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About adrenaline

Adrenaline is also known as epinephrine, which is its international name. They are the same drug.

Adrenaline acts quickly to reverse the symptoms of anaphylaxis. It opens up the airways by reducing swelling and raises blood pressure. It needs to be given as soon as possible when there are any signs of a serious allergic reaction. Serious symptoms are easier to reverse when they’re treated early.

Sometimes people use antihistamines first to put off or avoid using adrenaline, but you should use adrenaline first if you think the reaction is anaphylaxis.

Learn more about anaphylaxis

Download our adrenaline factsheet

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Do I need to carry adrenaline?

You might be prescribed adrenaline if you are at higher risk of a serious allergic reaction.

If you have had an allergic reaction, see your GP who can refer you to a specialist allergy clinic if needed. They can find a clinic in your area from the British Society for Allergy and Clinical Immunology (BSACI).

It’s important to get a referral even if your symptoms were mild because it can be hard to tell if future allergic reactions could be more serious and if you could be at risk of anaphylaxis.

Doctors should do a thorough assessment before prescribing adrenaline. This is best done at a specialist allergy clinic or by a GP who has had specialist training in allergy management.

Sometimes, when there is a long wait to see an allergy specialist, your GP may prescribe adrenaline as a precaution whilst you wait to be assessed. The prescription may or may not need to be continued once you have seen the specialist.

If you are prescribed adrenaline, keep two devices with you at all times in case of an emergency.

adrenaline for allergies advice
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Who should adrenaline be considered for?

Your doctor will consider prescribing you adrenaline if you:

  • have had anaphylaxis where the cause is unknown (called idiopathic anaphylaxis).
  • have had anaphylaxis where the cause is known but it’s not easy to avoid the allergen, for example if you have a peanut allergy.
  • have had a reaction in response to tiny amounts (trace amounts) of the allergen.
  • have Food-Dependent Exercise-Induced Anaphylaxis (FDEIA), where you are likely to have an allergic reaction to certain foods if you eat the food around the time of physical exercise.
  • have other significant risk factors, such as asthma, if you have a food allergy.
  • spend significant amounts of time in a location without access to emergency medical care.

 

You might not need to carry adrenaline in the long-term if you can easily avoid the allergen that affects you. For example, if you have an allergy to medicines.

Learn more about anaphylaxis

What adrenaline devices are available?

Current options for adrenaline treatment in the UK include:

EpiPen®

EpiPen® is available in two doses:

 

  • Adult: 0.3mgs (300mcg) of adrenaline – for adults and children weighing 25kg (3 stone 13lbs) or more.
  • Junior: 0.15mgs (150mcg) of adrenaline –  suitable for children weighing 7.5kgs – 25kgs (~1 st 3lbs – 3 st 13lbs).

EpiPen website

Jext®

Jext® is available in two doses:

 

  • Adult: 300 mcg (0.3mg) of adrenaline – for adults adults and children weighing 25kg (3st 13lbs) or more.
  • Junior: 150 mcg (0.15mg) of adrenaline –  suitable for children weighing 15kg – 24kg (2st 5 lbs – 3st 13lbs).

Jext website

EURneffy®

EURneffy® is a nasal adrenaline spray.

 

It is only available in one dose:

 

2mgs of adrenaline for the use of adults and children with a body weight of 30 kg or more for the emergency treatment of severe allergic reactions, including anaphylaxis.

EURneffy website

Always carry two

If you have been prescribed adrenaline you should carry two in-date devices with you at all times. You need two in case one misfires or you need a second dose.

Make sure your device is in date

Adrenaline devices have a use-by date so make sure you ask your GP for replacements at least one month before they expire.

The manufacturers also have an expiry alert service. If you register your devices and the expiry date, they will send you a reminder when it is due to expire:

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How to use your adrenaline devices

Adrenaline devices are designed to be used by yourself or by someone helping you. They are made to be easy-to-use by anyone without needing medical training, but it is still important to learn how to use them and practice often so you know what to do in an emergency.

Ask your healthcare professional to show you how to use your specific brand of adrenaline. Plus find help and training videos on the manufacturer’s website and get a free trainer device to practise with.

 

Who should learn how to use the adrenaline?

Everyone who might need to give you or your child adrenaline in an emergency should also learn how to use your device. This may include family members and colleagues, or school and nursery staff if the adrenaline is for a child.

When should you give adrenaline?

Use your first device straight away if you have any of the ABC symptoms.

Anaphylaxis (ana-fil-ax-is) is a serious allergic reaction that develops quickly and can sometimes be life threatening, so it needs to be treated quickly.

Most healthcare professionals consider an allergic reaction to be anaphylaxis when it involves difficulty breathing or affects the heart rhythm or blood pressure. Any one or more of the following symptoms may be present – these are often referred to as the ‘ABC’ symptoms.

In extreme cases there could be a dramatic fall in blood pressure. The person may become weak and floppy and may have a sense of something terrible happening. Any of the ABC symptoms may lead to collapse and unconsciousness and, on rare occasions, can be fatal.

More serious symptoms are often referred to as the ABC symptoms and can include:
  • right_arrow_orange_icon AIRWAY - swelling in the throat, tongue or upper airways, hoarse voice, difficulty swallowing
  • right_arrow_orange_icon BREATHING - sudden onset wheezing, breathing difficulty, noisy breathing, persistent cough
  • right_arrow_orange_icon CIRCULATION - dizziness, feeling faint, sudden sleepiness, confusion, pale clammy skin, loss of consciousness or collapse
Read more about anaphylaxis

Other symptoms

Mild to moderate symptoms may include: 

  • a red raised itchy rash (known as hives or urticaria) anywhere on the body  
  • swelling of the face, lips and/or eyes  
  • a tingling or itchy feeling in the mouth 
  • mild throat tightness 
  • stomach pain, vomiting or diarrhoea 

 

These symptoms can also happen on their own. If you don’t have the ABC symptoms, the reaction is likely to be less serious and is not the same as anaphylaxis, but watch carefully in case ABC symptoms develop.

If your symptoms don’t improve or get worse, use your second adrenaline device 5 minutes after the first.

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Positioning your body (using adrenaline)

The position of your body is important when you suspect anaphylaxis. Lie down on your back with your legs raised to help the blood flow to the heart and vital organs. If you’re having difficulty breathing, you can be propped up with legs stretched out straight.

Stay in this position until help arrives. Do not stand up, walk or run, even if you start to feel better.

Movement can make symptoms worse and cause a sudden drop in blood pressure.  

Read more about what to do in an emergency

Allergy action plans

Your doctor or allergy specialist should give you a written allergy action plan. This should be tailored for you or your child and will include advice on when to use the adrenaline and what to do in an emergency.

Allergy Action Plans for children

The British Society for Allergy and Clinical Immunology (BSACI) produce template Allergy Action Plans for children. There are three plans available; a generic plan for individuals assessed as not needing adrenaline, and a personal plan for individuals prescribed EpiPen, Jext or EURneffy.

Download the BSACI Allergy Action Plans here

Allergy Action Plan for adults

Anaphylaxis UK has developed a template Allergy Action Plan suitable for adults.

Download our Allergy Action Plan for adults here

EURneffy® Action Plan

You can access a template EURneffy® Action Plan suitable for people who have been prescribed EURneffy®. This document should be completed by a suitably trained healthcare professional.

Download our EURneffy® Action Plan here

Giving adrenaline in schools

Schools in the UK are able to buy spare adrenaline auto-injectors (AAIs) without a prescription. These are to use in emergencies to treat children who are at risk of anaphylaxis but whose own device is not available.

School staff can give adrenaline to a child, using the spare device, in the event of anaphylaxis.

Learn about our work in our Safer Schools Programme

Adrenaline FAQs

  • How many devices should I carry?

    You should be prescribed two adrenaline devices to carry at all times. You may need to use a second one if symptoms don’t improve or get worse 5 minutes after the first dose.

  • Does adrenaline have any risks?

    Some people worry that adrenaline may be harmful, but evidence shows adrenaline devices are safe as long as they are used correctly.

  • Does adrenaline interact with other drugs?

    Anaphylaxis may be made worse by beta-blockers (used to control heart rhythm, treat angina and reduce high blood pressure) as these drugs make adrenaline less effective. Other drugs may also not be suitable if you have been diagnosed with anaphylaxis. Discuss this with your GP or allergy specialist.

  • How do I store my adrenaline?

    • Adrenaline auto-injectors (AAIs): AAIs like EpiPen and Jext should be stored at room temperature, ideally between 15-25°C, and kept in their original protective cases to shield them from light. They must never be refrigerated, frozen, or exposed to extreme heat—avoid leaving them in hot cars or direct sunlight. Regularly check that the solution inside remains clear and replace the device if it becomes discoloured or goes past its expiry date.

     

    • EURneffy intranasal adrenaline should be stored at room temperature, ideally between 20°C and 25°C. Do not freeze the device. The spray can be kept at higher temperatures temporarily but avoid prolonged exposure to extreme heat or cold. EURneffy does not require any special storage conditions like refrigeration and should be kept out of reach of children. Always check the expiry date and replace the spray if it is past that date or if you suspect damage.

Key messages

  • Adrenaline is the first line of treatment for anaphylaxis.
  • If you’re prescribed adrenaline, keep two devices with you at all times in case of an emergency.
  • If you’re not sure if your reaction is serious, play it safe and use adrenaline. Serious symptoms are easier to reverse when they’re treated early.
  • Make sure you know how to use your adrenaline device. The doctor who prescribed them should show you how to use them or arrange training for you and your family.
  • Make sure you have an Allergy Action Plan which tells you how to recognise a serious reaction and what to do in an emergency.

Download our adrenaline factsheet

Download Now