An anaphylactic allergy can turn the most mundane tasks into stressful situations. An otherwise fun hike can require careful planning and precautions if you’re allergic to wasps; eating meals prepared by others can be nerve-inducing if you’re severely allergic to peanuts, milk, or any other food. And for parents sending their children with severe allergies to school, it can be incredibly stressful. For people with anaphylactic allergies, an epinephrine auto-injector (like the popular brand EpiPen) is a life-saving and necessary medication that should be carried at all times.
More than 50 million Americans suffer from allergies each year—a truly staggering number. According to the Centers for Disease Control and Prevention, allergies are the sixth leading cause of chronic illness in the United States. There are many different types of allergies, some more severe than others, but an allergy that results in an anaphylactic reaction requires immediate medical attention.
A study conducted by the Asthma and Allergy Foundation of America found that anaphylaxis reactions occur in at least 1 in 50 Americans, but the report goes on to clarify that the prevalence is likely closer to 1 in 20 Americans (the lower number due to low reporting and low education on what an anaphylactic reaction really is). A severe allergic reaction, known as an anaphylactic reaction, can be life-threatening. Signs include hives, tightness or swelling in the throat, difficulty breathing, loss of consciousness, or any other allergy-related symptoms.
Dr. Monya De, an internal medicine physician in Los Angeles, advises that anyone who has had an anaphylaxis reaction, or alarm symptoms, should carry an EpiPen with them. An EpiPen delivers the life-saving drug epinephrine through auto-injection. Alarm symptoms indicating you should use the injector, Dr. De says, include throat closing, lips swelling, difficulty breathing, and/or an immediate rash upon contact with the allergen.
EpiPen is the most widely known brand of epinephrine auto-injectors, but there are other brands available, including Symjepi, Adrenaclick, Adrenalin, and more. Keeping multiple epinephrine auto-injectors is advised.
“[People with allergies] should have at least two, one to be carried with them at all times and one at work,” says Dr. Susan L. Besser, a primary care physician at Mercy Medical Center in Baltimore. “It would be good if they also had a third one at home.”
If you have severe allergies, that you let someone at work and home know where your EpiPen is located, “just in case the person is too incapacitated to use it themselves,” Dr. Besser suggests. For your kids, it’s important to talk to the school nurse and your child’s teacher so they have access to the EpiPen while at school.
But just having EpiPens isn’t enough: You must always make sure that your EpiPens aren’t expired, and refill them in time so you’re never caught without. Dr. De recommends that you refill your prescription several weeks before the expiry date listed on the EpiPen, and stagger your pick-up times so that your EpiPens don’t expire all at once.
In the case where there’s an EpiPen shortage (as there is currently), or you’re unable to get a new EpiPen in time, Dr. Besser says you can continue to use the expired EpiPen. “According to the CDC and other experts, the Epipen is ‘good’ for six months to a year after the expiry date,” she explains.
EpiPen packaging now contains straightforward instructions for using the auto-injector, but it’s still a good idea to review the instructions for yourself and/or for your kids, and have close friends, family, and co-workers review it, too. There are also EpiPen training pens available for purchase; they contain no medication or needle, but simulate the auto-injector and allow for greater preparation.
EpiPens are life-saving devices, but they don’t negate the fact that you need to visit the ER if you come in contact with your allergen.
“Use the EpiPen at first sign of an allergic reaction,” Dr. Besser instructs. “Once it has been administered … go directly to the ER. The medication in the EpiPen may wear off causing the reaction to begin again so being in an environment where the patient can get medical support is critical.”
And it probably goes without saying, but, Dr. De gives one final word of advice: “Don’t let anyone inject you in the heart like in Pulp Fiction, please.”