TAM (Treatments and Medicines) NHS Highland
Important: Therapy notes
NPSA alert: recall of Emerade® 500 microgram and Emerade® 300 microgram auto-injectors due to the potential for device failure (May 2023) (www.gov.uk).
MHRA advice: Adrenaline auto-injectors: updated advice after European review (August 2017) (www.gov.uk).
Important: Formulation and dosage details
Formulation:
Injection 1 in 1,000: ampoule 500 micrograms/0·5mL, 1mg/mL
Dosage:
For intramuscular injection.
Important: Formulation and dosage details
Formulation:
Solution for injection pre-filled syringe 1 in 1,000 (1mg/mL)
Dosage:
For intramuscular injection.
Important: Formulation and dosage details
Formulation:
Injection 1 in 10,000 DILUTE: 1mg/10mL ampoules
Dosage:
For intravenous administration.
Important: Formulation and dosage details
Formulation:
Intramuscular injection 150 microgram:
- EpiPen® Junior 0·15mg Auto-injector
- Jext® 150 microgram pre-filled pen
Intramuscular injection 300 micrograms:
- EpiPen® 0·3mg Auto-injector
- Emerade® 300 micrograms pre-filled pen
- Jext® 300 microgram pre-filled pen
Intramuscular injection 500 micrograms:
- Emerade® 500 micrograms pre-filled pen
Dosage:
Intramuscular injection for self-administration.
- EpiPen® is the recommended device in NHS Highland but due to a long standing supply problems, alternatives may need to be prescribed/dispensed.
- If a patient has to switch to another brand it is important that the differences are brought to their attention by the staff issuing the new auto-injector.
Notes:
- Prescribe all new patients 2 adrenaline auto-injectors on diagnosis.
- Add note onto Key Information Summary.
- Advise patients of the benefits of wearing a device, such as a bracelet, (available from allergy charities) to inform bystanders at the time of any future attack.
- Training on anaphylaxis recognition and use of the auto-injector is essential.
At the point of prescribing and dispensing, it is vital that patients and carers receive training to ensure that they are completely familiar with how their device works. Injection technique is device-specific:
Patients should carry two devices at all times, in case they need to administer a second dose before the arrival of the emergency services.
Prescribers should issues no more than two adrenaline auto-injectors per patient unless:
- Schools require separate pens to be kept on school premises, up to four pens may be prescribed.
- Rarely, for patients who have had a prior severe reaction resistant to treatment with adrenaline.