Products
Epinephrine prefilled syringes (autoinjectors) are commercially available in many countries from various suppliers. The EpiPen has been approved since 1997 and Jext since 2010. Such syringes were originally developed for the army for the administration of antidotes to chemical weapons (e.g., ComboPen in many countries).
Structure and properties
Epinephrine (C9H13NO3, Mr = 183.2 g/mol) is present in the drug as a base or in the form of the salt adrenaline tartrate.
Effects
Epinephrine (ATC B02BC09) has sympathomimetic properties. It counteracts all the symptoms of anaphylaxis: it dilates the bronchi, constricts dilated vessels, increases blood pressure, and is effective against digestive symptoms. The effects are based on nonselective binding to α- and β-receptors.
Indications
For emergency self-treatment of anaphylaxis.
Dosage
According to the SmPC. Patients at risk of anaphylaxis should always carry the syringe for emergency use. The usual dose is 1 syringe intramuscularly into the outer thigh If the effect is too weak, a second syringe can be administered again after 5-15 min. Therefore, it is recommended that allergy sufferers carry two auto-injectors. Adrenaline has a short half-life. It should be noted that individual products differ in their application. Therefore, please refer to the package insert and drug label for proper administration. Important Notes:
- The allergy sufferer must know exactly when and how to apply the prefilled syringe.
- The expiration date must be observed, as the syringes have a shelf life of only 18-24 months.
- The auto-injector can be stored at room temperature and should not be stored in the refrigerator. Be careful if the temperature is too high or too low.
- Use autoinjector for one injection only.
- Do not switch between different products (different application).
- Confirmation when traveling: When traveling, patients can be given the following document as confirmation. It must be completed by a healthcare professional.
Contraindications
There are no absolute contraindications for life-threatening anaphylaxis. Full precautions can be found in the drug label.
Interactions
Drug-drug interactions are possible with antiarrhythmics, tricyclic antidepressants, MAO inhibitors, insulins, and beta-blockers.
Adverse effects
Adverse effects occur very rarely. Possible adverse effects include hyperglycemia, central disturbances, loss of appetite, headache, tremor, dizziness, palpitations, cardiac arrhythmias, feeling of coldness in the extremities, increase in blood pressure, difficulty breathing, nausea, vomiting, salivation, sweating, weakness, and injection site reactions.
