It’s now official – two autoinjectors, not one

The Anaphylaxis Campaign amongst others has been campaigning for some years for those at risk of anaphylaxis to carry two rather than just one adrenaline auto injector pens to use in case of an attack. Their reasoning is that one may not be enough because of the severity of the attack, the speed of action of the drug in the body, the possible delay in emergency services reaching the patient etc. Their view had been widely accepted so there was much shock and horror last year when the BSACI, one of the lead allergy bodies, actually disagreed and advised only prescribing one. (See this blog last September.)

However, the BSACI have now been put to flight not only by the Medicines Control Agency (MHRA) in the UK but  by the European Medicines Agency (EMA) who have just released new guidelines recommending that two pens should always be prescribed. You can see their full advice here but the nub of it is that:

• Patients should always be prescribed with two pens which they should carry at all times
• That patients and carers should be trained in the use of their chosen pen
• That patients and carers should be encouraged to practice with trainer pens

They also make the following pertinent comments:

• due to uncertainties about the site of drug delivery and the speed of adrenaline action within the body, it is recommended that healthcare professionals prescribe 2 auto-injectors, which patients should carry at all times
• the needle length of the device is now stated in the product information because this may be an important factor for the prescriber to consider when choosing a suitable auto-injector
• the training of patients and their carers in the correct use of the product is important and manufacturers were required to update their educational materials – see table below
• manufacturers should carry out studies in humans to more fully understand when and how much adrenaline reaches the blood stream, and how quickly and effectively it acts on body tissues when given through an auto-injector

Progress indeed – and congratulations to the AC, Angela Waters who ran a campaign on Change.org and everyone else who has been battling for the cause.