Auvi-Q 0.15mg Inj 2 Auto Injectors
It is used to treat an allergic reaction.It may be given to you for other reasons. Talk with the doctor.
Drug Class
Anaphylaxis agent; Vasopressor
Pharmacologic Class
Alpha- and Beta-adrenergic agonist
Pregnancy Category
Category C
FDA Approved
Aug 2013
DEA Schedule
Not Controlled
Overview
What is this medicine?
Auvi-Q 0.15mg is an auto-injector containing epinephrine, a medicine used for emergency treatment of severe allergic reactions (anaphylaxis) caused by insect bites or stings, foods, medications, or other allergens. It works quickly to open airways, raise blood pressure, and reduce swelling.
How to Use This Medicine
Proper Use of This Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. This medication is administered via injection into a muscle or the fatty part of the skin. It's essential to understand how to use it before an emergency situation arises. Carefully review the package insert and instructions for use that come with this medication. If you have any questions, consult your doctor or pharmacist.
Availability and Accessibility
Keep this medication with you at all times, and consider storing extra doses at work, school, and home in case someone else needs to administer it. Ensure that others know where the medication is stored and how to administer it if needed.
Pre-Use Checks
Before using the device, verify that the safety release is in place and that the device can be removed from its case. Do not remove the safety release until you are ready to use the medication.
Administration Technique
To administer the medication:
1. Remove the pen from its case.
2. Hold the pen with the tip facing down.
3. Make a fist around the pen.
4. Remove the safety release and discard it immediately after use, as it may pose a choking hazard to children or pets.
5. Inject the medication straight into the outer thigh, as instructed. If necessary, the medication can be administered through clothing.
6. Hold the injection site for the recommended duration.
Important Administration Considerations
Do not inject the medication into the buttocks.
When administering the medication to a child, hold their leg still to prevent injury and try to limit their movement before and during the injection.
Post-Use Procedures
After using the medication:
1. Seek immediate medical attention.
2. Return the device to its storage case.
3. Bring the device with you to the hospital.
Inspection and Replacement
Do not use the medication if the solution has changed color, is cloudy, or contains particles. Obtain a new device in such cases. If the device has expired, get a refill before a dose is needed. If the device has been accidentally activated, do not use it for an emergency; instead, replace it with a new one.
Storage and Disposal
Store the medication at room temperature, avoiding refrigeration or freezing.
Missed Dose
If you miss a dose, seek immediate medical attention.
To use this medication correctly, follow your doctor's instructions and read all the information provided. This medication is administered via injection into a muscle or the fatty part of the skin. It's essential to understand how to use it before an emergency situation arises. Carefully review the package insert and instructions for use that come with this medication. If you have any questions, consult your doctor or pharmacist.
Availability and Accessibility
Keep this medication with you at all times, and consider storing extra doses at work, school, and home in case someone else needs to administer it. Ensure that others know where the medication is stored and how to administer it if needed.
Pre-Use Checks
Before using the device, verify that the safety release is in place and that the device can be removed from its case. Do not remove the safety release until you are ready to use the medication.
Administration Technique
To administer the medication:
1. Remove the pen from its case.
2. Hold the pen with the tip facing down.
3. Make a fist around the pen.
4. Remove the safety release and discard it immediately after use, as it may pose a choking hazard to children or pets.
5. Inject the medication straight into the outer thigh, as instructed. If necessary, the medication can be administered through clothing.
6. Hold the injection site for the recommended duration.
Important Administration Considerations
Do not inject the medication into the buttocks.
When administering the medication to a child, hold their leg still to prevent injury and try to limit their movement before and during the injection.
Post-Use Procedures
After using the medication:
1. Seek immediate medical attention.
2. Return the device to its storage case.
3. Bring the device with you to the hospital.
Inspection and Replacement
Do not use the medication if the solution has changed color, is cloudy, or contains particles. Obtain a new device in such cases. If the device has expired, get a refill before a dose is needed. If the device has been accidentally activated, do not use it for an emergency; instead, replace it with a new one.
Storage and Disposal
Store the medication at room temperature, avoiding refrigeration or freezing.
Missed Dose
If you miss a dose, seek immediate medical attention.
Lifestyle & Tips
- Always carry two Auvi-Q auto-injectors with you at all times.
- Avoid known allergens.
- Know how to use the auto-injector and practice with the trainer device.
- Seek immediate medical attention after using Auvi-Q, even if symptoms improve, as a second reaction can occur.
- Store at room temperature, away from light and extreme heat or cold. Do not refrigerate.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
For patients weighing 15 to 30 kg (33 to 66 lbs): 0.15 mg administered intramuscularly or subcutaneously into the anterolateral aspect of the thigh. May repeat every 5 to 15 minutes if anaphylactic symptoms persist or recur. Note: Standard adult dose is typically 0.3 mg for patients >30 kg.
Dose Range:
0.15 - 0.15 mg
Condition-Specific Dosing:
anaphylaxis:
0.15 mg IM/SC, repeat as needed
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established for this strength; dosing is weight-based. For infants weighing 15 to 30 kg (33 to 66 lbs), 0.15 mg IM/SC.
Child:
For children weighing 15 to 30 kg (33 to 66 lbs): 0.15 mg administered intramuscularly or subcutaneously into the anterolateral aspect of the thigh. May repeat every 5 to 15 minutes if anaphylactic symptoms persist or recur.
Adolescent:
For adolescents weighing 15 to 30 kg (33 to 66 lbs): 0.15 mg administered intramuscularly or subcutaneously into the anterolateral aspect of the thigh. May repeat every 5 to 15 minutes if anaphylactic symptoms persist or recur. Adolescents >30 kg typically require 0.3 mg.
Dose Adjustments
Renal Impairment:
Mild:
No specific dose adjustment recommended for acute use.
Moderate:
No specific dose adjustment recommended for acute use.
Severe:
No specific dose adjustment recommended for acute use.
Dialysis:
No specific considerations for acute use; rapidly metabolized.
Hepatic Impairment:
Mild:
No specific dose adjustment recommended for acute use.
Moderate:
No specific dose adjustment recommended for acute use.
Severe:
No specific dose adjustment recommended for acute use.
Pharmacology
Mechanism of Action
Epinephrine is a sympathomimetic catecholamine that acts on alpha-1, beta-1, and beta-2 adrenergic receptors. Its alpha-1 adrenergic effects cause vasoconstriction, increasing peripheral vascular resistance and blood pressure, and decreasing mucosal edema. Its beta-1 adrenergic effects increase heart rate and myocardial contractility. Its beta-2 adrenergic effects cause bronchodilation and can decrease the release of mediators from mast cells and basophils.
Pharmacokinetics
Absorption:
Bioavailability:
Rapid and complete after intramuscular injection.
Tmax:
Approximately 5-10 minutes after IM injection.
FoodEffect:
Not applicable for injectable formulation.
Distribution:
Vd:
Not precisely quantified, but widely distributed to sympathetic nerve endings and various tissues.
ProteinBinding:
Approximately 50% (to albumin and other plasma proteins).
CnssPenetration:
Limited (does not readily cross the blood-brain barrier).
Elimination:
HalfLife:
Approximately 2-3 minutes (plasma half-life).
Clearance:
Very rapid.
ExcretionRoute:
Metabolites excreted primarily in urine.
Unchanged:
<1% (very little unchanged drug excreted).
Pharmacodynamics
OnsetOfAction:
Rapid, within minutes after IM injection.
PeakEffect:
Within 5-10 minutes.
DurationOfAction:
Short, typically 5-10 minutes.
Confidence:
High
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of low potassium levels, including:
+ Muscle pain or weakness
+ Muscle cramps
+ An irregular heartbeat
Signs of high blood pressure, such as:
+ Severe headache or dizziness
+ Passing out
+ Changes in eyesight
Chest pain or pressure
Rapid heartbeat
Shortness of breath
Difficulty urinating or changes in urine output
Unusual burning, numbness, or tingling sensations
Weakness on one side of the body
Trouble speaking or thinking
Changes in balance
Drooping on one side of the face
Blurred vision
Abnormal heartbeat (which can be life-threatening, especially if you have pre-existing heart problems or take certain medications)
Signs of infection at the injection site, such as:
+ Redness that doesn't go away
+ Warmth
+ Swelling
+ Tenderness
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people experience no side effects or only mild ones, some may be more bothersome. If you experience any of the following side effects, contact your doctor or seek medical attention:
Feeling anxious, nervous, excitable, shaky, or restless
Upset stomach or vomiting
Excessive sweating
Pale skin
Headache
Dizziness, tiredness, or weakness
Goosebumps
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of low potassium levels, including:
+ Muscle pain or weakness
+ Muscle cramps
+ An irregular heartbeat
Signs of high blood pressure, such as:
+ Severe headache or dizziness
+ Passing out
+ Changes in eyesight
Chest pain or pressure
Rapid heartbeat
Shortness of breath
Difficulty urinating or changes in urine output
Unusual burning, numbness, or tingling sensations
Weakness on one side of the body
Trouble speaking or thinking
Changes in balance
Drooping on one side of the face
Blurred vision
Abnormal heartbeat (which can be life-threatening, especially if you have pre-existing heart problems or take certain medications)
Signs of infection at the injection site, such as:
+ Redness that doesn't go away
+ Warmth
+ Swelling
+ Tenderness
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people experience no side effects or only mild ones, some may be more bothersome. If you experience any of the following side effects, contact your doctor or seek medical attention:
Feeling anxious, nervous, excitable, shaky, or restless
Upset stomach or vomiting
Excessive sweating
Pale skin
Headache
Dizziness, tiredness, or weakness
Goosebumps
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Fast or pounding heartbeat (palpitations)
- Tremor or shaking
- Anxiety or nervousness
- Headache
- Dizziness
- Nausea or vomiting
- Sweating
- Pale skin
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, any of its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is not an exhaustive list, and it is crucial to disclose all your medications and health conditions to your doctor and pharmacist.
* Any health problems you have, as they may interact with this medication.
To ensure your safety, do not start, stop, or change the dose of any medication without first consulting your doctor. It is your responsibility to verify that it is safe to take this medication with all your other medications and health conditions.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, any of its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is not an exhaustive list, and it is crucial to disclose all your medications and health conditions to your doctor and pharmacist.
* Any health problems you have, as they may interact with this medication.
To ensure your safety, do not start, stop, or change the dose of any medication without first consulting your doctor. It is your responsibility to verify that it is safe to take this medication with all your other medications and health conditions.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
When administering this drug, avoid injecting it into the fingers, hands, or feet, as this may cause reduced blood flow to these areas. If accidental injection occurs, seek immediate medical attention.
If you have a sulfite allergy, consult your doctor before taking this medication, as some products may contain sulfites.
Patients with high blood sugar (diabetes) should closely monitor their blood sugar levels while taking this drug.
Individuals 65 years or older should exercise caution when using this medication, as they may be more susceptible to side effects.
If you are pregnant, planning to become pregnant, or are breast-feeding, inform your doctor to discuss the potential benefits and risks to both you and your baby.
When administering this drug, avoid injecting it into the fingers, hands, or feet, as this may cause reduced blood flow to these areas. If accidental injection occurs, seek immediate medical attention.
If you have a sulfite allergy, consult your doctor before taking this medication, as some products may contain sulfites.
Patients with high blood sugar (diabetes) should closely monitor their blood sugar levels while taking this drug.
Individuals 65 years or older should exercise caution when using this medication, as they may be more susceptible to side effects.
If you are pregnant, planning to become pregnant, or are breast-feeding, inform your doctor to discuss the potential benefits and risks to both you and your baby.
Overdose Information
Overdose Symptoms:
- Extreme hypertension (high blood pressure)
- Tachycardia (very fast heart rate)
- Cardiac arrhythmias (irregular heartbeats)
- Cerebral hemorrhage (bleeding in the brain)
- Pulmonary edema (fluid in the lungs)
- Renal failure
What to Do:
Call 911 or your local emergency number immediately. For poison control, call 1-800-222-1222. Treatment is supportive, including alpha-adrenergic blockers for severe hypertension and beta-blockers for arrhythmias.
Drug Interactions
Major Interactions
- Beta-adrenergic blockers (e.g., propranolol, carvedilol): May antagonize the bronchodilator and vasodilator effects of epinephrine, potentially leading to severe hypertension and reflex bradycardia.
- Alpha-adrenergic blockers (e.g., phentolamine): May antagonize the vasoconstrictor and pressor effects of epinephrine.
- Tricyclic antidepressants (TCAs) and Monoamine Oxidase Inhibitors (MAOIs): May potentiate the cardiovascular effects of epinephrine, leading to severe hypertension and arrhythmias.
- Digitalis glycosides: Increased risk of cardiac arrhythmias.
Moderate Interactions
- Antihistamines (e.g., diphenhydramine): May potentiate the effects of epinephrine.
- Diuretics (e.g., loop diuretics, thiazide diuretics): May reduce the pressor response to epinephrine.
- Thyroid hormones: May increase sensitivity to epinephrine's effects.
Monitoring
Symptom Monitoring
- Resolution of anaphylaxis symptoms (e.g., improved breathing, decreased swelling, improved blood pressure)
- Heart rate and rhythm (for tachycardia, arrhythmias)
- Blood pressure (for hypertension)
- Skin color and temperature
- Anxiety, tremor, headache, palpitations (common side effects)
Special Patient Groups
Pregnancy
Epinephrine is considered the drug of choice for anaphylaxis during pregnancy due to its life-saving potential. While animal studies show some risk, the benefits of treating anaphylaxis outweigh potential fetal risks. Use only when clearly needed.
Trimester-Specific Risks:
First Trimester:
Limited data, but risk of untreated anaphylaxis to mother and fetus is high.
Second Trimester:
Considered safe when indicated for anaphylaxis.
Third Trimester:
Considered safe when indicated for anaphylaxis; may cause uterine contractions but typically not significant enough to induce labor at therapeutic doses for anaphylaxis.
Lactation
Epinephrine is rapidly metabolized and has a very short half-life, making it unlikely to be present in significant amounts in breast milk. It is generally considered compatible with breastfeeding when used for acute, life-threatening conditions.
Infant Risk:
Low risk to the infant.
Pediatric Use
Auvi-Q 0.15mg is specifically designed for pediatric patients weighing 15 to 30 kg (33 to 66 lbs). Dosing is weight-based. Careful instruction for parents/caregivers on proper administration is crucial.
Geriatric Use
Use with caution in elderly patients due to increased risk of cardiovascular adverse effects (e.g., hypertension, arrhythmias, myocardial ischemia), especially in those with pre-existing cardiovascular disease. Monitor closely.
Clinical Information
Clinical Pearls
- Auvi-Q features a voice prompt system and an automatic retractable needle, which can be beneficial for ease of use, especially in stressful emergency situations.
- Always check the expiration date and replace the auto-injector before it expires.
- After administering epinephrine, always call 911 or seek immediate medical attention, even if symptoms improve, as a biphasic reaction (a second reaction) can occur hours later.
- Inject into the anterolateral aspect of the thigh, through clothing if necessary. Do not inject into buttocks, hands, or feet.
- The 0.15mg dose is specifically for patients weighing 15-30 kg (33-66 lbs). Patients outside this range should use the appropriate strength (0.3mg for >30kg, 0.1mg for <15kg if available/prescribed).
Alternative Therapies
- EpiPen Jr. (epinephrine auto-injector 0.15mg)
- Adrenaclick (epinephrine auto-injector 0.15mg)
- Symjepi (epinephrine pre-filled syringe 0.15mg)
Cost & Coverage
Average Cost:
$300 - $600 per 2 auto-injectors
Generic Available:
Yes
Insurance Coverage:
Tier 2 or 3 (varies by plan)
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.