The first PBS authority prescription needs to be provided by or in consultation with a clinical immunology/allergy specialist, respiratory physician or a paediatrician. 

An initial PBS prescription may also be prescribed after you have been discharged from hospital or an emergency department after treatment with adrenaline (epinephrine) for anaphylaxis.

A doctor (including a GP) or nurse practitioner can write follow-up prescriptions. The doctor/nurse practitioner will need to obtain an authority from Services Australia on each occasion. You can only purchase two in-date adrenaline injectors through the PBS on authority prescription at any one time.

If you use one or both of your devices you can replace them using an authority prescription, even if it has only been a short time since your last adrenaline injector authority prescription.

 Your doctor/nurse practitioner should provide an ASCIA Action Plan for Anaphylaxis (red in colour) with every prescription for an adrenaline injector, even if your trigger allergens have not changed.

ASCIA Action Plans can be printed from the Australasian Society of Clinical Immunology and Allergy (ASCIA) website.

The ASCIA Action Plan for Anaphylaxis is regularly updated with best practice emergency treatment advice for anaphylaxis.

NOTE: Adrenaline injectors are not generally prescribed for people with medication allergies even if they have had a previous anaphylaxis. This is because medications are much easier to avoid than food or insects for example.

You need to take your authority prescription to a pharmacy, and you will be given two adrenaline injectors. The total cost for the two adrenaline injectors will be the cost of a single prescription.

Check with the pharmacy. If they have adrenaline injectors with an expiry date of less than ten months, you can consider asking them to order you an adrenaline injector with a longer expiry date. You may have to wait a couple of days for the order to arrive at the pharmacy, so do not leave it until the last minute to renew your adrenaline injector prescription. You may also like to phone a few pharmacies in your area to see which pharmacy has adrenaline injectors with the longest expiry dates.

On rare occasions adrenaline injectors may not be available with expiry dates of more than ten months. If this occurs, it is better to accept an in-date adrenaline injector even if the expiry date is short. If you purchase a device that has an expiry date less than 12 months, you can replace the devices through the PBS on authority prescription when they are due to expire.

You must replace your adrenaline injector if:

• you have used it
• it has been fired/triggered by accident
• it is about to expire or
• the liquid within the device becomes cloudy/discoloured or has floating particles.

NOTE: If you have used an adrenaline injector you should replace it immediately. You should always have at least one in-date adrenaline injector with you at all times.

Yes, they can be bought over the counter from any pharmacy. An adrenaline injector purchased over the counter without a prescription will cost around $80 to $120.

Some private health insurance funds will cover part of the cost of adrenaline injectors purchased on a general prescription (not a PBS authority prescription). Check with your private health fund whether you can get a rebate under your level of private health cover for a full-price adrenaline injector purchased with a general prescription.   When you buy non-PBS adrenaline injectors on a general prescription you will need to obtain a signed receipt from your pharmacist. This receipt will allow you to make a private health insurance claim if you are entitled to it.
 
If you purchase a device over the counter without a general prescription, you will not be entitled to any rebate.

Adrenaline injectors can be purchased over the counter from any pharmacy. The cost will be around $80 to $120. There is no government subsidy unless adrenaline injectors are prescribed to a specific individual on authority prescription.

Organisations that purchase an adrenaline injector for general use should keep an ASCIA First Aid Plan for Anaphylaxis (orange in colour) with the device.

ASCIA Action Plans can be printed from the Australasian Society of Clinical Immunology and Allergy (ASCIA) website.

ASCIA has information on adrenaline injectors for general use.

You will be able to purchase the two adrenaline injectors on a PBS authority prescription for the Health Care Card prescription price. There is no discount on over-the-counter devices bought without a PBS authority prescription.

Your adrenaline injector expires at the end of the month indicated on the device. You should allow enough time to make an appointment to see your doctor/nurse practitioner for a PBS authority prescription and to present the prescription to your pharmacy. Remember that the pharmacy may need to order the adrenaline injector, so allow a couple of days depending on your location. It is best to start the process of obtaining a prescription in the middle of the month the device expires in case there are any delays.

Ask your doctor/nurse practitioner to show you how to use the adrenaline injector when you get the prescription. You can also ask the pharmacist to demonstrate how to administer the device. Allergy & Anaphylaxis Australia (A&AA) has a quick and easy-to-understand video that demonstrates the use of adrenaline injectors currently available in Australia.  

You will also find instructions on the adrenaline injector itself and your ASCIA Action Plan for Anaphylaxis, which includes instructions for the device you were prescribed.

A&AA encourages people at risk of anaphylaxis and their carers to purchase an adrenaline injector trainer device so they can practice using it. This also allows others, such as family, friends, colleagues, school/childcare staff, to learn how to administer the adrenaline injector in case of an emergency.

Adrenaline injector trainers are available for a small cost from A&AA’s online shop.

Adrenaline injector trainer devices do not contain any medication or a needle. A trainer device should be clearly labelled with the word ‘Trainer’ so it is not confused with a real device containing adrenaline and a needle. A&AA suggests using masking/electrical tape to do this so that it looks different to the real adrenaline injector. Adrenaline injector trainers should be stored in a different location to the real adrenaline injectors so there is no confusion about which device to use in an emergency.

Practice using the device every 3– 4 months so you are familiar with the device if an emergency occurs.

For information on ordering Anapen® stock, the pharmacy should contact the distributor (Arrotex) on 1800 195 055.

For information on ordering EpiPen® stock, the pharmacy should contact the distributor (Viatris) on 1800 931 625.

If they are unsuccessful, please ask them to call Allergy & Anaphylaxis Australia on 1300 728 000.

Your doctor/nurse practitioner will prescribe the correct dose adrenaline injector based on the person's weight. ASCIA has information on adrenaline injector dose recommendations. Dose recommendations are also on the ASCIA Action Plan for Anaphylaxis.

The type of adrenaline injector prescribed is based on a medical decision by the doctor as well as the patient/carer preference. Considerations may include the weight of the patient, history of anaphylaxis and the training on a new device.  It is very important that you know how to use the type of device prescribed, especially if it is different to one you have used in the past.