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Presentation: EpiPen delivers a single dose of 0.3mg of adrenaline BP 1:1000 (0.3ml) in a sterile solution. EpiPen Jr. delivers a single dose of 0.15mg adrenaline BP 1:2000 (0.3ml) in a sterile solution. 1.7ml of adrenaline remains in the auto-injector after activation.
Uses: Adrenaline is considered the first-line drug of choice for allergic emergencies. Adrenaline effectively reverses the symptoms of rhinitis, urticaria, bronchospasm and hypotension. The strong vasoconstrictor action of adrenaline, through its effect on alpha adrenergic receptors, acts quickly to counter vasodilation and increased vascular permeability which can lead to loss of intravascular fluid volume and hypotension during anaphylactic reactions. Adrenaline, through its action on beta receptors on bronchial smooth muscles, causes relaxation which alleviates wheezing and dyspnoea. Adrenaline also alleviates pruritus, urticaria and angioedema and may be effective in relieving gastrointestinal and genitourinary symptoms associated with anaphylaxis.
Indication: EpiPen is intended for immediate self administration in the emergency treatment of allergic anaphylactic reactions. Anaphylaxis may be caused by insect stings or bites, foods, drugs and other allergens as well as idiopathic or exercise-induced anaphylaxis. Reactions may occur within minutes of exposure and consist of flushing, syncope, tachycardia, faint or unobtainable pulse associated with a fall in blood pressure, convulsions, vomiting, diarrhoea and abdominal cramps, involuntary voiding, wheezing, dyspnoea due to laryngeal spasm, pruritus, rashes, urticaria or angioedema.
Dosage and Administration: ADULTS: Self administration of 0.3mg adrenaline (EpiPen ) intramuscularly. CHILDREN: The appropriate dosage may be 0.15mg (EpiPen Jr.) for children 15-30kg body weight and 0.3mg (EpiPen) adrenaline for children >30kg body weight, or at the discretion of the physician. EpiPen should only be injected into the anterolateral aspect of the thigh.
Contra-indications: There are no absolute contra-indications to the use of adrenaline in a life threatening situation.
Warnings: Avoid the risk of inadvertent intravascular injection. DO NOT INJECT INTO THE BUTTOCKS. Accidental injection into the hands or feet may result in loss of blood flow to the affected areas.
Precautions: Patients must be instructed in the proper use of EpiPen . Use with extreme caution in patients with heart disease and those taking digitalis, mercurial diuretic or quinidine. The effects of adrenaline may be potentiated by tricyclic antidepressants and monoamine oxidase inhibitors.
Adverse events: May include palpitations, tachycardia, sweating, nausea and vomiting, respiratory difficultly, pallor, dizziness, nervousness and anxiety.
Legal Category: POM.
Basic NHS Cost: EpiPen and EpiPen Jr. are available as single unit doses at £28.05 each. EpiPen and EpiPen Jr. are also available as twin packs; two single unit doses at £56.10.
Marketing Authorisation Numbers: Epi-Pen Auto Injector 10085/0012. EpiPen Jr. Auto-Injector 10085/0013.
Marketing Authorisation holder: ALK-Abelló A/S, Bøge Alle 6-8, DK-2970, Hørsholm, Denmark. Telephone: (+45) 45 74 74 45.
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