Twinject Update
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Medicine for the Outdoors
Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Twinject Update


The Twinject auto-injector is designed to deliver two doses of aqueous epinephrine, USP 1:1000, and comes available for injections of 0.15 mg (each dose) or 0.30 mg (each dose). The product has been redesigned to make it easier for use. The first dose is a true autoinjection, in that the user removes the green caps at either end of the device, holds the red rounded tip against the middle of the outer thigh, then presses the pen-shaped device firmly ("hard") against the skin, which fires the auto-injector to thrust a needle through the skin. By the count of 10 (slowly), the drug is administered. If a second dose is needed (for instance, if a person is suffering a severe allergic reaction and symptoms are not improving or are worsening after 10-15 minutes), the rounded red cap is unscrewed from the device, which exposes a needle attached to a small syringe, the combination of which sits inside the barrel of the device. The needle-syringe combination is easily removed from the barrel, a small yellow collar then removed from the plunger on the syringe, and then the needle-syringe can be used to inject the second dose of epinephrine into the patient by inserting the needle and pushing the plunger all the way down.

Verus Pharmaceuticals, Inc. of San Diego, CA distributes the Twinject autoinjector, as well as an instructional DVD in both English and Spanish that also includes information on understanding and treating anaphylaxis (severe allergic reaction). A carrying case for the enhanced Twinject is available (pictured below).


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Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.

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