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Recall of Emerade 300 and 500 microgram adrenaline auto-injector devices

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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 auto-injectors 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 auto-injectors, keep them 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 auto-injectors (AAIs) 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 auto-injectors are available?

The brands of adrenaline auto-injector available in the UK are:

EpiPen®

EpiPen® is available in two doses:

  • Adult: 0.3mgs of adrenaline
  • Junior: 0.15 mgs of adrenaline (suitable for children weighing 5kgs – 25kgs / 1 stone 3lbs – 3 stone 13lbs)

EpiPen website

Jext®

Jext® is available in two doses:

  • Adult: 300 mcg of adrenaline
  • Junior: 150 mcg of adrenaline (suitable for children weighing 15kgs – 30kgs / 4 – 4.5 stone)
Jext® offer a mobile phone app which includes step-by-step instructions and tools for travelling abroad.

Jext website

Emerade®

Emerade® is available in 3 doses:

  • Adult: 500 mcg of adrenaline (suitable for adults over 60kg)
  • Adult: 300 mcg of adrenaline
  • Junior: 150 mcg of adrenaline (suitable for children weighing 15kgs – 30kgs/ 2.4 – 4.5 stone)

Emerade website

Always carry two

If you have been prescribed adrenaline you should carry two in-date AAIs 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 auto-injectors 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 auto-injectors

Adrenaline auto-injectors 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 AAI. Plus find help and training videos on the manufacturer’s website and get a free trainer device to practise with.

They are designed to be given into the middle of the outer thigh (upper leg). This can be through clothing if needed.

Who should learn how to use the adrenaline auto-injectors?

Everyone who might need to give you or your child adrenaline in an emergency should also learn how to use your AAIs. 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 auto-injector straight away if you have any of the ABC symptoms.

Anaphylaxis (anna-fill-axis) 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.

The ABC symptoms can include:
  • right_arrow_orange_icon AIRWAY - swelling in the throat, tongue or upper airways (tightening of the throat, hoarse voice, difficulty swallowing).
  • right_arrow_orange_icon BREATHING - sudden onset wheezing, breathing difficulty, noisy breathing.
  • right_arrow_orange_icon CIRCULATION - dizziness, feeling faint, sudden sleepiness, tiredness, confusion, pale clammy skin, loss of consciousness.
Read more about anaphylaxis

Other symptoms

Other symptoms that might be present include:

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

 

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 auto-injector 5 minutes after the first.

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Positioning your body

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 your heart and vital organs. If you’re struggling to breathe you may need to be propped up, but this should be for as short a time as possible.

Avoid any sudden change in posture. Don’t stand up or sit in a chair even if you are feeling better as this could lower your blood pressure dramatically, causing your heart to stop.

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 auto-injectors 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 four plans available; a generic plan for individuals assessed as not needing an adrenaline auto-injector, and a personal plan for individuals prescribed an EpiPen, Jext or Emerade.

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

Giving adrenaline in schools

Schools in the UK are able to buy spare adrenaline auto-injectors 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 auto-injectors, where medical authorisation and written parental consent have both been given.

Learn about our work in our Safer Schools Programme

Adrenaline FAQs

  • How many injectors should I carry?

    You should be prescribed two adrenaline auto-injectors 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 injection.

  • Does adrenaline have any risks?

    Some people worry that adrenaline may be harmful, but evidence shows auto-injectors are relatively 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 auto-injectors?

    Keep your auto-injectors in their original containers to stop light getting to them. Do not store them above 25°C and do not freeze them or keep them in the fridge. Check your devices often to make sure the liquid is clear and colourless. If the liquid is discoloured or contains particles, replace the devices.

Key messages

  • Adrenaline is the first line of treatment for anaphylaxis.
  • If you’re prescribed adrenaline auto-injectors, keep two 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 auto-injectors. 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