injection.

Epipen is available as:

EpiPen Auto-Injector 0.3 mg (0.3 mg/0.3 mL) single-dose pre-filled auto-injector

EpiPen Jr Auto-Injector: 0.15 mg (0.15 mg/0.3 mL) single-dose pre-filled auto-injectorkilograms).

Related/similar drugs

prednisone, loratadine, triamcinolone, diphenhydramine, promethazine, Benadryl, epinephrine, Phenergan, Adrenalin, neffy

Before using this medicine

Before using EpiPen, tell your doctor if any past use has caused an allergic reaction to get worse.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

• heart disease or high blood pressure;
• asthma;
• Parkinson's disease;
• depression or mental illness;
• a thyroid disorder; or
• diabetes.

Pregnancy and breastfeeding

Having an allergic reaction while pregnant or nursing could harm both mother and baby. 

You may need to use EpiPen during pregnancy or while you are breastfeeding. Seek emergency medical attention right away after using the injection. Epinephrine is the first-line medication of choice for the treatment of anaphylaxis during pregnancy and breastfeeding. Epinephrine should be used for the treatment of anaphylaxis during pregnancy and breastfeeding in the same manner as it is used in non-pregnant and non-breastfeeding patients.

If possible during an emergency, tell your medical caregivers if you are pregnant or breastfeeding.

What happens if I miss a dose?

Since EpiPen is used when needed, it does not have a daily dosing schedule.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include numbness or weakness, severe headache, blurred vision, pounding in your neck or ears, sweating, chills, chest pain, fast or slow heartbeats, severe shortness of breath, or cough with foamy mucus.

What should I avoid while using EpiPen?

Do not inject EpiPen into a vein or into the muscles of your buttocks, or it may not work as well. Inject it only into the fleshy outer portion of the thigh.

EpiPen side effects

Before using EpiPen, tell your doctor if any past use has caused an allergic reaction to get worse.

Call your doctor at once if you notice pain, swelling, warmth, redness, or other signs of infection around the area where you gave an injection.

Side effects may be more likely in older adults.

Common EpiPen side effects may include:

• breathing problems;
• fast, irregular, or pounding heartbeats;
• pale skin, sweating;
• nausea and vomiting;
• dizziness;
• weakness or tremors;
• headache; or
• feeling restless, fearful, nervous, anxious, or excited.

This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

What other drugs will affect EpiPen?

Tell your doctor about all your other medicines, especially:

• asthma medicine;
• an antidepressant;
• cold or allergy medicine (Benadryl and others);
• heart or blood pressure medicine;
• thyroid medication; or
• ergot medicine - dihydroergotamine, ergotamine, ergonovine, methylergonovine.

This list is not complete. Other drugs may interact with epinephrine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Storage

• Store EpiPen and EpiPen Jr auto-injectors at room temperature between 68° F to 77° F (20° C to 25° C).
• Do not expose it to extreme cold or heat. For example, do not store it in your vehicle’s glove box or trunk. Do not store in the refrigerator or freezer.
• Keep this medicine out of the sight and reach of young children.
• Keep a protective case in the outer carton to protect from light. When exposed to air or light epinephrine changes quickly to a pinkish or brown color and should not be used.
• Examine the contents in the medicine viewing window of your EpiPen or EpiPen Jr auto-injector regularly. The medicine should be clear. If the medicine is discolored (pinkish or brown color) or contains solid particles, replace the auto-injector.
• Always keep your EpiPen or EpiPen Jr auto-injectors in the protective cases to prevent damage to the device. The protective case is not waterproof.
• The blue safety top helps to prevent accidental injection. Keep the blue safety top in place until you need to use the EpiPen or EpiPen Jr auto-injector. After the auto-injector is used, throw away the blue safety top as this may pose a choking hazard for small children.

Ingredients

Active Ingredients: epinephrine

Inactive Ingredients: sodium chloride, sodium metabisulfite, hydrochloric acid, and water

Company

Manufactured for: Mylan Specialty L.P., Morgantown, WV 26505, U.S.A. by Meridian Medical Technologies, LLC, St. Louis, MO 63146, U.S.A.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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