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Ubayd Ali

Authored by

Ubayd Ali

Superintendent Pharmacist

Registration Number: 2219322

NHS Pharmacist and founding member of HEBA, with years of experience in healthcare across innovative organisations.
Sufyan Tahir

Reviewed by

Sufyan Tahir

Clinical Governance Lead

Registration Number: 2221275

Review Date 1 August 2025
Next Review 1 August 2027
Published on 7 January 2023
Last Update 1 August 2025

Overview

What is an EpiPen Auto-injector? 

An EpiPen is a pre-filled automatic injection device that delivers a dose of adrenaline (epinephrine). It is used as an emergency treatment for severe allergic reactions, known as Anaphylaxis.

What it does

When someone has a severe allergic reaction, the body can rapidly develop symptoms such as swelling of the throat, breathing difficulty, or a dangerous drop in blood pressure.

Adrenaline from an EpiPen works quickly to:

  • Relax airway muscles so breathing becomes easier
  • Reduce swelling in the throat and face
  • Increase blood pressure to prevent collapse
  • Slow down the allergic reaction

When an EpiPen is used

It should be used immediately if someone develops signs of severe allergy after exposure to triggers such as:

  • Foods (e.g. peanuts, tree nuts, shellfish)
  • Insect stings (bees or wasps)
  • Medications
  • Latex

Directions

Prepare the EpiPen

  • Remove the EpiPen from the carrier tube.
  • Hold the EpiPen in your dominant hand, forming a fist around it.
  • Make sure fingers do not cover either end of the device.
  • Pull off the blue safety release cap.

Inject the dose

  • Push the device firmly into the thigh until it clicks
  • The injection can be given through clothing if necessary.
  • Place the orange tip against the outer thigh at a right angle (90°).

Hold in place

  • Keep the EpiPen pressed firmly against the thigh for 3 seconds to deliver the dose.

Remove and massage

  • Remove the pen from the thigh.
  • The orange needle cover will automatically extend to cover the needle.
  • Massage the injection area for about 10 seconds.

Seek emergency help

  • Call 999 immediately and state that anaphylaxis is suspected.
  • The person should lie down with their legs raised, unless breathing is difficult.

Side effects

Because an EpiPen contains adrenaline, some temporary side effects can occur after the injection. These effects are usually short-lived and happen because adrenaline stimulates the heart and nervous system.

Common side effects

  • Fast or irregular heartbeat
  • Palpitations (feeling your heart pounding)
  • Sweating
  • Nausea or vomiting
  • Breathing difficulties
  • Pale skin
  • Dizziness
  • Weakness
  • Headache
  • Restlessness, anxiety or nervousness
  • Tremor (shaking)

Injection site effects

  • Pain or swelling at the injection site
  • Bruising
  • Numbness or tingling

Important safety note

Even if side effects occur, adrenaline should still be used in cases of suspected anaphylaxis, as the benefits of treatment outweigh the risks in a life-threatening allergic reaction.

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