Epinephrine, Injection

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KEY POINTS

• This medicine is given injection to treat severe allergic reactions. Use it exactly as directed.
• You may get infections more easily when you are taking this medicine.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: bronchodilator; adrenergic agonist

Generic and brand names: epinephrine, injection; Adrenaclick; Auvi-Q; EpiPen Auto-Injector; EpiPen Jr. Auto-Injector

What is this medicine used for?

This medicine is given by injection (shot) to treat severe allergic reactions (anaphylaxis) to foods, drugs, insect stings, or other things. This medicine acts fast to improve breathing problems, stimulate the heart, and reduce swelling of your face, lips, and throat.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A stroke or transient ischemic attack (TIA)
• Diabetes
• Glaucoma
• Heart disease or an irregular heartbeat
• High blood pressure
• Parkinson's Disease
• Thyroid problems

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

Check the label on the medicine for directions about your specific dose. Use this medicine exactly as directed by your healthcare provider. Use only the amount prescribed. For severe allergic reactions, this medicine is given as a shot in the outer thigh muscle. It can be given through clothing if needed. Do NOT inject this medicine in the hands, feet, or buttocks. If the medicine is injected in your hands, feet, or buttocks, contact your healthcare provider or get emergency help right away.

Your provider may prescribe an emergency kit for you to use in case of a severe allergic reaction. Follow the directions that come in the kit. Be sure to keep the emergency kit with you. Let family members, coworkers, and others know where you keep the medicine and how to use it in case of emergency. Use the auto-injector only once and dispose of it safely.

If you are not sure of how to give yourself the shots, ask your healthcare provider or pharmacist for help.

Use the medicine as soon as you have any symptoms of an allergic reaction. You may need to take a second dose of this medicine if your symptoms continue after the first dose. Do not take more than 2 doses of this medicine for a single allergic reaction.

Whenever you use this medicine, contact your healthcare provider right away.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: fast, slow, or irregular heartbeat; severe throbbing headache; large pupils; trouble breathing; decreased urination; weakness; seizures; slurred speech; pale and cold skin.

What should I watch out for?

If an allergic reaction continues, or you still have trouble breathing after you use this medicine, call 911 right away.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are using this medicine.

If you have diabetes: If you use this medicine very often, it may affect your blood sugar level and change the amount of insulin or other diabetes medicines you may need. Talk to your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Continued allergic reaction; trouble breathing.

Serious (Report these to your healthcare provider right away.): Chest pain; seizures; irregular or fast heartbeat; sudden or severe headache; continued warmth, redness, swelling, or tenderness where the shot was given.

Other: Nausea, vomiting, paleness, sweating, dizziness, weakness, headache, shakiness, nervousness.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), methyldopa, phentolamine, prazosin (Minipress), tamsulosin (Flomax), and terazosin
• Antibiotics such as linezolid (Zyvox) and tedizolid (Sivextro)
• Antidepressants such as amitriptyline, clomipramine, desipramine (Norpramin), desvenlafaxine (Pristiq), duloxetine (Cymbalta), imipramine (Tofranil), nortriptyline (Pamelor), and venlafaxine (Effexor)
• Antihistamines such as chlorpheniramine (Chlor-Trimeton) and diphenhydramine (Benadryl)
• Antipsychotic medicines such as chlorpromazine, fluphenazine, perphenazine, thioridazine, and trifluoperazine
• Beta blockers such as acebutolol (Sectral), atenolol (Tenormin), bisoprolol (Zebeta), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), nebivolol (Bystolic), pindolol, and sotalol (Betapace, Sorine)
• Diuretics (water pills) such as amiloride, bumetanide, chlorothiazide (Diuril), chlorthalidone, eplerenone (Inspra), ethacrynic acid (Edecrin), furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), torsemide (Demadex), and triamterene (Dyrenium)
• Doxepin (Silenor)
• Entacapone (Comtan) or levodopa/carbidopa/entacapone (Stalevo)
• Heart medicines such as amiodarone (Cordarone, Pacerone), digoxin (Lanoxin), disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), flecainide, procainamide, propafenone (Rythmol), and quinidine
• Levothyroxine (Levo-T, Levothroid, Levoxyl, Synthroid, Unithroid)
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• Migraine medicines such as dihydroergotamine (D.H.E. 45, Migranal) and ergotamine (Ergomar)
• Nausea medicines such as prochlorperazine (Compro) and promethazine
• Procarbazine (Matulane)
• Propranolol (Hemangeol, Inderal, InnoPran)
• Rasagiline (Azilect)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

This medicine is sensitive to light. Store it in a dark, cool place in its original container. Do not refrigerate. From time to time, check the liquid to see make sure that it is clear and colorless. Do not use any medicine that is discolored or cloudy.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.