Epinephrine comes in the form of easy-to-use auto-injectors or a syringe. It is only available through a prescription from your doctor.

If you or your child have severe food allergies, you need to have epinephrine quickly and easily available at all times. For children, this might mean having extra epinephrine devices. For example, your child may need to keep epinephrine at school, as well as at after-school care. You may also want additional epinephrine devices that remain at home or travel with you when you go out. For adults, two devices might be enough.

Epinephrine Devices Available With a Prescription in the United States

Epinephrine is the first-line treatment for anaphylaxis. Several epinephrine auto-injectors and a pre-filled syringe are now available in the United States. There are also generic versions. Each contains the drug epinephrine. But, each device has its own unique set of instructions for use. Understanding the differences is important so that you get the device you want and you know how to properly use it.

The chart below summarizes the key facts about each of the available epinephrine devices. More details are available at the manufacturers’ websites. These websites also have videos that show you how to use them.

Pharmacists must follow state and federal regulations when filling your prescription for epinephrine. You should keep this in mind when filling your prescription.

There are many states in which the pharmacist can substitute a generic form of the prescription. This must be on the prescription in writing. The pharmacist must also get a verbal approval from the doctor. If you or your doctor prefer to receive a specific brand name, your doctor must write the brand name and “DAW” (dispense as written) or “do not substitute” on the prescription. This notation prohibits the pharmacist from dispensing a generic form of the prescription. Before you leave the pharmacy, make sure the pharmacy fills your prescription exactly as you and your child’s doctor expects.

Remember to speak to your child’s doctor about which epinephrine product is best for your child. Each device works differently. Make sure that you have been trained to use the device that you leave the pharmacy with. Also, review the training video for that device.

Other Epinephrine Options

There are other options that do not auto-inject the epinephrine. Glass vials of epinephrine with needles/syringes may be in emergency kits as seen on airplanes. There is also a pre-filled syringe device that you can use to inject epinephrine. This device works differently than the auto-injectors. Be sure to have your doctor, nurse, or pharmacist demonstrate how to use your device.

What If You Can’t Afford Your Epinephrine Auto-Injectors?

Unfortunately, some people cannot afford to buy this potentially life-saving medicine. If this is the case for you, there are options to help. On our blog, we offer up-to-date details about:

• Savings programs
• Pharmacy differences
• Insurance preferences
• Other sources of assistance

Read our blog post: What to Do If You Can’t Afford Epinephrine

Stocking Epinephrine in Schools and Public Places

Around 45% of severe allergic reactions severe allergic reactions in schools begin in the classroom. Since these people (children, staff, and visitors) have not been previously diagnosed with allergies, they may not have their own epinephrine auto-injectors on hand. Most states have passed legislation to allow schools to stock undesignated epinephrine as a part of their emergency medical kits. This allows specified staff to treat someone suffering anaphylaxis, even for their very first allergic reaction. Many states are looking beyond the classroom to other areas where food allergy triggers could be present. In any public space where food is present – such as sports and recreation venues, summer camps, amusement parks, movie theaters – there is a risk for an allergic person to come in contact with their allergen. To find out the status of epinephrine laws in your state, visit aafa.org/epinephrine.

Related Epinephrine Resources

• Researchers Review Effects of Heat, Cold, on Epinephrine
  Researchers looked at what is known about the effects of extreme temperatures on epinephrine.
• Guidelines for the Diagnosis and Management of Food Allergy in the United States (Leave KFA website)
  The NIH guidelines provide steps for parents and medical providers on how to manage and treat food allergies and severe allergic reactions.
• Severe Allergy / Anaphylaxis Emergency Action Plan Samples
• Epinephrine Resource School Nurse Program (Leave KFA website)
  The National Association of School Nurses offers a “Get Trained” program to teach school staff how to respond to allergic emergencies and will answer questions and provide support. Find the ERSN in your state if your school needs assistance in epinephrine or food allergy training for staff.
• What Is Anaphylaxis? Take Steps to Prevent Allergic Reactions
  Learn how to recognize symptoms and treat anaphylaxis.