Dosage And Administration
Dosage in any specific patient should be based on body weight. A physician who prescribes EpiPen® or EpiPen Jr® should take appropriate steps to ensure that the patient thoroughly understands the indications and use of the device. The physician should review with the patient, in detail, the CONSUMER INFORMATION section and operation of the auto-injector.
Recommended Dose and Dosage Adjustment :
The effective dose is usually in the range 0.005-0.01 mg/kg bodyweight.
The EpiPen® auto-injector is intended for intramuscular administration in adults and children who weigh 30 kg or more.
EpiPen® auto-injector delivers a single intramuscular dose of 0.3 mg epinephrine in a 0.3 mL volume (0.3 mg/0.3 mL).
The EpiPen Jr® auto-injector is intended for pediatric intramuscular administration in children who weigh between 15 kg and 30 kg.
EpiPen Jr® auto-injector delivers a single intramuscular dose of 0.15 mg epinephrine in a 0.3 mL volume (0.15 mg/0.3 mL).
For children weighing more than 30 kg, EpiPen® auto-injector 0.3 mg (adult formulation) is recommended.
Since the dose of epinephrine delivered from EpiPen Jr® is fixed at 0.15 mg, the physician can consider other forms of injectable epinephrine if doses lower than 0.15 mg are felt to be necessary (e.g., for children weighing less than 15 kg).
An initial dose should be administered as soon as symptoms of anaphylaxis are recognised. In the absence of clinical improvement or if deterioration occurs after the initial treatment, a second injection with an additional EpiPen® auto-injector may be administered 5 – 15 minutes after the first injection. It is recommended that patients are prescribed two EpiPen® or EpiPen Jr® auto-injectors which they should carry at all times.
All individuals receiving emergency epinephrine must be immediately transported to hospital, ideally by ambulance, for evaluation and observation even if symptoms appear to be improving.
The patient/carer should be informed that following each use of EpiPen® and EpiPen Jr® auto-injector:
- As EpiPen® and EpiPen Jr® auto-injector is designed as emergency treatment only, the patient should be advised to always seek medical help immediately.
- Conscious patients should preferably lie flat with feet elevated but sit up if they have breathing difficulties. Unconscious patients should be placed on their side in the recovery position.
- The patient should if possible remain with another person until medical assistance arrives.
EpiPen® and EpiPen Jr® are intended for intramuscular use in the anterolateral aspect of the thigh, through clothing if necessary. Do not inject into the buttock
Instruct caregivers to hold the leg of young children firmly in place and limit movement prior to and during injection. Lacerations, bent needles, and embedded needles have been reported when EpiPen® and EpiPen Jr® have been injected into the thigh of young children who are uncooperative and kick or move during an injection (see WARNINGS AND PRECAUTIONS section).
Patients with a history of severe allergic reactions should be instructed about the circumstances under which epinephrine should be used (see INDICATIONS AND CLINICAL USE section).
A physician who prescribes EpiPen® or EpiPen Jr® should take appropriate steps to ensure that the patient thoroughly understands the indications and use of the device. The patient’s physician or pharmacist should review the package insert in detail with the patient or caregiver to ensure that he/she understands the indications and use of EpiPen® or EpiPen Jr®. Actual demonstration of the injection technique by a physician or a pharmacist is recommended.
A training device for patient instruction purposes is also available. Instruct patients and/or caregivers to use and practice with the Trainer to familiarize themselves with the use of EpiPen® in an allergic emergency.
EpiPen® and EpiPen Jr® contain 2 mL of solution but deliver only a single dose in a volume of 0.3 mL, with 1.7 mL remaining in the unit after use.