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A.They both contain adrenaline, but in different amounts. EpiPen^® contains 300mcg, and EpiPen^® Junior contains 150mcg. Selection of the appropriate dosage strength for the patient is determined by the prescribing physician according to patient body weight.

EpiPen^® auto injector 300mcg is recommended for adults and children weighing >30kg .

EpiPen^® Junior auto injector 150mcg is recommended for children weighing between 7.5^*– 30kg .

^*Children below 15 kg in weight: the suitability of EpiPen Junior has to be judged individually. The use in children weighing less than 7.5 kg is not recommended unless in a life-threatening situation and under medical advice.

A.Each EpiPen^® contains 2 ml adrenaline solution, but the volume administered is 0.3 ml as approximately 1.7 ml remains in the auto-injector after activation. The remaining volume cannot be used.

EpiPen^® delivers 300mcg adrenaline and EpiPen^® Junior delivers 150mcg adrenaline.

A.During anaphylaxis, airways constrict and blood vessels dilate and become more permeable, which can lead to loss of fluid volume from within the vessels and low blood pressure (hypotension). Adrenaline acts on different parts of the body to constrict blood vessels and relax bronchial muscle, helping to reduce bronchospasm, wheezing and dyspnoea. Adrenaline also alleviates pruritus (itching), urticaria (rash), and angioedema (swelling) and may be effective in relieving gastrointestinal and genitourinary symptoms associated with anaphylaxis because of its relaxant effects on the smooth muscle of the stomach, intestine, uterus, and urinary bladder.

A.During an anaphylactic reaction, EpiPen^® should be given immediately and an ambulance called. An initial dose should be administered as soon as symptoms of anaphylaxis are recognised. In the absence of clinical improvement or if deterioration occurs, 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^® pens which they should carry at all times. Any more than 2 doses of adrenaline should only be administered under direct medical supervision. The physician prescribing an EpiPen Auto-Injector must ensure that the patient understands the indications for use and the correct method of application.

A.EpiPen^® is not intended as a substitute for immediate medical care. In conjunction with the administration of adrenaline, the patient (or someone with the patient) should call 112 immediately. The patient should stay lying down or seated and have someone stay with them until they have been assessed by a paramedic. Unconscious patients should be placed in the recovery position.

A.With severe persistent anaphylaxis, repeat injections with an additional EpiPen^® may be necessary, 5 to 15 minutes after the first. More than two sequential doses of adrenaline should only be administered under direct medical supervision.

A.Adrenaline is ordinarily administered with extreme caution to patients who have a heart disease. Adrenaline should only be prescribed to those patients, but also those suffering from diabetes, hyperthyroidism, hypertension and elderly individuals if the potential benefit justifies the potential risk. There is a risk of adverse reactions following epinephrine administration in patients with high intraocular pressure, severe renal impairment, prostatic adenoma leading to residual urine, hypercalcaemia and hypokalaemia. In patients with Parkinson's disease, epinephrine may be associated with a transient worsening of Parkinson symptoms such as rigidity and tremor.

A.Check the solution periodically through the viewing window of the unit to make sure the solution is clear and colourless. Discard and replace the Auto-Injector if the solution is discoloured or contains a precipitate.

A.Both EpiPen^® and EpiPen^® Junior should be injected intramuscularly into the outside of the thigh, through clothing if necessary. The extended needle length after activation is 15 mm as per SmPC for the EpiPen^® and 13 mm for the EpiPen^® Junior.

A.Adrenaline is sensitive to light. Keep the auto-injector in the outer carton. Do not store above 25°C. Do not refrigerate or freeze.

A.EpiPen^® does not contain any of these substances.

A.Each 0.3 mL of EpiPen^® contains 0.5 mg sodium metabisulfite.

A.EpiPen^® contains sodium metabisulfite, a sulfite that may in other products cause allergic-type reactions, including anaphylactic symptoms or life-threatening or less severe asthmatic episodes in certain susceptible persons.

In a patient with documented sulfite sensitivity, the alternatives to using adrenaline in a life-threatening situation may not be satisfactory. Therefore, the presence of a sulfite in this product should not deter administration of the drug for treatment of serious allergic or other emergency situations when sulfite-free alternatives are not available.

A.Yes. Although EpiPen^® contains sodium metabisulphite, a patient with a 'sulfa allergy' is allergic to medications that contain a sulphonamide group(s) within their chemical structure. The allergy is specific to the sulphonamide group and does not predispose a patient to allergy with any other compounds containing sulphates, sulfite or sulphates.

A.Since adrenaline is a strong vasoconstrictor, accidental injection into the hands or feet may result in loss of blood flow to the affected area and so should be avoided. If accidental injection does occur in these areas, the patient should go immediately to the nearest urgent care facility.

A.Document the dosage of EpiPen^® given and dispose of in a sharps container.

A.EpiPen^® is a Pregnancy Category C drug. Adrenaline should be used during pregnancy only if the potential benefit justifies the potential risk to the foetus.

A.The blue cap serves as a safety pin, which prevents the internal spring from activating, causing the ampoule to be penetrated and the needle to protrude. The blue pin should only be removed immediately prior to use. Providing the EpiPen^® has not been activated, the blue cap can be re-inserted. It is important to note that recapping is not recommended.

A.Guidelines recommend that 2 adrenaline auto-injectors are prescribed, which patients should carry at all times.¹

A.Acute anaphylaxis for self-administration should be treated by intramuscular injection^1,2

• -For adult and child body weight 30kg and above – 300mcg.^1,2
• -For child body weight 7.5 kg- 30kg – 150mcg.^1,2

A.EpiPen^® has a shelf life of 24 months¹ and EpiPen^® Junior, 19 months.¹