EpiPen Age Indications and Usage Guidelines

Primary Indications Across All Ages

The American Academy of Pediatrics recommends EpiPens for patients with a history of anaphylaxis characterized by respiratory or cardiovascular compromise to a trigger that may be encountered outside the hospital 3
EpiPens should be prescribed for patients at high risk who have not yet experienced anaphylaxis, if specific circumstances warrant, including those with confirmed food or insect venom allergies combined with risk factors 1, 2
Any child with generalized acute urticaria after an insect sting should be considered for an EpiPen prescription, as the risk of a more severe future reaction is approximately 10% 3

Infants and children weighing less than 15 kg, especially those weighing 7.5 kg or less, require careful consideration of EpiPen dosing, as the lowest available dose may be too high for many infants and some young children 1, 2, 4
Children weighing 10-25 kg should use EpiPen Jr (0.15 mg), while children weighing 25 kg or more should use the adult EpiPen (0.3 mg) 5

Patients with asthma requiring preventer medication are at higher risk of fatal anaphylaxis and may benefit from an EpiPen prescription 3, 6
Remote location away from medical care is a factor that increases the likelihood of severe reactions and supports EpiPen prescription 3
Use of nonselective β-blockers is a factor that increases the likelihood of severe reactions and supports EpiPen prescription 3

Patients and caregivers should be provided with written, personalized anaphylaxis emergency action plans 8
Patients and caregivers should be trained to inject at the first signs of anaphylaxis, particularly with respiratory or cardiovascular symptoms 6
Patients and caregivers should be instructed to call 911 immediately and seek emergency department assessment after any EpiPen use 8
Prescribing two EpiPens is recommended, as approximately 6-19% of patients require a second dose 7