Your Guide to EpiPen: Usage, Side Effects, and More

Medically Reviewed By Debra Sullivan, Ph.D., MSN, R.N., CNE, COI
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An EpiPen auto-injector contains epinephrine, or adrenaline, for the immediate treatment of anaphylaxis. It provides essential first-line treatment if you have a life threatening allergic reaction. Around 1.6% to 5.1% of people in the United States have experienced anaphylaxis. It occurs when you have a sudden and severe allergic reaction.

If you have an allergic reaction, carrying an EpiPen with you at all times allows you or somebody else to administer potentially life saving epinephrine at the first sign of anaphylaxis.

Read on to learn more about how the EpiPen works and when to use it. This guide also discusses who should use an EpiPen, related costs, and possible side effects.

What does the EpiPen auto-injector do?

This is a close up of a person using an EpiPen.
Jessica Klaus/Stocksy United

EpiPen auto-injectors contain epinephrine. When you have an allergic reaction, injecting yourself with epinephrine helps:

  • constrict blood vessels to increase blood pressure
  • relax smooth lung muscles to improve breathing and reduce wheezing
  • increase heart rate
  • reduce hives and swelling around the lips and face

If you are at risk of anaphylaxis, you should have access to two EpiPens at all times. If you require more than two injections of epinephrine for first-line treatment of anaphylaxis, only a healthcare professional should administer additional doses.

EpiPen safety information

  • Carry your EpiPen with you at all times.
  • Use your EpiPen at the first sign of an allergic reaction.
  • Do not administer more than two doses consecutively.
  • Only inject the EpiPen into your upper thigh.
  • Never inject it into your veins, buttocks, fingers, toes, hands, or feet.
  • Use each EpiPen one time only. Do not try to use it again if the needle is visible.
  • Make sure that your EpiPen is always in date.
  • Remember: The blue tip should point to the sky, and the orange tip to the thigh.

How do I use an EpiPen?

It is important to know how to use your EpiPen before there is an emergency. If you have a friend, relative, or colleague with a known allergy, learning how to use an EpiPen may help you provide potentially life saving first-line treatment.

To use an EpiPen, follow the instructions below:

  1. Remove the auto-injector from the clear carrier tube.
  2. Hold the auto-injector in your fist, with the blue tip pointing to the sky and the orange tip pointing down to your thigh.
  3. Remove the blue safety cap with your other hand by pulling it straight up.
  4. Position the orange tip against the middle of the outer thigh at a right angle.
  5. Swing the auto-injector and push it firmly into the thigh, making sure that it clicks.
  6. Hold it in place for 3 seconds, counting slowly.
  7. Remove the auto-injector and massage the area for 10 seconds.

Make sure that you also seek immediate medical care when you experience anaphylaxis. If symptoms persist, you may require a second shot of epinephrine. It is important to note that only healthcare professionals should administer any additional doses after the second EpiPen injection.

If your doctor has prescribed an EpiPen for allergies, make sure to ask about the EpiPen Trainer. This allows you to practice using the EpiPen without the needle or any medication.

How to use an EpiPen

When using your EpiPen, remember the following:

  • Blue tip to the sky, orange tip to the thigh.
  • Push firmly so that you hear a “click.”
  • Hold it in place against your thigh, counting slowly for 3 seconds.

When should I use an EpiPen?

Use an EpiPen if you or somebody else experiences anaphylaxis. It is important to act fast as soon as symptoms appear.

Symptoms can appear in a matter of minutes once you have exposure to the allergen. If you have an allergy, make sure that those around you are aware of it and where you store your EpiPen in case they need to administer the EpiPen for you.

Once you notice symptoms of an allergic reaction or anaphylaxis, use the EpiPen immediately.

What does anaphylaxis look like?

Anaphylaxis is a severe allergic reaction to a particular allergen, such as a certain type of food, a medication, or an insect sting. Anaphylaxis is a potentially life threatening reaction that requires immediate medical attention.

The symptoms of anaphylaxis may differ for each individual, but they will typically include:

Anaphylaxis can be unpredictable, and not all symptoms may be present.

Use an EpiPen to administer first-line treatment for anaphylaxis, then seek immediate medical care. In some cases, more than one EpiPen may be necessary to reduce or stop the symptoms of a severe allergic reaction.

Learn more about anaphylaxis here.

How many times should I use my EpiPen?

You should use each EpiPen only once. If the needle is still visible once you pull the EpiPen away from your thigh, do not attempt to use it again.

You can use a second EpiPen around 5–15 minutes after the first injection if your symptoms do not improve.

It is important that you do not use more than two EpiPens consecutively, as this can lead to an overdose of epinephrine. An epinephrine overdose can result in:

Seek immediate medical care when you experience anaphylaxis. If you require more than two doses of epinephrine, a healthcare professional can assist with this.

Remember to request additional EpiPen auto-injectors before you leave the hospital or clinic. It is important to make sure that you carry EpiPens with you at all times if you have a known allergy.

Who should use an EpiPen?

Your doctor may prescribe an EpiPen if you experience an allergic reaction. Contact your doctor if you have experienced an allergic reaction or have a known allergy.

Common allergies that can cause anaphylaxis include, but are not limited to, the following:

  • certain foods, such as:
    • peanuts
    • tree nuts
    • walnuts
    • cashews
    • Brazil nuts
    • shellfish
    • milk
    • fish
    • eggs
    • preservatives
  • some medications, including:
  • insect stings, such as from:
    • yellow jackets
    • honey bees
    • paper wasps
    • hornets
    • fire ants
  • latex

In rare cases, exercise-induced anaphylaxis may occur. This typically happens if you consume a certain food a few hours before exercising.

Around 32 million people in the U.S. have a food allergy, including 5.6 million people under the age of 18 years. This equates to around two children in every classroom. The EpiPen4Schools program is designed to provide schools with the necessary training and equipment to efficiently respond to allergic reactions.

Find out more about allergic reactions and anaphylaxis here.

Is there an EpiPen for children?

There is an EpiPen for children. The EpiPen Jr contains 0.15 milligrams (mg) of epinephrine and has a green label.

Children weighing 33–66 pounds (lb) can use the EpiPen Jr.

The EpiPen Jr is half the strength of the regular EpiPen, which contains 0.3 mg

of epinephrine and has a yellow label. The regular EpiPen is suitable for people weighing over 66 lb.

Are there any side effects of an EpiPen?

You may experience side effects after you administer your EpiPen.

Common side effects of an EpiPen include:

These side effects will usually go away once you lie down and rest. Seek immediate medical care if you have any persistent or severe side effects.

Do I need a prescription for an EpiPen?

You will need a prescription for an EpiPen. Your doctor will prescribe an EpiPen if you have a known allergy.

Contact your doctor if you have an allergy and do not have a prescription for an EpiPen.

If you have an EpiPen prescription, it is important to make sure that you request a new EpiPen as soon as you use one.

Make sure that your EpiPen is always in date. If your EpiPen is due to expire, make sure that you request a new prescription.

How much does an EpiPen cost?

The cost of an EpiPen will vary depending on what type of medical insurance you have and where you buy the EpiPen. It can cost as much as $500 for two EpiPens, and this price can vary.

If you have commercial insurance, you may be eligible for the EpiPen Savings Card. This means that you can receive up to $300 off per EpiPen 2-Pak or EpiPen Jr 2-Pak carton, up to six cartons per calendar year.

The EpiPen 2-Pak contains two single-dose prefilled auto-injectors (0.3 mg) and one auto-injector trainer device. The EpiPen Jr 2-Pak contains two single-dose prefilled auto-injectors (0.15 mg) and one auto-injector trainer device.

Contact your doctor or insurance provider for more information about EpiPen prescriptions. Shopping around and comparing prices can also help you get the best EpiPen prices.

Are there any alternatives to an EpiPen?

There are different epinephrine auto-injector devices available. Other epinephrine auto-injectors include:

  • AUVI-Q
  • Epinephrine Injection, USP auto-injector
  • Generic EpiPen
  • SYMJEPI

If you do switch from one auto-injector device to another, it is important to make sure that you know how to use the new device correctly, as it may operate differently.

Learn more about finding alternatives to EpiPens here.

Other frequently asked questions

Below are some more frequently asked questions about EpiPens.

Can I inject EpiPen through my clothing?

Yes, you can inject your EpiPen through clothing if necessary.

How do I dispose of a used EpiPen?

Once you have used your EpiPen, take it to your local emergency room or doctor’s office. They will be able to dispose of it properly for you.

How do I store my EpiPen?

Store your EpiPen in the carrier tube at temperatures of around 68–77°F (20–25°C). Do not store your EpiPen in a refrigerator or vehicle glove box, in extreme temperatures, or in direct light.

Can I travel with an EpiPen?

It is important to take your EpiPen with you wherever you go. If you are flying, make sure that it is in your carry-on bag. Make sure that airline staff members are aware of your allergies and the fact that you are carrying your EpiPen.

Summary

When you experience anaphylaxis, you should inject your EpiPen into your upper thigh. It will inject epinephrine, which will help reduce symptoms of a severe allergic reaction.

It is important to take your EpiPen with you wherever you go. Anaphylaxis can occur as a result of a severe allergic reaction to a wide range of allergens, including foods, medications, and insect stings.

Contact your doctor if you have experienced an allergic reaction or if you have an allergy and do not have a prescription for epinephrine.

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Medical Reviewer: Debra Sullivan, Ph.D., MSN, R.N., CNE, COI
Last Review Date: 2022 May 19
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