Where is the Epipen injection site for anaphylaxis?

• Epipen (epinephrine injection) is given as an intramuscular (in the muscle) or subcutaneous (under the skin) injection only in the middle of the outer side of the thigh (the upper leg). It can be injected through clothing if needed.
• Do not inject into a vein, the buttocks, fingers, hands or feet.
• Get emergency medical help right away after the first dose. An EpiPen is NOT a substitute for emergency medical care.
• You may need to give a second dose, so it is important to keep two injections available at all times.

How do you administer Epipen (epinephrine)?

• If you are administering Epipen to a young child, hold the leg firmly in place while administering an injection.
• Place the orange tip against the middle of the outer thigh (upper leg) at a right angle (perpendicular) to the thigh.
• Swing and push the auto-injector firmly until it “clicks.” The click signals that the injection has started.
• Hold firmly in place for 3 seconds (count slowly 1, 2, 3).
• Remove the auto-injector from the thigh. The orange tip will extend to cover the needle. If the needle is still visible, do not attempt to reuse it.
• Massage the injection area for 10 seconds.

Get emergency medical help right away. Always have two doses of an epinephrine auto-injector available. A second dose may be needed if the allergic reaction lasts longer.

If you have life-threatening allergies, you should wear a medical alert identification necklace or bracelet to alert first-responders to your severe allergy.

Learn more: Where is the proper location to give an EpiPen injection? (detailed "Instructions for Use" and illustrations). Ask your healthcare provider how to give an EpiPen shot the first time it is prescribed.

When do you administer an EpiPen?

You administer EpiPen or EpiPen Jr injection right away when there is an allergic emergency (anaphylaxis). For example, this might occur with peanut exposure, a bee sting or with some medications. Severe allergic reactions may occur due to:

• Foods like eggs, shellfish, other seafood, tree nuts (like walnuts, pecans or cashews), grains, and milk
• Medicine: including penicillin-type drugs, "sulfa" antibiotics like Bactrim, NSAIDs, or lidocaine, allergy shots
• Insects, for example wasps like yellow jackets, paper wasps, and hornets, fire ants, and bees
• Certain X-ray contrast dyes like iodine or barium. Industrial/household chemicals like bleach.
• Latex rubber (may be found in medical devices, syringes, gloves)
• Exercise-induced anaphylaxis

Get emergency medical help by calling 911 right away. You may need further medical follow-up by a doctor. An EpiPen is NOT a substitute for urgent medical care by a healthcare provider.

You may also need to use a second EpiPen or EpiPen Jr if the allergic symptoms continue or recur. If more than 2 doses of EpiPen are needed for the same allergy emergency, only a healthcare provider should do this.

What is the route of administration for the EpiPen?

EpiPen and EpiPen Jr. can be given intramuscularly (into the muscle) or subcutaneously (under the skin). It is given in the middle of the outer thigh (upper leg) at a right angle (perpendicular) to the thigh. You can inject through clothing if necessary. Each EpiPen device only holds one dose of medicine (single-dose) and is for a single use only.

This medicine may come with a "trainer pen". The trainer pen contains no medicine and no needle. This will allow you to practice giving an epinephrine injection before an emergency occurs.

How long do you hold an EpiPen in place?

• Once the injection has started, firmly hold the autoinjector in place for 3 seconds (count slowly: 1, 2, 3).
• You can then remove the auto-injector from the thigh.
• Massage the injection area for 10 seconds.
• Get emergency medical help immediately.

What are the brand names for epinephrine?

Brand name epinephrine products include:

• EpiPen
• EpiPen Jr.
• Adrenaclick
• Symjepi
• Auvi-Q

Generics and authorized generics for epinephrine injection are also available. Ask your pharmacist for details and availability.

This is not all the information you need to know about EpiPen injection for safe and effective use and does not take the place of your doctor’s directions. Review the full EpiPen injection information and discuss any questions you have with your doctor or other health care provider.