EpiPen (epinephrine) is a prescription drug-device combination product that’s used as an emergency treatment for severe allergic reactions, including anaphylaxis. The drug comes inside a prefilled injection pen for injection into the thigh.
In this article, EpiPen and EpiPen Jr will both be referred to simply as “EpiPen” unless differences between the two products need to be highlighted.
To learn more about EpiPen’s uses, see the “What is EpiPen used for?” section below.
EpiPen injection pens contain the active ingredient epinephrine. (An active ingredient is what makes a drug work.) Epinephrine is an adrenergic drug. It comes as a liquid solution inside an injection pen.
EpiPen and EpiPen Jr are brand-name products. A generic epinephrine injection pen is also available.
Whether you have health insurance or not, cost may be a factor when you’re considering EpiPen. What you’ll pay for EpiPen may depend on several things, such as the pharmacy you use.
Here are a few things to consider regarding cost:
- Cost information and savings coupons: You can visit Optum Perks* to get price estimates of what you’d pay for EpiPen and EpiPen Jr when using coupons from the site.
- Generic form: EpiPen is available as a generic epinephrine injection pen. Generics usually cost less than brand-name products. Talk with your doctor if you’d like to know whether generic epinephrine injection pens could be an option for you.
- Savings program: If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You may be eligible for the Viatris Patient Assistance Program. And an EpiPen Savings Card may also be available.
Check out this article to learn more about saving money on prescriptions.
* Optum Perks is a sister site of Healthline. Optum Perks coupons cannot be used with insurance copays or benefits.
Your doctor will recommend the dosage that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.
Form and strengths
EpiPen and EpiPen Jr contain epinephrine as a liquid solution inside single-dose injection pens. You’ll use the pen to inject the drug into your outer thigh. The drug will go under the skin or into the muscle of the thigh.
EpiPen contains 0.3 milligrams (mg) of epinephrine in 0.3 milliliters (mL) of liquid solution.
EpiPen Jr contains 0.15 mg of epinephrine in 0.3 mL of liquid solution.
You’ll use EpiPen or EpiPen Jr as needed for emergency treatment of an allergic reaction. Adults will typically use EpiPen. A child may use EpiPen or EpiPen Jr depending on their weight. Dosage details are shown in the table below. One kilogram (kg) is approximately 2.2 pounds (lb).
|Body weight||Product||Epinephrine dose|
|15–30 kg||EpiPen Jr||0.15 mg|
|30 kg or more||EpiPen||0.3 mg|
If your child weighs less than 15 kg, talk with their doctor to learn about other options.
Up to two doses can be given for a single incident. EpiPen and EpiPen Jr come packaged in sets of two.
How to use
Your doctor will explain how and when you should use EpiPen. An EpiPen Trainer without a needle or medication is included with the prescription for practice.
The drug’s manufacturer also has step-by-step instructions online.
Using the injection pen, you’ll inject the medication into your outer thigh. The injection pen needle can go through clothing if needed. Leave the injection pen in place for 3 seconds. Then remove the injection pen from the thigh and massage the injection site for 10 seconds.
The injection pens come in sets of two. A second injection pen is included in case your symptoms recur or aren’t relieved after the first dose. Do not give yourself more than two doses of epinephrine.
Immediately after using EpiPen, call 911 or go to the nearest emergency department. Medical care is still required, even if you feel better after injecting the drug.
To learn more about EpiPen’s dosage, see this article.
Questions about using EpiPen
Below are some common questions about using EpiPen.
- Should I take EpiPen with food? Food won’t affect how well EpiPen works. You should use EpiPen when needed, regardless of when you last ate.
- Will I need to use EpiPen long term? If your doctor has recommended that you carry EpiPen with you in case of a severe allergic reaction, you’ll likely use it long term. But sometimes, childhood allergies, such as egg allergies, become less severe with time. Talk with your doctor if you have questions about your continued risk of a severe allergic reaction.
Do not take more than two doses of epinephrine for an allergic reaction. It’s important that you seek emergency care after your first dose. If needed, you can take a second dose. But using more than this without medical supervision can lead to harmful effects.
Symptoms of overdose
Symptoms caused by an overdose can include:
- high blood pressure emergency
- fluid in your lungs
- bleeding in your brain
- irregular heartbeat
- extremely cold skin
- kidney failure
What to do in case you take too much epinephrine
You should always seek immediate medical care once you’ve used EpiPen. If you think you’ve taken too many doses of EpiPen or have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.
Like most drugs, EpiPen may cause mild or serious side effects. The lists below describe some of the more common side effects that may be experienced with EpiPen use. These lists don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
Your doctor or pharmacist can tell you more about the potential side effects of using EpiPen. They can also suggest ways to help reduce side effects.
Mild side effects
Here’s a list of some of the mild side effects caused by EpiPen use. To learn about other mild side effects, talk with your doctor or pharmacist, or read EpiPen’s prescribing information.
Mild side effects following EpiPen use that have been reported include:
- feeling anxious
- nausea and vomiting
- pale appearance to your skin or gums
- heart palpitations (racing or pounding heartbeat)
- tremors (shaking in a part of your body)
When you receive follow-up care immediately after using EpiPen, tell the medical team about any side effects you’re having.
Serious side effects
Serious side effects from EpiPen use can occur, but they aren’t common. Some side effects may occur after the immediate emergency has passed, such as a skin infection at the injection site. In this case, you should call your doctor right away to schedule an appointment. But if your symptoms are serious or you’ve just used EpiPen and have any side effects, you should call 911 or your local emergency number.
Serious side effects of EpiPen that have been reported include:
- irregular heart rhythm
- serious infection at the injection site, including gas gangrene and necrotizing fasciitis
- stress-induced cardiomyopathy (short-term weakening of the heart)
If you have any questions or concerns about potential side effects from EpiPen or EpiPen Jr use, talk with your doctor.
Find answers to some commonly asked questions about EpiPen.
How does an EpiPen work?
An EpiPen is a prefilled injection pen containing the drug epinephrine.
- opening up your airways
- causing your heart muscle to pump harder and faster
- narrowing your blood vessels
- directing blood to vital organs such as your heart, lungs, and brain
- stopping certain cells in your body from releasing histamine and other chemicals that cause inflammation (swelling and damage)
Epinephrine is a manufactured version of the same hormone that’s naturally in your body. Another name for epinephrine is adrenaline. In your body, it’s responsible for reactions such as an adrenaline rush and the fight-or-flight response.
Does EpiPen expire?
Yes, both EpiPen and EpiPen Jr expire after some time. Most have a shelf-life of approximately 18 months. After this date, the drug will slowly lose potency (strength) and may not work as well.
When you pick up your prescription, your pharmacist will place a label with the expiration date on the box. When your EpiPen expires, you should ask your doctor for a new prescription.
Once you have a replacement, dispose of your unused EpiPen in a
Can I use EpiPen for an asthma attack?
Yes, in an emergency, you can use EpiPen for an asthma attack.
If you’re experiencing a severe asthma attack that isn’t responding to your rescue inhaler, call 911 or your local emergency number. EpiPen isn’t approved for treating an asthma attack, but it may help to open your airways until you can receive emergency medical care.
If you have asthma, talk with your doctor about an asthma action plan. A personalized plan can tell you which medications to take and when to seek medical attention based on your asthma symptoms.
An allergic reaction occurs when your immune system responds to a substance that isn’t a threat to your body. These substances are called allergens. Examples of allergens include:
Sometimes the allergic reaction is severe and becomes a medical emergency. With a severe allergic reaction, you may experience swelling in your mouth and throat, trouble breathing, a low pulse, and confusion. Without treatment, the reaction can progress to anaphylactic shock.
If you’ve had a severe allergic reaction or anaphylaxis, it can happen again if you encounter the same allergen. At the first sign of allergic symptoms, you’ll inject yourself with EpiPen. Epinephrine treats the symptoms and can stop them from getting worse. Then you’ll seek medical care by calling 911 or going to the nearest emergency department. Using an EpiPen is a supportive treatment. Using EpiPen is not a substitute for immediate medical care.
Other epinephrine-containing injection pens are available to treat severe allergic reactions, including anaphylaxis. If you’d like to explore an alternative to EpiPen, talk with your doctor. They can tell you about other products that might work well for you.
The following epinephrine-containing injection pens are similar to EpiPen:
- generic epinephrine injection
Before using EpiPen, consider the important information below.
Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.
EpiPen can interact with several other medications.
Before you pick up your EpiPen prescription, talk with your doctor and pharmacist. Tell them about all prescription and over-the-counter drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
Below is a list of medications that can interact with epinephrine. This list does not contain all drugs that may interact with epinephrine. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
|Drug group or drug name||Drug examples|
|diuretics (water pills)||• furosemide (Lasix)|
• bumetanide (Bumex)
|antiarrhythmic drugs||• amiodarone (Pacerone)|
• sotalol (Betapace)
|tricyclic antidepressants||• amitriptyline|
• nortriptyline (Pamelor)
|monoamine oxidase inhibitors||• phenelzine (Nardil)|
• imipramine (Tofranil)
|certain antihistamines||• diphenhydramine (Benadryl)|
|beta-blockers||• metoprolol (Lopressor, Toprol XL)|
• carvedilol (Coreg)
|alpha-blockers||• prazosin (Minipress)|
• doxazosin (Cardura)
|migraine drugs called ergot alkaloids||• ergotamine (Ergomar)|
• dihydroergotamine (Trudhesa)
EpiPen and alcohol
Alcohol is not known to interact with EpiPen. It’s likely safe to use EpiPen even if you’ve consumed alcohol.
Pregnancy and breastfeeding
It’s safe to use EpiPen if you’re pregnant or breastfeeding. Be sure to seek immediate medical care after using EpiPen.
EpiPen can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether EpiPen is a good treatment option for you.
Talk with your doctor about your health history when discussing an EpiPen prescription. Be sure to tell them if any of these conditions apply to you:
If you have questions about using EpiPen, talk with your doctor or pharmacist. Questions you may want to ask include:
- If I can’t afford my prescription, what are my options?
- Does my health history increase my risk of side effects if I use EpiPen?
- Can a medication I take interact with EpiPen and cause it not to work?
- How do I give my child an EpiPen injection?
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.