EpiPen? Generic? Impax? Auto-Injector? Sorting through the lingo

Confused

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

It’s true… the lingo can be confusing, so let’s sort through the names so we’re all on the same page.

First, let’s discuss 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 similar to calling a cotton swab a Q-Tip or lip balm Chapstick.

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An epinephrine auto-injector automatically delivers a dose of epinephrine when applied as directed. It combines the steps of inserting the needle and delivering the epinephrine in a single step.

Now that we’ve got that straight, let’s define all the names:

  • 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 are in short supply due to manufacturing problems at Pfizer’s Meridian plant.
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  • 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 has since been acquired by Impax Laboratories.
  • Impax Epinephrine Injection, USP Auto-Injector – this is the generic version of the Adrenaclick auto-injector for sale at CVS pharmacies et al. Though this is 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 recent shortages.
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  • 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.[Click here for website]
  • 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 last year and is more appropriate for use by trained individuals such as nurses, emergency responders, and trained adults. It is expected to hit the market in the coming months;
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  • Generic for EpiPen, EpiPen Jr – this is the device marketed by Teva and approved by the FDA last week. It functions similarly to the EpiPen and as such will be the first FDA approved generic for EpiPen. We expect this device to come to market fairly quickly as Antares – the company that manufactures the device – has been ramping up production in preparation for approval.
    [Website not yet available.]
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Still confused? That’s totally understandable given all the above. If nothing else, here are two important points to remember:

  1. 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.
  2. 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 look out for.

Whatever you call it, remember: the sooner epinephrine is administered when anaphylaxis is expected, the better the outcome.

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