When you are first prescribed EpiPen, you must make sure that you understand the reason it has been prescribed for you. You should be confident that you know exactly how and when to use it.

Always use EpiPen exactly as your healthcare professional has told you. If you are at all unsure about how to use it, ask to have the instructions repeated by your doctor, nurse, or pharmacist. It is recommended that your family members, carers, or teachers are also instructed in the correct use of EpiPen.

If you have been stung by an insect, try to remove the stinger with your fingernails – do not squeeze, pinch, or push it deeper into the skin. If possible, put an ice pack on the area of the sting. For allergic reactions caused by foods make sure you remove any remaining food from the mouth immediately.

As the EpiPen is designed as emergency treatment only, you should always seek medical help immediately after using it by dialling 999, ask for an ambulance and state ‘anaphylaxis’ even if symptoms appear to be improving. You will need to go to hospital for observation and further treatment as required.

While waiting for the ambulance you should lie down with your feet raised unless this makes you breathless in which case you should sit up. Ask someone to stay with you until the ambulance arrives in case you feel unwell again. Unconscious patients should be placed on their side in the recovery position. Make sure that you inform the healthcare professional that you have received an intramuscular injection of Adrenaline or show them the container and/or leaflet.

Dosage

The usual adult dose for allergic emergencies is 0.3mg Adrenaline for injection into the outer thigh muscle (intramuscular use).

Each EpiPen Auto-Injector delivers one single dose of 0.3ml liquid which is equal to 0.3mg (300 micrograms) Adrenaline. After use, a volume of 1.7ml will remain in the Auto-Injector but this cannot be reused.

If you notice the signs of an acute allergic reaction, use EpiPen immediately, through your clothing if necessary.

Sometimes a single dose of Adrenaline may not be sufficient to completely reverse the effects of a serious allergic reaction. For this reason, your doctor is likely to prescribe more than one EpiPen for you.

If your symptoms have not improved or have deteriorated within 5-15 minutes after the first injection, either you or the person with you should give a second injection. For this reason, you should carry more than one EpiPen with you at all times.

EpiPen is intended to be used by people with a body weight above 25 kg (3 stone 13 lbs). For persons weighing less than this, EpiPen Jr. may be more appropriate for use.

In case of overdose or accidental injection of Adrenaline, you should always seek immediate medical help. Your blood pressure may rise sharply, and it will need to be monitored.

Method of administration

EpiPen is designed to be used easily by people without medical training. The device should simply be jabbed firmly against the outer portion of the thigh from a distance of approximately 10 cm (4 inches). There is no need for precise placement in the outer portion of the thigh. EpiPen should only be injected into the outer thigh.

When you jab the EpiPen firmly into your thigh, a spring activated plunger will be released, which pushes the hidden needle into the thigh muscle and administers a dose of Adrenaline. If you are wearing clothes, EpiPen can be injected through the clothing.

Before you ever need to use the EpiPen, fully familiarise yourself with it and when and how it should be used.

• Never put your thumb, fingers or hand over the orange tip
• Do not remove the blue safety cap until ready to use

Follow these directions only when ready to use.

Hold the EpiPen by the middle, never by the ends. For proper administration, look at the diagrams in the Patient Information leaflet (PIL) and follow these steps:

How to use EpiPen

• Grasp the EpiPen in your dominant hand and pull off the blue safety release cap at the end with your other hand
• Hold the pen firmly at a distance of approximately 10 cm (4 inches) away from the outer thigh. The orange tip should point towards the outer thigh
• Jab the EpiPen firmly into the outer thigh at a right angle (listen for a click). The Adrenaline will be released automatically into your thigh muscle
• Hold the EpiPen firmly against the thigh for three seconds. The injection is now complete, and the window is obscured
• As soon as you release pressure, a protective cover will extend over the needle tip
• Massage the area for 10 seconds
• Dial 999, ask for an ambulance and state anaphylaxis

Even though most of the liquid (about 90 %) remains in the EpiPen after use, it cannot be reused. However, you have received the correct dose of the medication if the orange needle tip is extended and the window is obscured.