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 product | Formulary
tier | Prior authorization required? |
EpiPen® | Preferred
brand | Not required |
Epinephrine (generic for EpiPen®)* | Generic | Not required |
Adrenaclick® | Non-Preferred brand | Required |
Epinephrine (generic for Adrenaclick®)*
| Generic | Not required |
Auvi-Q® | Non-Preferred
brand | Required |
*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.