Epinephrine autoinjectors: Who gets it and why?

Published Online: September 3, 2013

Epinephrine autoinjectors are commonly prescribed for patients at risk for anaphylaxis, including those with food allergies and insect sting allergies. However, epinephrine autoinjectors are also prescribed for other diseases. In a study by Agarwal and Wang published in The Journal of Allergy and Clinical Immunology: In Practice, the prescribing patterns for epinephrine autoinjectors within an urban adult population attending the internal medicine practice at a large tertiary care hospital were examined.  

1.6% of the population was prescribed epinephrine autoinjectors. The most common indications for the epinephrine autoinjectors were food allergy (57%) and angioedema (9%). Additional diagnoses associated with the epinephrine autoinjector prescriptions included hives, insect sting allergy, asthma, allergen immunotherapy, drug allergy, idiopathic anaphylaxis and radio-contrast allergy. The authors noted that 4.5% were prescribed a suboptimal dose of epinephrine autoinjector and only about 2/3 of patients who received epinephrine auotinjector prescriptions were referred to an allergy specialist for further evaluation and management.  

These results indicate that clinicians should regularly evaluate the indications and dosing for epinephrine autoinjectors and consider referral to an allergy specialist for confirmatory testing and management guidance. Additional studies to explore prescribing patterns in larger populations and guidelines for clinicians would be beneficial as well.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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