Food Allergy Reminder: Check Your Epinephrine Autoinjectors

When you haven’t had a food allergy reaction for some time, it’s easy to get lulled into a false sense of security. This places you at an increased risk of experiencing a severe allergic reaction, perhaps even anaphylaxis, and not being prepared to deal with it.

If your doctor gave you a prescription for epinephrine autoinjectors, I encourage you take the following precautions to remain prepared in the event of a severe food allergy reaction:

  • Fill your epinephrine autoinjector prescription immediately.
  • Read the instructions provided with your autoinjector and review them with each refill just in case the instructions have changed. Each of the major manufacturers of epinephrine autoinjectors, EpiPen and Twinject, has printed instructions and a training video on its website.
  • Make sure you’re getting the right dose. Autoinjectors come in 2 doses–a junior for young children and a regular strength for everyone else. Officially, the full strength devices are approved for use for anyone over 66 pounds. The junior strength is a perfect dose for someone who weighs 33 pounds, but for every pound above that it under-doses more and more. For this reason most experts, including me, recommend switching from junior to regular strength somewhere between 45 and 55 pounds.
  • Store epinephrine at normal room temperature away from cold and heat sources.
  • Examine the epinephrine cartridge window periodically to ensure that the solution is colorless and contains no floating particles. Replace solutions that are discolored or contain particles.
  • Check the expiration date on your autoinjectors regularly. An expired autoinjector is better than no injector, so if all you can find during an emergency is an expired one, use it. However, if your autoinjectors are past their expiration dates, have your prescription refilled.
  • Keep at least two epinephrine autoinjectors with you at all times. Having an additional autoinjector at work, school, and home is a great idea.
  • Store the home injector in a convenient location, and let family members and friends know where it is. Sticking it in the “junk drawer” or a cluttered medicine cabinet is a bad idea.
  • Train family members, close friends, teachers, and co-workers on proper use in preparation for a possible emergency. In the midst of a reaction, you may panic and be unable to assist with your own injection.
  • Act quickly when you first notice symptoms. A quick response is essential in preventing serious complications. Few, if any, known fatal reactions have been due to food-induced anaphylaxis when epinephrine was given promptly.
  • A second dose may be needed if symptoms are worsening or not improving within 10-15 minutes or if symptoms return before emergency personnel and equipment are available. Symptoms may even return hours later, in the case of a biphasic reaction, requiring an additional injection and a return trip to the hospital.

Remember: Epinephrine is no substitute for emergency medical treatment. It can buy you valuable time on your way to the hospital, but don’t assume that once your symptoms begin to subside that you’re home free. Symptoms can return. I have had a reaction that required five shots. After the first shot, call 911 and obtain emergency medical care immediately. You may need to take a second or third shot while waiting for help to arrive or on your way to the hospital.