MHRA Issues New Guidance on Use of Adrenaline Auto-Injectors

Today marks the start of World Allergy Week, an annual initiative led by the World Allergy Organization, aiming to raise awareness of allergies, their management and prevention. With over 20% of the UK's population affected by at least one allergy, adrenaline auto-injectors (AAIs) are an important healthcare product used for those at risk of anaphylaxis and can save lives.

AAIs in the UK include Epipens or Jext products, and are prescribed for those at risk of anaphylaxis.

According to NHS Digital's Hospital Episode Statistics (2021), over the last 20 years, there has been more than 100% increase in the rate of hospital admissions due to allergies and anaphylaxis in the UK, with almost 30,000 admissions per year.

Anaphylaxis can be fatal and it can develop suddenly at any age, even to substances that have previously been safe. The steps taken in response can mean the difference between life and death.

The Commission on Human Medicines (CHM), the independent body that advises the government on the safety, efficacy and quality of healthcare products, formed the Adrenaline Auto-injector Expert Working Group (AAI EWG), to provide advice and guidance to better inform patients, healthcare professionals and the wider public about the importance and life-saving potential of AAIs.

That's why the MHRA has collaborated with allergy awareness advocates to share an easy step-by-step infographic guide and

outlining the latest advice from the CHM's working group on the safe and effective use of AAIs.

Steps people should take in an anaphylaxis emergency

1. Use your AAI without delay

  • If you have any signs of anaphylaxis, use your AAI immediately.
  • Signs may include swelling in the throat or tongue, wheezing or breathing difficulty, dizziness, tiredness and confusion.
  • If in doubt, use it.

2. Immediately dial 999

  • Say anaphylaxis ("ana-fill-axis")

3. If you are not already lying down, then do so

  • Lie down flat and raise your legs (if you're pregnant, lie on your left side). This will assist blood flow to the heart and vital organs.
  • Stay lying down even if you feel better

4. Use your second AAI if you haven't improved after 5 minutes

  • You should carry two AAIs at all times.
  • Check the expiry dates! See a pharmacist if you need a replacement!

By being better informed, it is hoped that people with allergies are supported to better survive anaphylaxis with less serious consequences, even if they have never experienced anaphylaxis before, and that those without allergies know what to do if they see someone who needs help.

Julian Beach, Deputy Director of Population Health at the MHRA said:

For people experiencing anaphylaxis, either first hand or in the company of a loved one, it can be a scary and uncertain time.

AAIs are an important and potentially life-saving healthcare product, giving people experiencing anaphylaxis precious time before the emergency services arrive.

Knowing how to use AAIs and what to do in an emergency is vital and so I encourage everyone to review the latest guidance and download these materials so they can be prepared.

The MHRA will be sharing posts on its social channels throughout the week, with information on AAIs and anaphylaxis, using the main awareness week hashtag, #worldallergyweek.

Simon Williams, Chief Executive of Anaphylaxis UK said:

People living with allergies often fear the worst and many of the people we work with have extreme anxiety doing things like eating out and traveling, that others may take for granted.

We hope that by collaborating with the MHRA and allergy awareness advocates, we can raise awareness for people with and without allergies, so everyone knows what to do during anaphylaxis.

By educating about allergies, anaphylaxis and what to do in an emergency, we hope to help people feel more confident going about their daily lives.

Steve Barclay, Secretary of State for Health and Social Care said:

A severe allergic reaction can be life-threatening. One in five people in the UK suffer with at least one allergy, so it's vital people are equipped with the knowledge to keep themselves safe.

Adrenaline auto-injectors - also known as AAIs or by their brand names such as EpiPen - are highly effective and convenient for the immediate treatment of anaphylaxis. If you have been prescribed one, please carry it with you at all times and make sure you are up to date on the latest safety guidance - it could save your life.

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