The UK’s Medicines and Healthcare Products Regulatory Agency (MHRA) advised in June 2014 and more recently in August 2017 that anyone who is at risk of suffering anaphylaxis should always have at least two adrenaline injector devices immediately available for use. The MHRA report said: “It is acknowledged that in some cases, a single injection is not sufficient to achieve a response for a number of reasons, including severity of attack as well as the possibility that a dose has not been effectively administered; a second injection may therefore be needed.” Anaphylaxis UK supports this view.
In cases where the risk of anaphylaxis is thought to be low, there is a difference of opinion among members of the medical community. While some doctors agree that two injectors must always be immediately available (in line with the MHRA report), others believe it is sufficient to have one device available, arguing that one injection is likely to be enough to treat the symptoms until emergency medical help arrives.
In August 2017 The European Medicines Agency (EMA) recommended several measures, including updating the educational material produced by distributors, to ensure that patients and carers use AAIs successfully. The recommendation includes information for patients and for healthcare professionals. The information for healthcare professionals includes a recommendation to prescribe 2 auto-injectors, which patients should carry at all times. Read their recommendation here: https://assets.publishing.service.gov.uk/media/5996e7aced915d57445311a3/AAI_patient_advice_sheet_August_2017.pdf
Anaphylaxis UK actively campaigns for people to be prescribed two AAIs.