Living with Food Allergies

Food Allergy Awareness Kit

Epinephrine

Epinephrine is the only treatment that will stop a severe allergic reaction known as anaphylaxis [anna-fih-LACK-sis].

Epinephrine comes in the form of easy-to-use auto-injectors or a syringe. It is only available through a prescription from your doctor.

If you or your child have severe food allergies, you need to have epinephrine quickly and easily available at all times. For children, this might mean having extra epinephrine devices. For example, your child may need to keep epinephrine at school, as well as at after-school care. You may also want additional epinephrine devices that remain at home or travel with you when you go out. For adults, two devices might be enough.

Epinephrine Devices Available With a Prescription in the United States

Epinephrine is the first-line treatment for anaphylaxis. Several epinephrine auto-injectors and a pre-filled syringe are now available in the United States. There are also generic versions. 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.

The information below summarizes the key facts about each of the available epinephrine devices. More details are available at the manufacturers’ websites. These websites also have videos that show you how to use them.

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

There are many states 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 doctor. If you or your doctor prefer to receive a specific brand name, your doctor must write the brand name and “DAW” (dispense as written) or “do not substitute” on the prescription. This note prevents the pharmacist from filling a generic form of the prescription.

Before you leave the pharmacy, make sure the pharmacy fills your prescription exactly as you expect.

What’s the Difference Between Brand Name, Generic, and Authorized Generic Drugs?

Brand name drugs: When a new medicine is created and approved by the Food and Drug Administration (FDA), it is marketed under a brand name. The company that makes it patents the drug. This means this company is the only company that has the right to make and market this drug for a certain number of years, as noted in the patent.

Generic drugs: When a drug patent expires, other companies can make generic versions of the medicine if it follows certain standards set by the FDA. The generic medicines must have the:

  • Same active ingredient as the brand name drug
  • Same benefits and risks as the brand name drug
  • Same strength, dosage, and route of administration as the brand name drug
  • Same quality and manufacturing standards as the brand name drug

Generic drugs may be different from brand name drugs in the following ways:

  • May be made by the same company or by a different company
  • Different look and size, including packaging
  • Different inactive ingredients (side effects may vary from the brand name drug because of the inactive ingredients, but this is uncommon)
  • Lower costs (most of the time but not always)

Authorized generic drugs: This type of generic medicine is the same as the brand name medicine but without the brand name label. It will have the same active and inactive ingredients as the brand name drug. Authorized generic medicines may also cost less.

If a generic or authorized generic version of a drug exists, health insurance companies may cover those instead of the brand name medicine. Generic drugs can offer the same treatment at a lower cost than brand name.

When it comes to medicines like asthma inhalers and epinephrine devices, the active ingredient and doses will be the same, but the device may look and operate differently. It is very important for you to learn how to use the device prescribed to you even if it is the authorized generic of a brand name device.

AUVI-Q®


Auvi-Q epinephrine auto-injectorProduct Name:
AUVI-Q®

auvi-q.com

Manufacturer: kaléo

Training videos

Available Strengths: 0.1 mg, 0.15 mg and 0.3 mg

Generic available: No

Includes trainer: Yes

Talking feature: Yes

Needle exposed after injection: No

Injection hold time:  2 seconds

Refill reminder: Yes

Discount Program: AUVI-Q has two assistance programs. If you have commercial insurance that covers AUVI-Q, you may be able to get AUVI-Q for as little as $35 for multiple cartons filled during the same transaction. If your insurance doesn’t cover it or if you have a high-deductible plan, you’ll pay no more than $150. Eligible patients without commercial insurance or Medicaid may be able to get AUVI-Q for no cost through the kaléo patient assistance program. Call 502-213-7601 for questions.

EpiPen® and EpiPen Jr®

EpiPen epinephrine auto-injectorProduct Name: EpiPen® and EpiPen Jr®

epipen.com

Manufacturer: Mylan Inc., a VIATRIS™ company

Training videos

Available Strengths: 0.15 mg and 0.3 mg

Generic available: Yes, see below

Includes trainer: Yes

Talking feature: No

Needle exposed after injection: No

Injection hold time: 3 seconds

Refill reminder: No

Discount Program: Copay card provides a maximum benefit of $300 per EPIPEN TWO-PACK® and/or EPIPEN JR TWO-PACK® carton per prescription refill (up to three cartons per prescription) and can be used for six cartons per calendar year. If you have questions, call 1-800-657-7613 (8 a.m.-8 p.m. ET, Monday-Friday). VIATRIS™ also has a patient assistance program.

Epinephrine Injection, USP Auto-Injector, Authorized Generic (AG) of EpiPen® and EpiPen Jr®

EpiPen authorized generic epinephrine auto-injectorProduct Name: Epinephrine injection, USP auto-injector, authorized generic (AG) of EpiPen® and EpiPen Jr®

 epipen.com/en/about-epipen-and-generic-what-is-an-authorized-generic

Manufacturer: Mylan Inc., a VIATRIS™ company

Training videos

Available Strengths: 0.15 mg and 0.3 mg

Generic available: N/A

Includes trainer: Yes

Talking feature: No

Needle exposed after injection: No

Injection hold time:  3 seconds

Refill reminder: No

Discount Program: Use the Epinephrine Injection, USP Auto-Injector Savings Card to reduce out-of-pocket expenses for a maximum benefit of $25 per generic two-pack (up to three cartons per prescription) and can be used for three cartons per calendar year. If you have questions, call 1-800-657-7613 (8 a.m.-8 p.m. ET, Monday-Friday). VIATRIS™ ADVOCATE also has a patient assistance program.

Epinephrine Injection, USP Auto-Injector, Generic

EpiPen authorized generic epinephrine auto-injectorProduct Name: Epinephrine injection, USP auto-injector, generic

tevaephinephrine.com

Manufacturer: Teva Pharmaceutical Industries

Training videos

Available Strengths: 0.15 mg and 0.3 mg

Generic available: N/A

Includes trainer: Yes

Talking feature: No

Needle exposed after injection: Yes

Injection hold time:  3 seconds

Refill reminder: Yes

Discount Program: If you have commercial insurance, you may save up to $30 per carton, up to three per prescription. If you have any questions, call 1-844-248-7949.

Epinephrine Injection, USP Auto-Injector, Authorized Generic (AG) of Adrenaclick™

Product Name: Epinephrine injection, USP auto-injector, authorized generic (AG) of Adrenaclick™

epinephrineautoinject.com

Manufacturer: Distributed by Amneal Pharmaceuticals

Training videos

Available Strengths: 0.15 mg and 0.3 mg

Generic available: N/A

Includes trainer: Training devices are available for free via web or telephone

Talking feature: No

Needle exposed after injection: Yes

Injection hold time: 10 seconds

Refill reminder: No

Discount Program: If you have commercial insurance, you may receive up to $10 off per pack of their out-of-pocket cost. If you have any questions, call 330-757-8402.

Other Epinephrine Options

There are other options that do not auto-inject the epinephrine. Glass vials of epinephrine with needles/syringes may be in emergency kits as seen on airplanes. Different types of epinephrine devices are being developed and are going through clinical trials.

neffy® Epinephrine Nasal Spray (In Development)

Product Name: neffy® epinephrine nasal spray

ars-pharma.com/product/

Manufacturer: ARS Pharmaceuticals

ARS Pharmaceuticals is developing neffy epinephrine nasal spray as a needle-free option to treat anaphylaxis. The Food and Drug Administration (FDA) reviewed neffy in 2023 but asked for an additional study. Read the latest about neffy.

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

Unfortunately, some people cannot afford to buy this potentially life-saving medicine. If this is the case for you, there are options to help. On our blog, we offer up-to-date details about:

  • Savings programs
  • Pharmacy differences
  • Insurance preferences
  • Other sources of assistance

Read our blog post: What to Do If You Can’t Afford Epinephrine

Stocking Epinephrine in Schools and Public Places

Around 45% of severe allergic reactions severe allergic reactions in schools begin in the classroom. 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. Most 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. Many states are looking beyond the classroom to other areas where food allergy triggers could be present. In any public space where food is present – such as sports and recreation venues, summer camps, amusement parks, movie theaters – there is a risk for an allergic person to come in contact with their allergen. To find out the status of epinephrine laws in your state, visit aafa.org/epinephrine.

Related Epinephrine Resources

Updated January 2024

Medical review: “What’s the Difference Between Brand Name, Generic, and Authorized Generic Drugs?” reviewed January 2024 by Jerry Shier, MD

Anaphylaxis facts: A serious allergic reaction that can be life threatening; requires immediate treatment with epinephrine; certain people are more at risk (if you have asthma, if you have a history of anaphylaxis); typically starts within minutes after contact with your allergen and get worse fast; symptoms usually affect more than one part of the body; may not occur the same way when it happens again (it an be worse or have different symptoms than the past)

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