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Brand Names: Adrenalin, EpiPen 2-Pak, EpiPen Auto-Injector, EpiPen JR 2-Pak, EpiPen JR Auto-Injector, Twinject Auto-Injector, Twinject Auto-Injector Two Pack

Generic Name: epinephrine injection (Pronunciation: EP i NEF rin)

• What is epinephrine injection (Epipen)?
• What are the possible side effects of epinephrine ?
• What is the most important information I should know about epinephrine injection?
• What should I discuss with my healthcare provider before using epinephrine injection?
• How should I use epinephrine injection?
• What happens if I miss a dose?
• What happens if I overdose?
• What should I avoid while using epinephrine ?
• What other drugs will affect epinephrine?
• Where can I get more information?

What is epinephrine injection (Epipen)?

Epinephrine is a chemical that narrows blood vessels and opens airways in the lungs. These effects can reverse severe low blood pressure, wheezing, severe skin itching, hives, and other symptoms of an allergic reaction.

Epinephrine injection is used to treat severe allergic reactions (anaphylaxis) to insect stings or bites, foods, drugs, and other allergens. Epinephrine is also used to treat exercise-induced anaphylaxis.

Epinephrine auto-injectors such as EpiPen and EpiPen Jr. may be kept on hand for self-injection by a person with a history of an severe allergic reaction.

Epinephrine injection may also be used for other purposes not listed in this medication guide.

What are the possible side effects of epinephrine ?

Before using epinephrine a second time, tell your doctor if your first injection caused a serious side effect such as increased breathing difficulty, or dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Less serious side effects may include:

• fast, pounding, or uneven heatbeats;
• sweating;
• nausea and vomiting;
• pale skin;
• dizziness;
• weakness or tremors;
• headache; or
• feeling nervous or anxious.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about epinephrine injection?

Before using this medication, tell your doctor if you have heart disease or high blood pressure, a heart rhythm disorder, coronary artery disease, Parkinson's disease, diabetes, or a thyroid disorder.

Before using epinephrine, tell your doctor about all other medications you use, especially digoxin (digitalis, Lanoxin), heart or blood pressure medicine, heart rhythm medication, an antidepressant, a diuretic (water pill), thyroid medication, migraine headache medicine, cold or sleep medicine that contains an antihistamine, or an MAO inhibitor such as Marplan, Nardil, Azilect, Eldepryl, Emsam, or Parnate.

Do not inject epinephrine into a vein or into the muscles of your buttocks, or it may not work as well. Inject it only into the fleshy outer portion of the thigh.

Accidentally injecting epinephrine into your hands or feet may result in a loss of blood flow to those areas, and resulting numbness. If this occurs, seek emergency medical attention.

Seek emergency medical attention even after you use epinephrine to treat a severe allergic reaction. The effects of epinephrine injection may wear off after 10 or 20 minutes. You will need to receive further treatment and observation.

Before using epinephrine a second time, tell your doctor if your first injection caused a serious side effect such as increased breathing difficulty, or dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Store the auto-injector device in the original tube it came in. Keep this tube at room temperature away from direct sunlight, heat, and moisture. Do not refrigerate this medication, or store it in a car.