People often ask me, are adrenaline injectors dangerous? “If I use one on my child and they weren’t having a severe reaction, could it cause them any harm?”
Is it safe to use an expired EpiPen, Jext of Emerade adrenaline injector?
Could using two auto-injectors ever cause an overdose of adrenaline?
Adrenaline is not dangerous, so if in doubt, inject!
These are all common and understandable worries, but thankfully I can put to rest immediately.
Adrenaline injectors contain a single dose for the use of patients with anaphylaxis. The amount of adrenaline will not cause you any danger as it’s such a small amount. Even using two, if the first doesn’t work, it’s quite safe and won’t cause you any harm.
What if I accidentally inject my finger with adrenaline?
This is becoming more and more common as allergies rise and more adrenaline injectors are prescribed. People who are unsure how to use the injectors can mistakenly hold their finger over the needle end and inject themselves accidentally. If you inject your finger or thumb it can be very painful and you will waste the adrenalin but contrary to myths about the danger this causes apart from swelling and pain the finger should recover with time.
The American Association of Hand Surgery published a paper entitled “Finger Injection with High-Dose (1:1,000) Epinephrine: Does it Cause Finger Necrosis and Should it be Treated?” which concluded that “There is not one case of finger necrosis in all of the 59 reported cases of finger injections with 1:1,000 epinephrine in the world literature.”
Make sure you are familiar with how to safely administer your adrenaline. Get some trainer pens and practise. Check out ‘How to use an Epipen – a simple demonstration’.
So it’s totally safe to inject adrenaline?
There is no danger from using your injector if you administer it correctly.
If in doubt, it is better to use an adrenaline autoinjector, than not use it, even if the reaction is not anaphylaxis. Under-treatment of anaphylaxis is more harmful so if in doubt, use it. Even if you’re not sure and want to wait to see if you or your child recovers naturally, if there is any swelling of the mouth or throat, any difficulty breathing or you are worried at all administer the adrenaline swiftly and call 999.
You are in more danger if you don’t carry your injector with you at all times.
What if I’m allergic to sulphites – adrenalin injectors contain sulphites…
I spoke to the makers of the adrenaline injectors in the UK and they told me that the adrenaline would counter act any reaction to the sulphites in the mixture, which are only used to preserve the drug and extend its shelf life. It is present in very small quantities so shouldn’t cause a problem but I’m not sure how reassuring that statement is for anyone with sulphite allergy.
Overdose of epiniphrine can be dangerous
The only instances I could find of death from epiniphrine (adrenaline) injection were caused by errors at hospital where incorrect doses were given and this is very rare. Steps have been taken to ensure that large doses of adrenaline/epiniphrine phials are not kept in operating theatres and lessons have been learnt, thankfully, from these mistakes. The dose in your adrenaline injector is small and will not cause you any harm but because the drug increases blood pressure, high doses wrongly administered can be dangerous, or if the patient has a pre-existing condition which may be affected by heightened blood pressure.
The dose in your injector is so small that even using two, if you have a secondary reaction, will be completely safe.
I hope this blog post has allayed any fears any of you may have had and apologies for the Daily Fail style sensationalist headline. It’s a little experiment to see if the title affects visits to the site… Are you scared to use yours?
I have also read that if someone injected themselves with lots of out of date epipens that could be very dangerous. Don’t do this, store pens safely and dispose of old ones. Stay safe and store your medication safely.
I hope you found this blog helpful and I’ve helped to allay any fears. If in doubt about whether a reaction is serious enough, always inject.