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Use of epinephrine in the treatment of anaphylaxis

August 23, 2017

Anaphylaxis is a potentially life-threatening allergic reaction that may cause severe swelling, respiratory compromise (dyspnea, wheezing), hypotension, and possibly death. There are multiple ways to treat someone suffering from anaphylaxis. The most common course of treatment is the use of epinephrine.

Treatment of anaphylaxis using epinephrine and available products

Epinephrine is the first and most important treatment for anaphylactic reactions because it stimulates the alpha- and beta-adrenergic receptors, which increases vasoconstriction and bronchodilation.1 Epinephrine pens are indicated for the emergency treatment of allergic reactions (type I), including anaphylaxis, which may result from allergic reactions to insect stings, biting insects, foods, drugs, sera, diagnostic testing substances, and other allergens, as well as idiopathic anaphylaxis or exercise-induced anaphylaxis. There are multiple epinephrine products currently available on the market in 0.3 mg and 0.15 mg doses that are indicated for use as follows:

  • 0.3 mg: For adults and children over 30 kg;
  • 0.15 mg: For children between 15 kg and 29 kg.

The chart below shows the available epinephrine products, the formulary tier, and if prior authorization is required.

Epinephrine productFormulary tierPrior authorization required?
EpiPen®Preferred brandNot required
Epinephrine (generic for EpiPen®)*GenericNot required
Adrenaclick®Non-Preferred brandRequired
Epinephrine (generic for Adrenaclick®)* GenericNot required
Auvi-Q®Non-Preferred brandRequired

*If you wish to substitute the generic version, where available, you must note that substitution is allowed or write the chemical compound, epinephrine, on the prescription.

For additional information about pharmacy policies and programs, visit our website.

1Simmons, F Estelle, et al. ?World Allergy Organization Guidelines for the Assessment and Management of Anaphylaxis.? World Allergy Organization Journal. Available from: www.waojournal.org/content/4/2/13.


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