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CSACI position statement: transition recommendations on existing epinephrine autoinjectors Li, Lucy D. X.; Abrams, Elissa; Lavine, Elana; Hildebrand, Kyla; Mack, Douglas P.

Abstract

Epinephrine is the first line treatment for anaphylaxis, an acute potentially life-threatening allergic reaction. It is typically administered intramuscularly in the anterolateral thigh at a dose of 0.01 mg/kg of 1:1000 (1 mg/ml) solution to a maximum initial dose of 0.5 mg. Currently in Canada, epinephrine autoinjectors (EAI) are available in three doses, 0.15 mg, 0.30 mg, and 0.50 mg. There are currently no published studies comparing 0.3 mg and 0.5 mg EAIs in the paediatric or adult populations to compare clinical effectiveness. However, as weight increases above 30 kg, the percentage of the recommended 0.01 mg/kg epinephrine dose from an existing 0.3 mg EAI decreases resulting in potential underdosing. As such, The Canadian Society of Allergy and Immunology (CSACI) recommends that for those who weigh ≥ 45 kg, physicians could consider prescribing the 0.50 mg EAI based on shared decision making with patients.

Item Metadata

Title
CSACI position statement: transition recommendations on existing epinephrine autoinjectors
Creator
Li, Lucy D. X.; Abrams, Elissa; Lavine, Elana; Hildebrand, Kyla; Mack, Douglas P.
Publisher
BioMed Central
Date Issued
2021-12-13
Description
Epinephrine is the first line treatment for anaphylaxis, an acute potentially life-threatening allergic reaction. It is typically administered intramuscularly in the anterolateral thigh at a dose of 0.01 mg/kg of 1:1000 (1 mg/ml) solution to a maximum initial dose of 0.5 mg. Currently in Canada, epinephrine autoinjectors (EAI) are available in three doses, 0.15 mg, 0.30 mg, and 0.50 mg. There are currently no published studies comparing 0.3 mg and 0.5 mg EAIs in the paediatric or adult populations to compare clinical effectiveness. However, as weight increases above 30 kg, the percentage of the recommended 0.01 mg/kg epinephrine dose from an existing 0.3 mg EAI decreases resulting in potential underdosing. As such, The Canadian Society of Allergy and Immunology (CSACI) recommends that for those who weigh ≥ 45 kg, physicians could consider prescribing the 0.50 mg EAI based on shared decision making with patients.
Subject
Epinephrine; Anaphylaxis; CSACI position statement; 0.5 mg epinephrine autoinjector
Genre
Article
Type
Text
Language
eng
Date Available
2022-01-11
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0406245
URI
http://hdl.handle.net/2429/80636
Affiliation
Medicine, Faculty of; Non UBC; Allergy and Immunology, Division of; Medicine, Department of; Pediatrics, Department of
Citation
Allergy, Asthma & Clinical Immunology. 2021 Dec 13;17(1):130
Publisher DOI
10.1186/s13223-021-00634-2
Peer Review Status
Reviewed
Scholarly Level
Faculty
Copyright Holder
The Author(s)
Rights URI
http://creativecommons.org/licenses/by/4.0/
Aggregated Source Repository
DSpace

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Rights

Attribution 4.0 International (CC BY 4.0)