How to Use An Epinephrine Auto-Injector

Epinephrine auto-injectors are simple to use and come with clear instructions. The device’s needle sits protected inside the device until you inject it.

Ask your doctor for training on how to correctly use an epinephrine auto-injector; manufacturer websites may also provide detailed steps and how-to videos.

Step-by-Step Instructions

1. Remove the auto-injector from its protective case. Check to make sure the expiration date has not passed and the liquid inside looks clear.

2. Follow instructions to remove the safety cap(s). Keep your hand and fingers away from the needle end.

3. Hold the injector in your fist with the needle end (usually red or orange) away from your  thumb, and place the needle end firmly against the outer thigh (the upper leg). Do not inject into the buttocks or elsewhere on the body. The needle is designed to go through clothing, if necessary

4. Press firmly to release the needle and inject the epinephrine into the outer thigh. Hold the leg and keep it steady while you inject the epinephrine.

5. Once injected, follow the device instructions on how long to keep it in place – usually several seconds – until all the epinephrine is delivered.

6. Remove the device and massage the injection site for 10 seconds.

7. Some injectors have a needle that retracts back into the case after use; others leave the needle exposed. If the needle remains exposed, carefully insert the injector — needle first — back into the carrying case. Don’t be concerned if you see liquid left in the device; it is designed to release the proper dose correctly. Never try to re-inject.

8. Call 911 immediately. Tell the dispatcher you just used epinephrine to treat a suspected anaphylactic reaction. Make arrangements for transport to an emergency department for additional treatment.

9. Do not dispose of the auto-injector yourself. Give it to the emergency care team and tell them where it was injected.

Side effects may include uncontrollable shaking or twitchiness and feelings of panic or anxiety. These should subside within a few minutes or in an hour.

Note: In June 2016, FDA announced changes to safety labeling for epinephrine auto-injectors. The changes include the need to hold a child’s leg firmly during injection and to see a doctor for signs of infection at the injection site.