Lifesaving Drug Out of Reach

Do you carry an Epipen, or another type of self-injectable epinephrine? Such devices are unavailable for adults and children in many countries. It's also completely unavailable in doses for infants, no matter where you live.

Findings published in the May 2005 Annals of Allergy, Asthma & Immunology (the scientific journal of the American College of Allergy, Asthma and Immunology or ACAAI) state that many parts of the world have no supply of epinephrine auto-injector kits. This is a serious risk for those with anaphylaxis, a life-threatening allergic reaction.

Anaphylaxis is a body-wide reaction to an allergen. The symptoms most associated with anaphylaxis are the swelling of the tongue and airways. This can result in asphyxiation and death. Epinephrine injections are the first-line therapy for anaphylaxis.

Epinephrine auto-injectors, for emergency self-treatment of anaphylaxis, are available and widely used throughout the United States, Europe, Canada and Australia. However, this contrasts significantly with unavailability in Asia, South America and Africa. Cost is the main factor that affects availability in these countries, as the purchase price is often as high as a month's salary.

Just because you live in an area where epinephrine auto-injectors are available, doesn't mean that you're not at risk. If you develop an anaphylaxis episode when traveling internationally and use your epinephrine, you may not be able to obtain prescription refills, depending on where you are travelling.

Epinephrine injected by an auto-injector in the upper thigh is standard during emergency self-treatment of anaphylaxis. However, women may inadequately administer epinephrine. This can result in an insufficient dosage getting into the intramuscular area (the muscle tissue where it's properly absorbed into the bloodstream), because the distance from skin to muscle in the thigh is often greater in females compared to males. In fact, auto-injector needles in brands like Epipen may not even be long enough. Therefore, if the needle is too short, the drug is likely to be delivered subcutaneously (under the skin and inside the fat layer). Obesity could also affect a person's ability to get epinephrine delivered intramuscularly.

News Release, May 23, 2005
Source: American College of Asthma, Allergy and Immunology (ACAAI)

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