Greater Glasgow and Clyde Medicines

Adrenaline Auto-Injectors for self-administration for Acute Anaphylaxis

Update (October 2020)

Key messages

  • Two adrenaline auto-injector (AAI) devices should always be prescribed
  • Patients should carry two in-date AAI devices at all times
  • Patients and their carers should be trained on their particular device, as injection technique varies between brands (Emerade®, Epipen®, Jext®)

In 2017, the MHRA issued updated advice after European review of AAI devices. Following an inquest in England into the death of a young adult from anaphylaxis, where a number of factors contributed to her death, including the supply of a single pen and lack of training, it is important to reinforce the key messages above that had been included in the MHRA advice.

Key actions for healthcare professionals involved in prescribing/dispensing AAI devices

Ensure that patients are educated including advising on the following:

  • It is vitally important patients carry two in-date AAI devices at all times. One dose to be administered and then a further dose administered after 5 – 15 minutes as required. An additional supply should be provided if needed, e.g. spare supply for school
  • Regular review of expiry dates on devices to ensure in-date supply always available - an expiry alert service may be available on some manufacturers’ websites
  • In view of recent shortages/recalls, for the most up-to-date information, please refer to NHS GGC Current Medicine Supply Problems and Shortages page on StaffNet
  • Encourage patients to seek advice from a healthcare professional if further advice on anaphylaxis, allergy management, or device-specific training is required
  • Patients and their carers can obtain and practise using a trainer device – available for free from the manufacturers’ websites

Further information
As doses may vary between brands, please refer to the relevant Summary of Product Characteristics for further information on each device:
Summary of Product Characteristics for Emerade®
Summary of Product Characteristics for EpiPen®
Summary of Product Characteristics for Jext®


Published 03/11/2020. Medicines Update blogs are correct at the time of publication.