Adrenaline auto-injector (EpiPen and EpiPen Jr)

Medication Information Leaflet

What is this medication for?

  • This medication contains epinephrine (or commonly known as adrenaline), which is used for the emergency treatment of sudden life-threatening allergic reactions (anaphylaxis). 
  • Symptoms of allergic reactions include:
    • Mouth: itch and swelling of lips, tongue, or mouth
    • Throat*: itching and/or a sense of tightness in the throat, hoarseness, hacking cough
    • Skin: hives, itchy rash, and/or swelling on the face or extremities
    • Gut: nausea, abdominal cramps, vomiting, diarrhea
    • Lung*: shortness of breath, repetitive coughing and/or wheezing
    • Heart*: passing out, fainting, dizziness
  • The severity of symptoms can quickly change. *All these symptoms can potentially progress to a life-threatening situation.

How should I take/use this medication?

There are two available strengths (EpiPen and EpiPen Jr), and the doctor will decide on the suitability according to your weight.

1. Remove auto-injector from the carrier tube. 
2. Hold the auto-injector with tip down.
3. Make a fist around the auto-injector.
4. Pull off the blue safety release. Do not put your fingers or hand over the orange tip.
5. Hold the auto-injector at a 90° angle to the outer thigh, Swing and firmly push the orange tip against the middle of the outer thigh, through clothing if needed.
6. If you are administering EpiPen or EpiPen Jr to another person, hold the leg of the person firmly to prevent injury. Push the orange tip firmly against the middle of the outer thigh, through clothing if needed.

7. Press hard into the outer thigh until it clicks.
8. Hold in place for 3 seconds then remove.
9. The orange tip will extend to cover the needle.
10. Massage the area of injection for 10 seconds.
11. Record the time the auto-injector was administered.
12. Seek medical help immediately, by reporting to your doctor or the nearest hospital, or call the local emergency response team (call 995 if in Singapore).
  • Effects of the auto-injector only last for 20-30 minutes.
  • If your symptoms are still present 15 minutes after the first injection, you may need a second auto-injector.
13. The auto-injector is for single use only. 
14. See your doctor for a refill or replacement of this medication.

What should I do if I forget to take/use this medication?

Seek medical help immediately.

What precautions should I take?

  • There is no known reason why anyone should not use EpiPen or EpiPen Jr during life-threatening allergic reactions as they are critical for the treatment. However, inform your healthcare professional if you: 
    • Have heart conditions or high blood pressure
    • Have diabetes
    • Have thyroid conditions
    • Have asthma
    • Have history of depression
    • Have Parkinson’s disease
    • Have any other medical conditions 
    • Are allergic to this medication, sodium metabisulfite, or any of the other ingredients of this medication.
    • Are pregnant, planning to become pregnant, or breastfeeding.
  • Check the “viewing window” to ensure that the solution is clear and colorless. If the “viewing window” is obscured, this means that the auto-injector has been used and cannot be used again. Replace the EpiPen or EpiPen Jr if the medication appears cloudy, contains particles, or changes color (from clear solution to pink or brown color).
  • Always check the expiry date indicated on the label. Replace the EpiPen and EpiPen Jr if they have expired. Do not use them after the expiry date.
  • Do not inject this medication into your blood vessels, buttocks, fingers, toes, hands or feet. If you accidentally inject into any of these areas, go to the nearest emergency room immediately.
  • Always carry this medication with you at all times.

What are some common side-effects of this medication?

These common side effects may disappear with rest. If any of the following effects persist or are severe, consult your doctor.
  • Fast, irregular or pounding heartbeat
  • Sweating
  • Headache
  • Weakness
  • Dizziness 
  • Paleness
  • Coldness
  • Anxiety, feeling nervous or overexcitement
  • Nausea, vomiting
  • Breathing problems

What are some rare but serious side-effects that I need to seek medical advice immediately?

If you experience any of these symptoms, you should inform your healthcare professional immediately.
  • Symptoms of infection
    • Persistent redness, warmth, swelling at site of injection
  • Symptoms of allergic reaction
    • Swollen face/eyes/lips/tongue
    • Difficulty in breathing
    • Itchy skin rashes over your whole body
  • Symptoms of high blood pressure
    • Severe headache
    • Dizziness
    • Passing out
    • Vision changes
  • Unable to pass urine or change in urine volume

What food or medication should I avoid when I take this medication?

Inform your healthcare professional if you:
  • Are taking any other medications, especially
    • Medications for Parkinson’s disease e.g., catechol-O-methyl transferase inhibitors (COMT inhibitors) 
    • Medications for heart condition and high blood pressure e.g., beta-blockers
    • Medications for depression e.g., tricyclic antidepressants
    • Medications for diabetes
    • Medications for asthma e.g., theophylline
  • Are taking supplements, traditional medications and herbal remedies.

How should I store this medication?

Always keep the auto-injector in the carrier tube. Keep this medication in a cool dry place. Protect from light, heat, cold and moisture. Do not refrigerate or freeze. Keep this medication away from children.

How should I throw away this medication safely?

This medication should be thrown away in a rigid container that is closed, puncture-resistant and leak-resistant. You may return the used auto-injector to the pharmacy where you received the medication from for proper disposal.

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

Last updated on Oct 2022
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