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Who uses an EpiPen?
EpiPens are first aid treatment for anaphylaxis, a potentially life threatening allergic reaction that affects a person's breathing and blood pressure.
EpiPens deliver a single shot of adrenaline to reverse the symptoms of anaphylaxis. Allergy sufferers who experience an anaphylactic allergic reaction need to call an ambulance immediately and go to hospital, both for further treatment and to be under observation for at least four hours.
Why is there a shortage?
Australian supplier Mylan says the US manufacturer Pfizer is responsible for the supply shortage. Pfizer puts the delay down to a problem with the autoinjector's components – one that's caused production delays for months.
Pfizer tells CHOICE the shortage has to do with a third-party component, as well as changes made to its manufacturing facility. "At this time, we cannot commit to a specific time for when the supply constraint will be fully resolved," a spokesperson says.
The company is advising people to fill their prescriptions closer to expiration dates to help them manage EpiPen supply over the next few months.
What happens if I have an attack?
If you don't have an EpiPen on hand, immediately call 000 – or better yet, have someone with you make the call.
Follow your ASCIA action plan that you've developed with your doctor, and either sit or lay down on the ground with your feet outstretched in front of you. Don't stand up or sit on a chair, as this could cause a sudden drop in blood pressure.
If you're having a severe allergic reaction, Allergy & Anaphylaxis Australia recommends that you follow your ASCIA action plan:
- sit or lie down on the ground
- use the EpiPen on your outer mid-thigh
- call for an ambulance
- (if the symptoms persist and it's needed) take a second EpiPen five minutes after the first.
You'll need to go to hospital for further treatment and remain under observation for at least four hours.
Can I use an expired EpiPen?
Most allergy sufferers will have an EpiPen on hand, even if it's an expired one.
EpiPens have a one- to two-year shelf life before they expire. It's not ideal, but consumer allergy groups and pharmacists recommend people use their expired EpiPens if necessary during the shortage.
These adrenaline autoinjectors do become less effective over time, but the consensus is an expired EpiPen is better than not having one to use at the time of an attack.
If all of your EpiPens have expired, use the most recent one. Be sure to check the expiration date on the EpiPen itself and not on the box as they may differ.
You can gauge the quality of an EpiPen by checking the clear window near its tip. The adrenaline should be transparent – free from sediment and discolouration – for it to be most effective.
How long do I have to wait for a replacement EpiPen?
After leaving your prescription with a pharmacist, it takes between a couple of days to two weeks for an EpiPen to arrive.
The pharmacists we spoke to say they haven't had EpiPens in stock for months. Before the shortage, pharmacies would typically stock two EpiPens at any time, with replacement stock being delivered daily.
The shortage has been going on for how long?
The government's Therapeutics Goods Administration (TGA) says EpiPens have been in short supply since January 2018.
Initially orders were not being fulfilled at all, forcing people to visit different pharmacies in the hope they could find untapped stock. Supply has marginally improved, with an ordering system delivering EpiPens to the people who need an EpiPen the most.
Has the shortage been linked to any deaths or serious injuries?
The shortage has not been linked to any deaths or serious injuries in Australia, a Department of Health spokesperson told CHOICE.
We asked manufacturer Pfizer if it has contributed to any deaths or injuries globally, but the company chose not to address the question.
Can I reuse an EpiPen?
EpiPens can only be used once – even if there's some adrenaline still in the device. After use, they should be placed in a container, marked with the time it was administered and handed over to ambulance staff.
Does the shortage affect EpiPen Junior autoinjectors?
EpiPen Junior autoinjectors are not experiencing a stock shortage.
Are there any alternatives to an EpiPen?
We're one of the few countries that don't have an alternative adrenaline autoinjector, along with Canada, which makes us more vulnerable to the ongoing shortage as people don't have a substitute.