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Epipen®Junior auto-injector 150mcg shortage: Advice from NHS England for parents

13 Oct 2018

Superintendent update on NHS guidance letter providing advice for parents during the supply shortage of Epipen Junior

 Dear Superintendent,

 NHS England has prepared a letter that GP surgeries will share with the parents and carers of children with severe allergy.

Experts in children’s allergies have made the following recommendations:

  • Administer adrenaline – during severe allergic or anaphylactic reaction, adrenaline must always be administered and an immediate referral made to 999 stating “suspected anaphylaxis, adrenaline supplied”
  • Caution – continue to be vigilant in avoiding the risk of allergen exposure
  • Efficacy of expired pen administration – an out-of-date adrenaline pen may not provide the full dosage, but the recommendation is that this should still be administered: it is not considered dangerous to do so and is better than no immediate treatment
    • An expiry date displayed as month / year is recognised to expire on the last day of the month, for example a product marked 10/2018 would expire on 31 October 2018
  • Alternative presentations – other brands of adrenaline auto-injectors may be prescribed for children – parents/carers should familiarise themselves with how these devices are to be administered as there can be variations between the different devices
  • Adult strength adrenaline pen – GPs may prescribe 300mcg adrenaline pens to children over 25kg: Jext 300mcg and Emerade 300mg auto-injectors are licensed for use in children over 30kg but during this period of supply shortage, experts state these can still be used in patients over 25kg
  • Requesting replacements – patients are asked not to request repeat supplies until their existing pens have expired: new stock is expected soon and patients with expired stock will be prioritised until the supply issues are resolved

NPA members can access the latest adrenaline stock update on the NPA website. The availability information is updated regularly. Further guidance for patients, pharmacists and prescribers can be found on the EpiPen® website.

For further information on this or any other query, please contact the NPA Pharmacy team on 01727 891 800 or email

Kind regards,


Leyla Hannbeck MSc, MRPharmS, MBA
NPA Director of Pharmacy
Medication Safety officer