Know Your Epinephrine Auto-Injector Options and How to Use Your Device

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When the FDA approved Teva’s device as a generic version of the EpiPen, we received an overwhelming “Huh? I thought my [insert name here] is the generic?”

It’s true… the lingo can be confusing, but it’s important to know your options and how to use your device. Let’s clarify.

First, it’s important to know the proper name for the device that delivers emergency epinephrine in case of a reaction. Many people — including the press — often call this an EpiPen, but “EpiPen” is the brand name of an epinephrine auto-injector. It’s like calling a cotton swab Q-Tip or a lip balm Chapstick.

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An epinephrine auto-injector automatically delivers a dose of epinephrine when applied as directed and is administered in an emergency when anaphylaxis is suspected. It combines the functions of inserting the needle and delivering the epinephrine in a single step.

Now that we’ve got that straight, let’s step through the options:

EpiPen, EpiPen Jr

These are epinephrine auto-injectors manufactured by Pfizer and marketed by Mylan in 0.30mg and 0.15mg doses. They currently hold the largest market share but have often been in short supply due to manufacturing problems at Pfizer’s Meridian plant.
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Here’s a video showing how to use the EpiPen, EpiPen Jr, and Mylan’s Authorized Generics described in the next entry:

Mylan Authorized Generic for EpiPen, EpiPen Jr

These are identical to the EpiPen and EpiPen Jr but labeled as “generic” by Mylan. They are roughly half the price of the brand name devices and were introduced at the time Mylan was under fire for their pricing practices.
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Adrenaclick

This was the brand name version of an epinephrine auto-injector that has since been discontinued. It was marketed by Amedra which was acquired by Impax Laboratories which itself was acquired by Amneal Pharmaceuticals. See Impax below.

Impax (also Amneal or Lineage) Epinephrine Injection, USP Auto-Injector

This is the generic version of the Adrenaclick auto-injector for sale at CVS pharmacies et al, but known under different names due to numerous acquisitions. Though this is technically a generic, it does not work the same way as EpiPen; hence, it cannot generally be dispensed in place of EpiPen or Mylan’s Authorized Generic and must be filled using a separate prescription. This device is also manufactured by Pfizer and has been prone to shortages.
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Here’s a video showing how to use this auto-injector:

Auvi-Q

This is the rectangular auto-injector manufactured and marketed by Kaléo available in three dosages: 0.1mg, 0.15mg and 0.3mg. When activated, a voice prompt steps you through the administration process. It is principally available via mail order and at Walgreens pharmacies.
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Here’s a video showing how to use the Auvi-Q:

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Symjepi

This device is a prefilled syringe, not a true auto-injector. It requires you to insert the needle, then press the plunger to administer the epinephrine. The device was approved by the FDA in 2017 and may be more appropriate for use by trained individuals such as nurses, emergency responders, and adults.
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Here’s a video showing how to use the Symjepi:

Teva Generic for EpiPen, EpiPen Jr

This is the device marketed by Teva that was approved by the FDA in 2019. It functions similarly to the EpiPen and as such is the first FDA-approved generic for EpiPen other than Mylan’s generic.
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Here is a video showing how to use the Teva generic for EpiPen:

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For specific advice on which device you currently own or which you should consider the next time you are scheduled to refill, please consult your pharmacist or allergist.

Still confused? That’s totally understandable given all the above. If nothing else, here are a few important points to remember:

  • When you talk about the device in general, use the term epinephrine auto-injector. When you talk about Mylan’s device in particular, use the term EpiPen.
  • The public and the press often use the brand name EpiPen to refer to auto-injectors in general. This is not correct but something to keep in mind.
  • Your allergist may have a preference for prescribing a particular brand of epinephrine auto-injector which may not be the best choice for your particular lifestyle and circumstances. We suggest you research the various brands and discuss your preference with your doctor.

Most importantly, remember: the sooner epinephrine is administered when anaphylaxis is suspected, the better the outcome. Always take two epinephrine auto-injectors everywhere, every time!

Note of disclosure: Kaléo is an advertiser with SnackSafely.com.
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Dave Bloom
Dave Bloom
Dave Bloom is CEO and "Blogger in Chief" of SnackSafely.com.

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