Living With Food Allergies

Epinephrine is the First Line of Treatment for Severe Allergic Reactions (Anaphylaxis)

Epinephrine is the only treatment for a severe allergic reaction known as anaphylaxis (anna-fih-LACK-sis). Epinephrine comes in the form of easy-to-use auto-injectors. It is only available through a prescription by your doctor. Each prescription comes with two auto-injectors in a set.

Children or adults who have severe food allergies need two of these auto-injectors with them at all times. For children, this might mean having more than one set of medication. For example, the child may need to keep one set at school and one set at after-school care. Another set typically remains at home. For adults, two auto-injectors might be enough.

Below, you will find a lot of information about this life-saving medication, so you can use these links to jump to the information you need:

Epinephrine Auto-Injectors Available with a Prescription in the United States

Epinephrine auto-injectors are the treatment for anaphylaxis. Several epinephrine auto-injectors are now available in the United States. There is also a generic version. Each contains the drug epinephrine. But, each device has its own unique set of instructions for use. Understanding the differences is important so that you get the device you want and you know how to properly use it.

epinephrine-available-US

The chart below summarizes the key facts about each of the available epinephrine auto-injectors. All listed auto-injectors are available in twin packs which contain two (2) devices. Epinephrine Injection, USP auto-injector is also available as a single injection. This is the authorized generic of Adrenaclick. More details are available at the manufacturers’ websites. These websites also have patient instructional videos.

Pharmacists must follow state and federal regulations when filling your prescription for epinephrine. You should keep this in mind when filling your prescription.

There are many states in which the pharmacist can substitute a generic form of the prescription. This must be on the prescription in writing. The pharmacist must also get a verbal approval from the physician. If you or your physician prefer to receive a specific brand name, your physician must write the brand name and “DAW” (dispense as written) or “do not substitute” on the prescription. This notation prohibits the pharmacist from dispensing a generic form of the prescription. Before you leave the pharmacy, make sure the pharmacy fills your prescription exactly as you and your child's doctor expects.

Remember to speak to your child’s physician to determine which epinephrine product is best for your child. Each device operates differently. Make sure that you have been trained to use the device that you leave the pharmacy with. Also, you should review the training video for that device.

PRODUCT NAME (website)
PRODUCT IMAGE
Adrenaclick™


www.adrenaclick.com
adrenaclick
Available Strengths
Manufacturer
Generic available
Discount Program

0.15 mg and
0.3 mg
 

Amedra
Pharmaceuticals
LLC

Yes

Co-pay card provides maximum benefit of $100 per twin pack (can be redeemed up to 3 times)
 

Includes Trainer
Talking feature
Needle exposed
after injection
Refill reminder feature

Not included, but training devices are available for free via web or telephone.
 


No

 

Yes

 

No

 

 

PRODUCT NAME (website)
PRODUCT IMAGE
Auvi-Q™

www.auvi-q.com
auvi-q-epi
Available Strengths
Manufacturer
Generic available
Discount Program

0.15 mg and
0.3 mg
 

Sanofi-Aventis U.S. LLC
 

No

Patients can receive up to $100 off co-pay or out-of-pocket expenses
and is valid for a maximum of
three two-packs per prescription
until December 31, 2015.
 

Includes Trainer
Talking feature
Needle exposed
after injection
Refill reminder feature

Yes

 

 


Yes

 

No

 

E-mail notices and an app
for iPhones remind patients
when their auto-injector expires

 

PRODUCT NAME (website)
PRODUCT IMAGE
EpiPen™ and
EpiPen Jr™

www.epipen.com
epi-pen
Available Strengths
Manufacturer
Generic available
Discount Program

0.15 mg and
0.3 mg
 

Mylan Inc.
 

No

Co-pay card provides maximum
benefit of $100 per EpiPen®
twin pack and can be redeemed up to 3 times until December 31, 2015.
 

Includes Trainer
Talking feature
Needle exposed
after injection
Refill reminder feature

Yes

 

 


No

 

No

 

Patients can register on the
product website for an e-mail
reminder when their medication
will expire
 

 

PRODUCT NAME (website)
PRODUCT IMAGE
Epinephrine Injection, USP auto-injector, authorized generic (AG) of Adrenaclick™

www.epinephrineautoinject.com
generic-epi
Available Strengths
Manufacturer
Generic available
Discount Program

0.15 mg and
0.3 mg*
 

Distributed by Lineage Therapeutics
 

**

Co-pay card provides maximum benefit of $100 per twin pack (can be redeemed up to 3 times)
 

Includes Trainer
Talking feature
Needle exposed
after injection
Refill reminder feature

Not included, but

training devices are available for free via web or telephone.

 

No

Yes

When you register for the refill reminder program, a reminder email will be sent one month prior to expiration date
 

*Available as a single injection or a twin pack.

** Epinephrine, USP auto-injector is the generically available option for Adrenaclick.

 

Everything You Wanted to Know about Epinephrine

Kids With Food Allergies (KFA), a division of the Asthma and Allergy Foundation of America, hosted a free educational webinar on February 26, 2014 featuring two of our medical advisors, Michael Pistiner, MD, and Angela Nace, PharmD.

They presented information about:

  • Epinephrine auto-injectors (available in the US)
  • How epinephrine treats anaphylaxis
  • Antihistamines
  • Accidental injections
  • Key facts about the drug including storage temperature recommendations and more

 

What If You Can't Afford Your Epinephrine Auto-Injectors?

Unfortunately, many people cannot afford to buy this potentially life-saving medication. If this is the case for you, consider using one or more of the following options:

Use Coupons – Coupons are available for all epinephrine auto-injectors for sale in the U.S. These coupons may reduce your cost to zero. It will depend on what kind of insurance coverage you have.

  • EpiPen 2-Pak® – Mylan Specialty’s “$0 Co-Pay” card can be used to reduce the amount of your out-of-pocket expense up to $100 per EpiPen® two-pack. The card is good for up to three two-packs per prescription. Visit https://www.epipen.com/copay-offer for details and card download. Offer expires 12/31/2015.
  • Auvi-Q® Two-Pack – Sanofi’s “$0 Co-Pay Offer” can reduce the amount of your out-of-pocket expense up to $100 per Auvi-Q® two-pack. The coupon is good for up three two-packs per prescription. Visit https://www.auvi-q.com/sign-up for details and offer registration/download. Expires 12/31/2015.
  • Generic Epinephrine Auto-Injector – Lineage Therapeutics Inc.’s “$0 Co-Pay Savings Card” can reduce the amount of your out-of-pocket expense up to $100 per generic epinephrine auto-injector two-pack. Each savings card can be used for up to three two-packs per prescription. Visit https://webrebate.trialcard.co...n/EpinephrinePortal/ for details and savings card download. Note: Although this savings card does not expire, you must print out a new savings card for each prescription. Every time you access the webpage the code on the savings card automatically changes. Each unique savings card is valid for just one use.


Use Mail Order – If you have prescription benefits, look into your plan’s mail order pharmacy options. This may give you a lower price or provide more sets of medication for the same price. Many mail order prescription plans provide patients with a three month’s supply of medication for the cost of two month’s copay.

Talk to Your Doctor – If you have insurance, talk to your doctor. Sometimes they can write the prescription that so that you can get more sets of medication for one co-pay. Typically a twin pack of injectors is considered a 30-day supply under your prescription plan. A physician might ask for six injectors (three twin packs) to be filled at once. This could then be filled through the mail order pharmacy, as described above.

Shop Around – Call around to different pharmacies. Prices can vary, especially between large chain pharmacies and smaller independent pharmacies. Be aware that the pharmacies at club stores such as Costco and Sam’s are generally available to non-members, too.

Switch to the “Preferred” Brand – If you have prescription drug coverage, call your pharmacy benefits manager. Ask which brand of epinephrine auto-injector your plan “prefers.” This one may be cheaper for you than the other brands.

Check with the Local Children’s Hospital – This option may work if your child sees doctors at a major children’s hospital. Ask if they have any grants or patient assistance programs that can help pay for your child’s prescription

Apply for Help – Both Mylan Specialty (maker of EpiPen) and Sanofi (maker of Auvi-Q) offer patient assistance programs. If your family’s income is below a certain level and you have no prescription coverage, you can apply for free or reduced cost epinephrine auto-injectors.

Talk to Your Employer – If you have medical insurance through an employer, contact their human resources department. Explain that your insurance is not covering a life-saving medication for you or your child. Sometimes, if you have a generous employer, they will try to help you.
 

Change Insurance Plans – During your next open enrollment period, look into a different plan. If your family’s income is below a certain level, you might be offered Medicaid. This depends on your state. Visit www.healthcare.gov, or your state’s health insurance site for details.

Stocking Epinephrine in Schools

Up to 25% of severe allergic reactions that occur on school campuses happen to people who are experiencing their very first anaphylaxis reaction. Since these people (children, staff and visitors) have not been previously diagnosed with allergies, they may not have their own epinephrine auto-injectors on hand. Many states have passed legislation to allow schools to stock undesignated epinephrine as a part of their emergency medical kits. This allows specified staff to treat someone suffering anaphylaxis, even for their very first allergic reaction. To find out if your state allows or requires schools to stock epinephrine, visit www.aafa.org/epinephrine (click on Action Center to find the current status of legislation across the country).


Children show their support for Pennsylvania's epinephrine stocking bill

 

Related Epinephrine Resources

REFERENCES
1. Product information for Adrenaclick™. Amedra Pharmaceuticals LLC. Horsham, PA 19044. April 2013.
2. Product information for Auvi-Q™. Sanofi-Aventis U.S. Bridgewater, NJ 08807. February 2014.
3. Product information for Epinephrine Injection, USP auto-injector, the authorized generic (AG) of Adrenaclick™. Lineage Therapeutics. Horsham, PA 19044. April 2013.
4. Product information for EpiPen. Mylan Inc. Basking Ridge, NJ 07920. August 2012.


angela-nace Angela Nace is Field Coordinator for Experiential Education, Department of Pharmacy Practice, at Jefferson University School of Pharmacy. She is also a member of the Kids With Food Allergies (KFA) Advisory Board and Medical Advisory Team.

 

Medical review February 2014, June 2014, January 2015.