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Published on 10 June 2014

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MHRA advice about adrenaline auto-injectors

The Medicines and Healthcare Products Regulatory Agency  has issued revised guidance for the prescribing and use of adrenaline auto-injectors (AAIs).

The Medicines and Healthcare Products Regulatory Agency  has issued revised guidance for the prescribing and use of adrenaline auto-injectors (AAIs).

People who have been prescribed an AAI because of the risk of anaphylaxis should carry two with them at all times for emergency on-the-spot use. After every use of an AAI, an ambulance should be called (even if symptoms are improving), the individual should lie down with their legs raised and, if at all possible, should not be left alone.

The Anaphylaxis Campaign welcomed this statement from the MHRA. It actively campaigns for people to be prescribed two AAIs and firmly recommends that once prescribed they should always be kept with the patient so they have access to them at all times. It also provides specialised training for patients/carers and healthcare professionals via its AllergyWise online courses.

The MHRA’s advice also includes the following key points:

Advice for people with allergies and their carers:

  • Carry two AAIs at all times. This is particularly important for people who also have allergic asthma as they are at increased risk of a severe anaphylactic reaction.
  • Use the AAI at the first signs of a severe allergic reaction.
  •  Take the following actions immediately after every use of an AAI:
  • Call 999, ask for an ambulance and state ‘anaphylaxis’, even if symptoms are improving.
  • Lie flat with the legs raised in order to maintain blood flow. If you have breathing difficulties sit up to make breathing easier.
  • Seek help immediately after using the auto-injector and if at all possible stay with the person while waiting for the ambulance.
  • If the person does not start to feel better, the second auto-injector should be used 5 to 15 minutes after the first.
  • Check the expiry date of the AAIs and obtain replacements before they expire. Expired injectors will be less effective.

Advice for healthcare professionals:

  • Ensure that people with allergies and their carers have been trained to use the particular auto-injector that they have been prescribed. Injection technique varies between injectors.
  • Encourage people with allergies and their carers to obtain and practise using a trainer device (available for free from the manufacturers’ websites).


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