Los Angeles Allergist

Los Angeles Allergist

Alan Khadavi, MD, APC
  • Home
  • Meet Dr. Khadavi
  • Conditions We Treat
  • Your First Visit
  • Insurance Accepted
  • Allergy and Asthma Info
    • Asthma Info
    • Allergic Rhinitis
    • Allergic Triggers
  • Blog
  • Media
  • Contact Us

9001 Wilshire Blvd. Suite 204
Beverly Hills, CA 90211
Phone: 310-282-8822

16260 Ventura Blvd., Suite 140
Encino, CA 91436
Phone: 818-528-7776

November 3, 2017 by Alan Khadavi

EpiPen Failure, can epinephrine injectors improve?

The FDA has reported 228 complaints and 7 deaths this year for possible Epipen failure.  The FDA received 4 complaints in 2012 for Epipen failure.  They also reported 35 cases of hospitalizations.  The FDA warned: “There is no certainty that the reported event … was due to the product.”

Epipen Failure News Link

Food related anaphylaxis is increasing, particularly in young children.  The prevalence of food allergy in 2010 was as high as 8% in children younger than 18 years.  A most recent study of children 6 months to 18 years of age suggests that emergency room visits for food related anaphylaxis continues to increase.

Intramuscular epinephrine is recommended as the therapy of choice for anaphylaxis.  In the event of an allergic emergency, treatment in the thigh with injectable epinephrine is recommended.

Despite the knowledge that epinephrine can save lives, it may be underused by physicians, health care professionals, emergency medical services and patients.

Common features of fatal food anaphylaxis are reactions to peanuts or tree nuts, history of food allergy or asthma, and failure to administer epinephrine promptly.  A mild previous reactions does not always guarantee that future reactions will also be mild.

Two doses of epinephrine may be required in approximately 20-36% of cases of anaphylaxis.  When one dose is not effective, a patient carrying 2 injectors can administer a second dose while waiting for emergency medical services.

There are multiple epinephrine autoinjectors on the market now.  All of them are not the same and have different attributes.  Current ones on the market are Epipen, Auvi-Q, Adrenaclick and Symjepi.

Auvi-Q to return to market

Symjepi a cheaper alternative to Epipen, FDA Approved

Anapen

Injuries have occurred in children using Epipen, primarily toddlers.  Lacerations to the leg, embedded needles have been reported.  Data suggests that a new device, one with a shorter needle length, may be necessary to ensure safe injections in children weighing less than 15 kg.  A device with shorter, autoretractable needles may prevent unintended injuries in younger patients.

The following is a list of a few products on the horizon in the US and features that will help improve epinephrine autoinjectors.

  • Smaller devices and more portable (Adrenacard, Abiliject, Epi-Bracelet)
  • Needless injections, sublingual
  • Needle lengths appropriate for individual patient needs
  • 2 injections within 1 device
  • 0.1 mg dose for infants
  • 0.5 or 0.75 mg dose for larger adults
  • Better temperature stability and longer shelf life
  • Impact and weather-resistant casing
  • More intuitive and easier to use
  • Less expensive

Speak to your allergy doctor to see which epinephrine autoinjector is best for you.  All patients should have 2 of them and get regular device training.  Increased vigilance for anaphylaxis in younger age groups and public education by allergy doctors is necessary to combat this increasing health care issue.

Filed Under: Anaphylaxis, Blog

alan-khadavi
Dr. Alan Khadavi
Allergy & Asthma Specialist

Latest Posts

May 31, 2023

Understanding Yeast Allergy, am I Allergic to Yeast?

yeast allergy

May 23, 2023

Neffy, a New Epinephrine Nasal Spray

neffy

May 19, 2023

Broccoli Allergy: An Emerging Concern in Allergy

broccoli allergy

May 16, 2023

Xolair vs. Nucala vs. Dupixent in Asthma, which is the best?

Xolair vs. Nucala vs. Dupixent

May 10, 2023

Garlic Allergy, An Overview and its Benefits

garlic allergy

May 4, 2023

Oat Allergy: Symptoms, Diagnosis, and Treatment

oat allergy

May 3, 2023

Rice Allergy Overview, all you need to know

rice allergy

April 11, 2023

Banana Allergy Can Come in Many Flavors

banana allergy

April 9, 2023

Eggplant Allergy, an uncommon food allergen

eggplant allergy

April 7, 2023

Corn Allergy: Causes, Symptoms, and Treatment

corn allergy

Read More Posts...

Follow Us…

© 2023 Allergy Los Angeles. All Rights Reserved · Log in · Return to top of page