EpiPens - The Ultimate Guide

Found out you have a severe allergy and need to know more about EpiPen’s and how they can help you? Read on for our ultimate guide to EpiPen’s – what’s in them, how they work and exactly how much an EpiPen costs in New Zealand.

What Is An EpiPen

The term EpiPen is commonly used to describe the hand held device known as a Epinephrine Auto Injector.  These devices are often carried by those who have severe allergies in order to provide emergency treatment for an anaphylactic reaction. Epipen’s provide an immediate dose of the medication known as Epinephrine (or adrenaline).

What Is Epinephrine And What Does It Do?

Epinephrine is a hormone secreted by the adrenal glands, it is also known as Adrenaline. Epinephrine is naturally released by the Adrenal Glands in the body’s response to perceived threat or danger, commonly referred to as the ‘Fight or Flight’ response.

The purpose of Epinephrine is to provide a burst of energy to the body’s major muscles in order to provide the best possible chance of survival against the danger encountered. Epinephrine works quickly in the body by stimulating the heart (increasing the blood supply), relaxing the lungs (aiding increased oxygen supply and respiration) and encouraging the liver to produce glycogen which the body converts to glucose for increased energy.

Official EpiPen Ingredients

EpiPens contain one 0.3 mL dose of Epinephrine (adrenaline) which provides a 300 μg dosage.

The EpiPen injection also contains small amounts of sodium chloride, sodium metabisulfite and hydrochloric acid. It does not contain any lactose, sucrose, gluten or tartrazine.

EpiPens And Allergic Reactions

EpiPens containing Epinephrine are used as a portable emergency treatment for severe allergic reactions caused by things like bee stings, medications and foods (nuts, seafood etc). This reaction is referred to as anaphylaxis, anaphylactic shock or an anaphylactic reaction.

7 Symptoms Of Anaphylaxis

Some commonly experienced symptoms of Anaphylaxis are:

1. Swelling of the face particularly the eyes and lips, or throat.
2. Hoarseness in the voice
3. Feeling faint as a result of low blood pressure
4. Difficulty breathing including wheezing and or coughing caused by narrowing of the airways
5. Itchy skin or hives
6. Nausea or Vomiting
7. Rapid heart beat

How Does Epinephrine Help An Anaphylactic Reaction?

When you have an allergic reaction, antibodies that are designed to protect the body against viruses, and infections are produced by the body when mistakenly identified allergens “invade”. The antibodies attach themselves to mast cells triggering them to release powerful chemicals including histamine.

Epinephrine rapidly improves breathing by opening the airways, raises blood pressure by narrowing the blood vessels, and reduces swelling of the face, lips, and throat as well as skin reactions such as hives.

When treated with an EpiPen this is considered to be a temporary measure, the patient still needs to be taken to hospital. In some cases two injections may be necessary. The effects of Epinephrine are expected to last 10 to 20 minutes only.

Are You At Risk From Anaphylaxis And Do You Need An EpiPen?

Any allergic reaction is worth investigating as even if you only reacted mildly the first time as future reactions can be much more severe. Other complications such as Asthma can also place you at a higher risk, it is important to consult your doctor if you have a suspected unconfirmed allergy.

Your doctor will advise you on the tests and precautions necessary for your particular allergy and may refer you on to specialist services. If anaphylaxis is suspected, managing the risks and being prepared become the priorities. It is important to know your triggers and limit exposure as much as possible but also be prepared for an unexpected reaction at all times.

Allergy New Zealand is also a great resource for people with allergies, EpiPens and other helpful information.

6 Common Allergens That Can Cause Severe Allergic Reactions

An allergy is often only discovered when the person is exposed to the specific allergen, this is why people sometimes do not realise they are allergic. Some of the more common allergens that can cause severe allergic reactions are:

1. Pollen from grass and trees
2. Animal dander (skin, scales or flakes from animals as well as animal saliva)
3. Latex in rubber products
4. Moulds
5. Dust mites
6. Insect bites and stings
7. Foods including peanuts, eggs, seafood and dairy.

How To Administer An EpiPen Injection?

It is important to use an EpiPen exactly as prescribed by your doctor. Follow all instruction and carry out the injection exactly as demonstrated.

The following information is given as a guide only.

• The EpiPen is usually injected into the muscle of your outer upper thigh (this can be performed through clothing if necessary)
• The EpiPen will need to be swung or pushed with force into the thigh until it “Clicks”.
• Hold the EpiPen firmly for approximately 3 seconds then release.

For more detailed information please see the EpiPen How To Guide here.

8 Things You Should Know About Your EpiPen

If you need to carry an EpiPen there are some things you should know.

1. The orange end holds the needle which injects the adrenaline.
2. Do not refrigerate your EpiPen.
3. Do not store an EpiPen a car subject to extreme changes in temperature.
4. Always replace your EpiPen before the expiry date.
5. Replace your EpiPen if you notice any discolouration or particles in the tube.
6. Keep the EpiPen out of reach of children.
7. Do not inject into hands, feet, ears, nose, buttocks, or into a blood vessel.
8. There can be side effects to using Epinephrine.

Side Effects Of Epinephrine

Like most medicines, Epinephrine can cause side effects in different people. Some of the more common side effects are paleness, dizziness, weakness, restlessness, anxiety, tenseness, shaking, headaches or throbbing.

Serious side effects can include chest pain, increased or irregular heart rates and a stroke. For  a more complete list of side effects please see your doctor or pharmacist.

Medical Conditions And Medications To Be Aware Of

Certain medical conditions may mean care is needed when using an EpiPen, this includes things like asthma, diabetes, high blood pressure and heart disease, pregnancy. For a complete list of medical conditions please see the Allergy NZ website.

It is also important to inform the pharmacist or doctor of any other medications you are taking, especially medicines for high blood pressure and asthma along with antihistamines and thyroid hormones.

How Much Does An EpiPen Cost In NZ And Where Can I Get One?

There is only one brand of Epinephrine Auto Injector available in New Zealand, this is the EpiPen. In New Zealand the cost of an EpiPen is generally around $120 to $135, but keep an eye out for special deals.

The shelf life of an EpiPen will vary, this can sometimes explain why they are offered at a lower price. Look out for Epipens that have a shelf life of 12 to 15 months for best value for money.

There are two versions available; EpiPen Adult for adults and children over 30kg, and EpiPen Jnr for children between 15 to 30kg. EpiPens are not PHARMAC funded and can be purchased without a prescription.

5 Tips For Storing Your EpiPen

Keeping you EpiPen safe is important to prolong its shelf life and make sure it will function as required in an emergency.

1. Always keep your EpiPen nearby, this may mean carrying it with you everywhere you go.
2. Store the EpiPen in a cool dry place, preferably below 25°C.
3. Refrigeration is not necessary, extreme temperatures can cause the EpiPen to malfunction.
4. Protect the EpiPen from direct sunlight.
5. Do not store your EpiPen in the bathroom or near a sink, heat and/or dampness can affect the medicine.

Managing Allergies And Anaphylaxis In Schools

As an adult managing anaphylaxis and allergies can be a daunting process, but for children attending school and attending things like school camps - it can be even more difficult. There are several things you can do to help your child and reduce the risks.

• Prepare Your Child. Make sure they know what they are allergic to, what foods may contain these things and not to share foods with other children. Providing clear advice on what to do if they come into contact with the allergens is also vital.
• Create A Care Plan. Working with the school to create a Health Care Plan or Action Plan means staff and students are all aware of the situation. Things like education around the allergies, risk management and staff training are all addressed.
• Get Involved. School camps and daily outings can be a nightmare for parents who have children with allergies. The unpredictability and inability to reduce exposure can be a scary experience. Getting involved where possible is a great way to help manage the risks, get in touch with the camp organisers, talk to the caterers, seek out allergy information on the places they are visiting/eating etc.

Useful Links For Allergy Sufferers

Epi Club. Online educational resource for New Zealanders living with the risk of anaphylaxis.

Allergy NZ. National Charity supporting those with allergies.

ASCIA. The Australasian Society of Clinical Immunology and Allergy Limited.

The information contained in this article is intended to act as a guide only, if you are unsure or have more questions about anaphylaxis, EpiPens or allergic reactions ask your doctor or pharmacist.