Adrenaline Auto-injectors

Due to longer expiry dates, longer needles and a clinically suitable dose, the APC suggests that Emerade 500mcg/dose is used as the first line choice for anaphylaxis.

There are several brands of adrenaline auto-injector available to the Hospital Trust and primary care organisations. These include the following:

Epipen:

150mcg dose   £26.45             Exp. 18 months           15mm needle
300mcg dose   £26.45             Exp. 18 months           15mm needle

Emerade:

150mcg dose   £26.94             Exp. 30 months           16mm needle
300mcg dose   £26.94             Exp. 30 months           25mm needle
500mcg dose   £28.74             Exp. 30 months           25mm needle

Jext:

150mcg dose   £23.99             Exp. 18 months           15mm needle
300mcg dose   £23.00             Exp. 18 months           15mm needle

Adrenaline auto-injectors are used for emergency treatment of allergic reactions (anaphylaxis). The reactions can be due to many factors, but most commonly insect stings, food allergies and allergies to chemical substances (including medicines). The BNF states that ‘First-line treatment of anaphylaxis includes securing the airway, restoration of blood pressure (laying the patient flat and raising the legs, or in the recovery position if unconscious or nauseated and at risk of vomiting) and administration of adrenaline (epinephrine) injection. Adrenaline is given intramuscularly in a dose of 500 micrograms (0.5 mL adrenaline injection 1 in 1000); a dose of 300 micrograms (0.3 mL adrenaline injection 1 in 1000) may be appropriate for immediate self-administration.’ A summary poster from the Resuscitation Council (UK) can be found here:

https://www.resus.org.uk/EasySiteWeb/GatewayLink.aspx?alId=792

With regard to practical usage and needle length, information from the European Medicines Agency can be found here:

http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/referrals/Adrenaline_auto_injectors/human_referral_000367.jsp