information for parents and carers

Adrenaline auto-injector for anaphylaxis

This leaflet is about the use of adrenaline auto-injector
(Emerade, EpiPen or Jext) for anaphylaxis.

This leaflet is for parents and carers about how to use this •• The following symptoms may indicate a severe reaction:
medicine in children. Our information sometimes differs from difficulty swallowing, speaking or breathing, swelling of
that provided by the manufacturers, because their information the throat and mouth, a skin rash anywhere on the body,
is usually aimed at adults. Please read this leaflet carefully. or generalised flushing of the skin, abdominal cramps,
Keep it somewhere safe so that you can read it again. feeling sick (nausea), being sick (vomiting), sudden
feeling of weakness, racing heart, panic and anxiety.
Anaphylaxis is a severe and life-threatening allergic
reaction – it can be fatal if treatment is not given The person may collapse or become unconscious.
quickly. The adrenaline auto-injectors should be used If symptoms have not improved 5 minutes after using the
in an emergency while waiting for medical help. Make auto-injector, another dose with a new auto-injector can be
sure that your child always has their auto-injector with given.
them, that it is not past its use by or expiry date, and
Telephone for an ambulance and say that your child is
that anyone who looks after them knows how to use it 999 having an anaphylactic reaction.
as well, particularly their school or nursery.
You must take your child to hospital after using the auto-
injector, even if they seem well. Take the auto-injector
Name of drug with you. Tell the doctor which auto-injector you used,
Adrenaline (also known as epinephrine) and how many.
Brand names: Emerade ,EpiPen, Jext
(intramuscular injection for self-administration) How much should I give?
Your doctor will work out which size of auto-injector is right
Why is it important to use the adrenaline? for your child. Each auto-injector delivers a fixed amount of
Anaphylaxis is a severe allergic reaction, which may be adrenaline. Each auto-injector can be used only once.
life-threatening. It usually occurs straight after coming into
contact with the trigger (also called the allergen); however, it How should I give it?
can occur a few hours later. Different people have different There are three different types of adrenaline auto-
triggers, such as foods (e.g. peanuts, eggs or seafood), injector – Emerade, EpiPen and Jext. These are used
medicines (e.g. penicillin) or animals (e.g. bee or wasp in different ways. You MUST follow the instructions
stings). provided with your auto-injector. If you follow the wrong
By using the adrenaline auto-injector as soon as your child instructions, you risk injecting the adrenaline into your
has signs of an anaphylactic reaction, you may be able to own thumb. If you are not sure which auto-injector
prevent a full-blown reaction, while you wait for an ambulance. you have, or how to use it, ask your doctor, nurse or
What is adrenaline available as? pharmacist to show you. For more information, see the
resources listed at the bottom of this leaflet.
•• Emerade 150 micrograms: delivers 150 micrograms of
The auto-injector must only be used in the thigh. Never
adrenaline
inject it anywhere else on the body, as this could do
•• Emerade 300 micograms: delivers 300 micrograms of
harm.
adrenaline
•• Emerade 500 micrograms: delivers 350 micrograms of
adrenaline
•• EpiPen Auto-injector 0.3 mg (yellow label): delivers
300 micrograms of adrenaline
•• EpiPen Jr Auto-injector 0.15 mg (white label with
yellow stripe): delivers 150 micrograms of adrenaline
•• Jext 300 micrograms: delivers 300 micrograms of Detailed information on how to use adrenaline
adrenaline auto-injectors can be found on the manufacturers’
•• Jext 150 micrograms: delivers 150 micrograms of websites:
adrenaline Emerade - www.emerade-bausch.co.uk
EpiPen - www.epipen.co.uk
When should I give adrenaline?
You should use the adrenaline auto-injector if your child has Jext (Lifeline) - www.jext.co.uk
symptoms of an anaphylactic reaction. If your child also has Keep your auto-injectors in date, but remember that even an
an asthma inhaler, they should use this too. out of date pen is better than nothing.
•• The early signs of an anaphylactic reaction are After giving adrenaline
tightening of the throat, difficulty breathing, swelling
You must take your child to hospital after using the auto-
or tingling of the mouth or tongue, developing a skin injector, even if they seem well. Take the auto-injector with
rash or itching. In many cases the reaction will follow you, where it can be safely disposed of.
exposure to a known trigger.
When should the medicine start working? If someone accidentally injects the adrenaline into
The medicine should start working almost immediately. If your their hands or fingers, the blood flow to this area may
child’s symptoms have not improved 5 minutes after using stop (the skin will go pale). Take the person to hospital
the auto-injector, give another dose of adrenaline using a straight away.
new pen. Keep the child in the recovery position or lying •• Make sure that you always have at least two auto-
down till help arrives. injectors. Order a new prescription as soon as you have
Even if you are not sure the first injection worked used one.
properly, you must wait 5 minutes before giving another •• Make sure that the auto-injector you carry with you
injection. Otherwise you risk giving too much is still within its ‘use by’ date. Give old pens to your
pharmacist to dispose of.
What if my child is sick (vomits)?
You do not need to give another dose of adrenaline, as it will Where should I keep this medicine?
still work.
•• There are differences between each brand – check the
What if I give too much? manufacturers’ websites for detailed information.on how
You are unlikely to do harm if you give an extra dose of to store your child’s auto-injectors.
adrenaline by mistake. If you are concerned, discuss this with •• Keep the auto-injectors out of the reach and sight of
your doctor when you get to the hospital. other children.

Are there any possible side-effects?

•• Keep the auto-injectors in the box they came in, to
protect the contents from light.
We use medicines to make our children better, but sometimes
If you have EpiPen or Jext auto-injectors, check, from
they have other effects that we don’t want (side-effects).
time to time, that the liquid in the glass container is clear
Your child may get any (or none) of the following side-effects
and colourless. If it is pink or brown, or has bits in it,
after using the adrenaline auto-injector, but they usually do
not last for long: order a new prescription and give the old auto-injector to
your pharmacist to dispose of.
•• feeling sick or being sick (vomit)
•• fast or irregular heart rate (feeling that the heart is Who to contact for more information
racing or fluttery) Your child’s doctor, pharmacist or nurse will be able to give
•• cold hands and feet you more information about adrenaline auto-injectors and
•• difficulty breathing about other medicines used to treat allergies and anaphylaxis.
•• feeling anxious, shaky, restless, weak or dizzy You can also get useful information from:
•• headache England: NHS 111
•• sweating Tel 111 - www.nhs.uk
•• difficulty passing urine (doing a wee) Scotland: NHS 24
•• the skin where the adrenaline was injected may go pale Tel 111 - www.nhs24.com
or feel sore. Wales: NHS 111 Wales
Tel 111
Is there anything else I need to know about www.111.wales.nhs.uk
adrenaline? Northern Ireland: NI Direct
The auto-injector must only be used in the thigh. Never www.nidirect.gov.uk
inject it anywhere else on the body, as this could do
The Anaphylaxis Campaign
harm.
www.anaphylaxis.org.uk - 01252 542029
•• Make sure you know how to use the auto-injector
Allergy UK
correctly, otherwise it may not work. Remember that
www.allergyuk.org - 01322 619898
Emerade, EpiPen, and Jext are used in different ways,
so ensure you know how to use the one your child has. Detailed information on how to use adrenaline auto-injectors
Make sure that your child has their auto-injector with can be found on the manufacturers’ websites:
them at all times. Emerade - www.emerade-bausch.co.uk
Make sure that anyone who looks after your child knows EpiPen - www.epipen.co.uk
what to do and how to use the auto-injector if your child
Jext (Lifeline) - www.jext.co.uk
has an anaphylactic reaction. You need to make special
arrangements with your child’s school or nursery.

www.medicinesforchildren.org.uk

Version 2.3, August 2013 (September 2014). © NPPG, RCPCH and WellChild 2011, all rights reserved. Reviewed by: August 2016.
The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through
our website, www.medicinesforchildren.org.uk
We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is
important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply
to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and
editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.