Auvi-Q 0.1 mg is being used for children weighing 16.5 to 33 pounds. In a previous post we discussed this when it first came out.
The Auvi-Q 0.1 mg has a smaller needle length and there is less risk of hitting a bone, which could result in other complications. A recent study was published in the Annals of Allergy, Asthma and Immunology studying the various needle lengths of different epinephrine auto-injectors and to investigate what the best needle length should be.
The needle length is very important in treating anaphylaxis, the injection should be given in the muscle (intramuscular) for maximum efficacy. If a needle is too short, it would be a subcutaneous injection rather than an intramuscular injection. But if a needle is too long, it could hit the bone, causing its own problems. In a previous blog post, we discussed the various issues that epinephrine auto-injectors have.
The main conclusion of the study showed that compared with Epipen Jr, the Auvi-Q 0.1 mg for children weighing less than 33 pounds (15 kg), had a low risk of injection into the bone, but a very high risk of subcutaneous injection.
These are the current epinephrine auto injector recommendations based on weight.
• Patients ≥30 kg (≥66 pounds): 0.3 mg
• Patients 15 to 30 kg (33 to 66 pounds): 0.15 mg
• Patients 7.5 to 15 kg (16.5 to 33 pounds): 0.1 mg
- Patients ≥30 kg (≥66 pounds): 0.3 mg Epipen Auto Injector
- Patients 15 to 30 kg (33 to 66 pounds): 0.15 mg EpiPen Jr.
Epipen has only 2 doses, but if you have a child that weighs less than 33 pounds and all you have is an EpiPen Jr. who has anaphylaxis, it is important that you use it right away. Although it is preferable to use the Auvi-Q 0.1 mg, it should not preclude you to using it during an anaphylactic emergency. Before Auvi-Q 0.1 mg came out, EpiPen Jr. was routinely prescribed and used in children weighing less than 33 pounds.