EpiPen® and anaphylaxis factsheet

Introduction

An EpiPen® is a type of adrenaline autoinjector. It is an emergency device used to treat a severe allergic reaction called anaphylaxis.

Signs of anaphylaxis include: 

  • difficulty breathing 
  • wheezing 
  • swelling of the tongue and airways 
  • difficulty talking 
  • becoming pale and floppy 
  • your child feeling “strange” before symptoms show up. 

If your child has an anaphylactic reaction, use an EpiPen immediately if there is one available and call Triple Zero (000).

The EpiPen® is used to quickly inject a dose of adrenaline into a child’s leg muscle during anaphylaxis.

Adrenaline is a hormone that is made by the body. Adrenaline helps to reverse the symptoms of anaphylaxis very quickly by: 

  • opening the airways
  • raising blood pressure
  • reducing swelling.

 About the device

A photograph of an EpiPen.
The EpiPen® is a thick tube with a blue top and orange bottom. It comes in a bright yellow box with instructions and images printed on the label.

Children are more at risk of anaphylaxis if they have:

  • family members who have had anaphylaxis
  • asthma
  • eczema, also known as atopic dermatitis
  • other medical conditions like heart disease and breathing issues.

Children diagnosed with, or at high risk of an anaphylactic allergy will be prescribed an EpiPen® by their doctor. Families will work with the doctor to develop an allergy action plan and learn how to use the device. 

Using the device

Your child’s doctor will develop an action plan with you to use in an emergency.

Give the EpiPen® as your child has contact with their allergen or there are any signs of anaphylaxis. 

Signs of anaphylaxis include:

  • difficulty breathing 
  • wheezing 
  • swelling of the tongue and airways 
  • difficulty talking 
  • losing consciousness or passing out. 

Do not wait for symptoms to show up. It is always safer to use the EpiPen® even if you are unsure.

The steps to using the EpiPen® are:

  1. remove the EpiPen® from the container, form a fist around the EpiPen® and pull off the blue safety release cap from the top
  2. have yourself or another adult hold your child in place
  3. place the orange end of the EpiPen® against the middle of the outer thigh 
    (note: the EpiPen® can go through 1 layer of clothing, but not pockets or seams)
  4. push hard on the top of the EpiPen® until you hear a click
  5. hold in place for 3 seconds.

The orange end of the EpiPen® will look longer after it has been used because it is covering the needle. 

After using the EpiPen®, put it safely to the side and call Triple Zero (000) for an ambulance.

Tips for safely using an EpiPen® include:

  • use the rhyme “blue to the sky, orange to the thigh” to help place the pen
  • do not touch the orange tip of the EpiPen® with your fingers, thumb, or hand - this is where the needle is located.
  • do not “swing and jab” or “stab” the EpiPen® as this can cause the needle to come out before it hits your child’s thigh
  • do not try to remove your child’s clothing - the EpiPen® can go through 1 layer of clothing, but not pockets or seams.

 After using the device

Call Triple Zero (000) for an ambulance after using the EpiPen®, even if your child looks better.

Check your child for symptoms while you wait for the ambulance to arrive. 

If your child is still reacting five after the first EpiPen® is used, you can give a second EpiPen® if one is available.

Give the used EpiPen® to the paramedics when they arrive. Your child will be taken in an ambulance to the nearest hospital to be checked by a doctor. They will need to stay in the hospital for a minimum of 4 hours to make sure they do not have another anaphylactic reaction.

You can ask the doctor at the hospital to replace the used EpiPen® before your child is discharged home.

 Care of the device

EpiPen® prescription

Epipen® is a prescription device. The first Epipen® must be given by a specialist doctor like a paediatrician, allergist, or emergency specialist. 

Your child’s local doctor will need to work alongside your child’s specialist so they can write a prescription for a replacement Epipen® after the first one has expired or been used. 

There are two types of Epipen® available:

  • EpiPen® Jr for children between 7.5 and 20kg
  • EpiPen® for anyone over 20kg - generally six years of age and above.

Your child’s doctor will tell you what type of Epipen® to use if your child weighs under 7.5kg.

EpiPen® subsidy

In Australia, children and adults who need an EpiPen® can get a maximum of two EpiPens® for a lower cost under the Pharmaceutical Benefits Scheme (PBS).

Extra EpiPens® can be purchased for full price without a prescription from your local pharmacy or chemist.

EpiPen® storage

The EpiPen® needs to be stored in a cool place at room temperature. 

Do not refrigerate an EpiPen®.

Keep the EpiPen® in a place where it is readily available if your child needs to use it.

For younger children:

  • keep one EpiPen® in the daycare or preschool office
  • keep the second EpiPen® with a parent, carer or teacher who is with them throughout the day.

For older children and teenagers:

  • keep one EpiPen® in the primary or high school office
  • keep the second EpiPen® in a bag or pouch that is always with them throughout the day.

Never store an EpiPen® in a place that cannot be accessed quickly, like a school locker.

EpiPen® expiry

An EpiPen® will expire 12-18 months from the date it was made. The expiry date should be printed clearly on the box and the device.

Expired EpiPens® must be replaced as soon as possible. Do not throw away an expired EpiPen® until it has been replaced.

It is better to use an expired EpiPen® than no EpiPen® at all.

To make sure your child’s EpiPen® is always in-date:

  • write or save a date in the calendar a few days before the expiry date as a reminder
  • join the EpiClub to receive email or text reminders two months before the expiry date.

 Management

Side effects

The EpiPen® delivers a hormone called adrenaline into the body. Adrenaline is a natural hormone made by the body in response to stress. 

A sudden increase in adrenaline can cause:

  • shaking
  • anxiety
  • fast or fluttering heartbeats
  • headache
  • nausea.

Your child may also look more pale than usual.

These symptoms should go away once the adrenaline wears off.

Serious side effects from the EpiPen® are very rare. 

Anaphylaxis action plan

Families will work with their child’s doctor to develop an anaphylaxis action plan.

This plan tells people what to do if your child has an allergic reaction and when to give the EpiPen®. The action plan should be checked and updated regularly, and a copy should be kept:

  • with both of your child’s EpiPens®
  • on the mobile phones of parents and guardians
  • with the school or daycare and any other services your child goes to.

Your child must always carry their EpiPen® and action plan with them, especially when they are at risk of being exposed to their allergen.

An action plan template can be found under resources and more information.

EpiPen® trainer

An Epipen® trainer is a device used to help parents, carers, and children practice using the Epipen®. It does not contain a needle or adrenaline and is safe to use.

Epipen® trainers can be purchased at your local pharmacy or given by your child’s doctor.

Anaphylaxis and other medications

Do not use other medications like antihistamines or asthma relievers to treat anaphylaxis.

Anaphylaxis is a medical emergency and needs to be treated immediately. Using other medications can put your child at risk of death.

The adrenaline in the EpiPen® treats anaphylaxis fast and is safe for children.

Resources and more information

The Australian Society of Clinical Immunology and Allergy (ASCIA)

title
The Australian Society of Clinical Immunology and Allergy (ASCIA)

Biography
Provides resources including fact sheets, e-training and information on locating allergy specialists.
Related Links
Allergy & Anaphylaxis Australia - Your trusted charity for allergy support

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Allergy & Anaphylaxis Australia

Phone1300 728 000
Biography
Provides valuable updates and tips for dealing with food allergies.
Related Links
AllergyPal

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AllergyPal

Biography
AllergyPal is an app to help manage food allergies and provide carers with clear instructions on when and how to administer an adrenaline injector (e.g., EpiPen® or Anapen®).
Related Links
EpiClub®

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EpiClub®

Biography
Your registration with EpiClub® will enable quick and easy expiry reminders through SMS, email or post options to help you remember to renew your prescription before you pass the expiry date for your medication.
Related Links

Disclaimer

This factsheet is provided for general information only. It does not constitute health advice and should not be used to diagnose or treat any health condition.

Please consult with your doctor or other health professional to make sure this information is right for you and/or your child.

The Sydney Children’s Hospitals Network does not accept responsibility for inaccuracies or omissions, the interpretation of the information, or for success or appropriateness of any treatment described in the factsheet.

© Sydney Children’s Hospitals Network 2025


This factsheet was produced with support from John Hunter Children's Hospital.