Using an adrenaline injector FAQ

It is very rare that something goes wrong with an adrenaline injector.

If you find that your adrenaline injector has not worked properly, we recommend you report this once the emergency has been managed.

• Keep the device and take note of the serial number and expiry date
• Contact Allergy & Anaphylaxis Australia on 1300 728 000 for support
• You may wish report the problem yourself. You can do this through the Therapeutic Goods Administration (TGA) at Report a problem or side effect | TGA
• Contact the manufacturer at:
  • Anapen® –  Arrotex 1800 195 055
  • EpiPen® – Viatris 1800 931 625

Used and unused (and expired) adrenaline injectors must always be handled with care and should never be thrown in the regular or recycling bin.

They contain a needle that can be dangerous if not handled correctly and should always be placed in a sharps disposal container. Speak with your pharmacist or doctor about disposal of your adrenaline injector. 

Used adrenaline injectors can be given to ambulance paramedics who treat your anaphylaxis.

Unused (and expired) adrenaline injectors can be taken to pharmacies who can dispose of them using the Return Unwanted Medicine (RUM) campaign.

Both adrenaline injector brands have windows on the devices to check to see what the medication inside the device looks like.  

It is better that you check the colour of the fluid when it is not an emergency, for example check the fluid when you check the device expiry. A&AA recommend you routinely check your device to make sure it is still okay and has not expired.

It is better to know that the device you are carrying is in good condition than find something is not right when you need to use it for anaphylaxis.  

Discoloured or expired adrenaline injectors don’t work as well and should not be relied on to treat anaphylaxis BUT if a discoloured or expired adrenaline injector is the only one available it is better to use this rather than no adrenaline injector.

If someone is experiencing anaphylaxis, an adrenaline injector should be given.

If the prescribed dosage or brand of adrenaline injector is not available, any available adrenaline injector should still be given. This includes any brand (Anapen® or EpiPen®) using the following dosing guide.

The ASCIA Action Plan for Anaphylaxis states that further adrenaline may be given if there has been no response after 5 minutes: 

• If 300 micrograms of adrenaline has been given as a first dose and the child (over 20 kg) or adult requires a second dose of adrenaline, the adrenaline device that is available should be given.
• If 150 micrograms of adrenaline has been given as a first dose and the child (under 20 kg) requires a second dose of adrenaline (if symptoms of anaphylaxis persist or recur), a 300 microgram dose of adrenaline may be given if a 150 microgram adrenaline injector is not available.

The information above is from ASCIA’s Frequently Asked Questions on Adrenaline Injectors

Pharmacists can substitute one adrenaline injector for another if the “brand substitution is not permitted” box is not ticked or your prescription is for an Anapen® junior or Anapen® 300 (these devices are no longer available in Australia).

The pharmacist should:

• ask for your permission to do this
• show you how to use the adrenaline injector – instructions for using Anapen® and EpiPen® are different

It is important that you have an ASCIA Action Plan for Anaphylaxis that matches your adrenaline injector. 

If you do not have an Action Plan for Anaphylaxis that matches your adrenaline injector then you will need to go back to your doctor and get the matching Action Plan.