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Who needs an EpiPen and how to get one

If you have a life-threatening allergy, here’s what to know about this medication

If you have an allergy that causes a severe life-threatening reaction called anaphylaxis, your healthcare provider will likely recommend that you keep an epinephrine auto-injector in case of emergency to have on hand to combat your body’s reaction to the allergen. 

Many people call these single-use devices “EpiPens” because EpiPen is a well-known brand name, but there are other brands and even generic versions available. Here’s what else you need to know about getting these important medical devices.

Why do you need an EpiPen?

Serious allergic reactions are the reason that you need easy access to an epinephrine auto-injector. When injected into your upper outer thigh muscle, the epinephrine will decrease your body’s reaction to the allergen. It will relax the muscles in your airways to help you breathe easier and help lower your blood pressure. 

“While fatal anaphylaxis is rare, one of the greatest risk factors for a fatal reaction is delayed administration of epinephrine,” explains Zachary Rubin, MD, an allergist in Illinois and spokesperson for the American College of Allergy, Asthma, and Immunology (ACAAI). “Epinephrine auto-injectors work very rapidly and are life-saving treatments.” 

In a review of 164 deaths due to anaphylaxis, the median time interval between symptom onset and respiratory or cardiac arrest was 5 minutes to 30 minutes.

According to the American Academy of Allergy, Asthma & Immunology (AAAAI), the most common causes of anaphylaxis are certain types of foods, insect stings, medications, and latex. 

Schools commonly require that students with known allergies like peanut allergies have an epinephrine auto-injector at school with them in case they are accidentally exposed. In fact, it’s so important that students have access to them that Graig Straus, DNP, medical director of the North Rockland Central School District in New York, stocks about a dozen epinephrine auto-injectors in each school in addition to any devices that students may bring themselves. 

“A student who has an allergy can develop an anaphylaxis reaction, which will restrict their airway and keep them from breathing properly,” Straus says. “The quicker we can mitigate that with an EpiPen, the better chance we have of controlling their airway and controlling the allergic response.” 

Do you need a prescription for an EpiPen?

You need a prescription to get an epinephrine auto-injector, so you’ll need to see a healthcare provider. There have been some efforts to pass legislation to allow Epipens without prescription in some states, but it has not become law. If you are diagnosed with a life-threatening allergy such as a peanut allergy or a bee sting allergy, your healthcare provider can write a prescription for an EpiPen (or similar device). Then, like any prescription, you will need to fill and purchase it from a pharmacy (or online pharmacy). 

It is essential to have access to this medicine if you need it. In fact, it should be the first treatment used for an anaphylactic reaction. “Medications such as Benadryl, Zyrtec, Claritin, Allegra and Xyzal are not as effective and do not work nearly as quickly, so they should not be used first,” Dr. Rubin says.

You should also routinely check the expiration date on your device. “There is a risk that the epinephrine will not be as effective once it is past the expiration date, which is after the last day of the month that is listed on the device,” Dr. Rubin says. 

RELATED: How do allergies affect quality of life?

How to get an EpiPen

Once you have a prescription for an epinephrine auto-injector, it’s time to fill the prescription. But if you’re concerned about the cost–especially if you need to have more than one EpiPen–you have a few options. 

Check with your insurance company. 

Your insurance may cover part of or even the entire cost of a particular epinephrine auto-injector, so you will want to make sure you get a prescription for that specific one. 

Look for manufacturer discounts. 

It’s always a good idea to check with the manufacturers to see if they offer a coupon or savings program.

For example, Kaleo, the company that manufactures the Auvi-Q auto-injector, offers a discount program for people with certain types of insurance. They also offer a patient assistance program for people without insurance coverage who have a prescription for their product and meet the specified income requirements. 

Also, Meridian Medical Technologies, the Pfizer-subsidiary that manufactures EpiPen and EpiPen Jr. auto-injectors, offers the My EPIPEN® Savings Card to help patients afford the cost of their products. The program is designed to reduce the out-of-pocket costs by $300. Another option is the MyGenericEAI Savings Card, which reduces the cost of the generic version of the EpiPen by $25. 

Consider a generic version

There are generic versions available, and your provider can write a prescription for one of them, says Straus. In fact, he procures generic versions for the schools in his school system to keep costs down.

Be prepared

Keeping an epinephrine auto-injector on hand for easy access is crucial, but it’s just one element of being prepared. The AAAAI also recommends that you create an Anaphylaxis Action Plan and keep it on file at your workplace (or your child’s school or daycare, if your child is the one with the allergy) so that others will have access to the info they need in case of an emergency. The plan should list emergency action steps for stopping exposure to the allergen, administering the epinephrine into the upper outer thigh muscle, as well as the type of epinephrine injector you have and your emergency contact information.