STATEMENT: Update to Instructions for Use of
Epinephrine Autoinjectors
February 7, 2017
The US Food and Drug Administration (FDA) has recently updated the patient instructions for
epinephrine autoinjectors. The FDA recommends that the leg be held firmly in place
during the injection, and that the epinephrine pen be held in place for about 3 seconds
(instead of 10 seconds).
In young children, injections of epinephrine into the thigh can result in bent or embedded
needles, especially if the child is moving or uncooperative during the injection. The rationale for
the shortened injection duration is that it will decrease the likelihood of injury to a moving or
uncooperative child.
The American Heart Association (AHA) agrees with this change and will update our
instructions for epinephrine autoinjector use for all ages as shown below:
· Hold the leg firmly in place.
· Press the tip of the injector hard against the side of the person’s thigh, about halfway
between the hip and the knee.
· Hold the pen in place for about 3 seconds.
The AHA will include this change in future materials and communications.
We encourage healthcare providers to refer to their local medical control physicians for
guidance and treatment protocols.