Why aren’t parents using allergy pen?

For a child with severe allergies, symptoms like breathing problems can quickly become life-threatening. Having an EpiPen handy and being prepared to use it can slow down or stop an allergic reaction.

So it’s troubling that a new study finds half of kids who needed epinephrine didn’t receive it before a trip to the emergency room.

“Epinephrine is the first and only recommended life-saving medication for anaphylaxis,” said Dr. Melissa Robinson, an allergy and immunology fellow at National Jewish Health in Denver, Colorado, and lead author of the study, published in July in the Annals of Allergy, Asthma and Immunology.

A quick and progressive allergic reaction, anaphylactic shock it can be fatal, Robinson said.

“If an allergic person comes into contact with that allergen — typically foods, insect stings or medications — the immune system overreacts and can release a surge of chemicals that can cause rapid, life-threatening symptoms of anaphylaxis.

These symptoms include difficulty breathing due to tightening and swelling of the airway and lungs; wheezing; swelling of the throat, lips and eyes; hives; vomiting and diarrhea,” Robinson said.

Quickly administering epinephrine relieves allergic symptoms, leading to better outcomes and decreasing hospitalizations.

“Similar to previous studies, our study found that children who were treated with epinephrine before arrival to the emergency department or urgent care were more likely to be discharged home, compared to those who did not,” Robinson said.

Barriers to use

The study examined 408 records of children who were treated in the emergency room or urgent care. Fewer than half the children received epinephrine prior to arriving for medical care even though approximately 65 percent had a known history of anaphylaxis, and 47 percent had been prescribed epinephrine.

The study found that only twothirds of those who had an epinephrine prescription had their auto-injector available at the time of their allergic reaction.

“It’s vital to keep your epinephrine with you if you suffer from any sort of severe allergy. Anaphylaxis symptoms occur suddenly and can progress quickly,” said allergist David Stukus, spokesman for the American College of Allergy, Asthma and Immunology and co-author of the study.

Children who had an allergic reaction at home were less likely to receive epinephrine than kids who experienced a reaction at school.

“Treatment with epinephrine is often delayed or avoided by parents and caregivers. And sometimes antihistamines are used even though they are not an appropriate treatment,” Robinson said.

The study didn’t look at why parents and caregivers failed to use an EpiPen, but from personal clinical experience, “the lack of administration is due to multiple reasons: failure to recognize symptoms of anaphylaxis, not having one’s epinephrine pen available during the reaction, fear of using the injector device as it does contain a needle, treating with antihistamines rather than epinephrine, lack of access to specialty care and potentially medication,” Robinson said.

Another reason parents hesitate may be cost.

The price of Epipens has skyrocketed in the past few years, with a two-pack priced at $600 or more earlier this year, according to Consumer Reports.

That’s about six times the cost in 2009. Prices have since dropped at sites like GoodRx, and Mylan, the manufacturer of Epipens, is offering coupons.

An Epipen alternative, the generic Adrenaclick, is now available for as little as $10 for a two-pack at CVS stores, depending on your insurance and rebates like the one at https://sservices.trialcard.com/Coupon/ Epinephrine. Mylan also makes a generic, and an alternative called Auvi-Q is available from physicians.

Don’t hesitate

”If you suspect your child is having anaphylaxis and are considering epinephrine, I encourage parents to administer the medication rather than waiting or hesitating. It is the only life-saving medication during times of reactions and it can save your child’s life,” Robinson said.

Better safe than sorry

“The treatment of epinephrine during a life-threatening emergency outweighs the potential side effects, which are oftentimes a rapid heart rate and temporary sting from the needle site — both of which are temporary and resolve quickly,” Robinson said.

Be ready

“If you have food allergies, epinephrine should always go with you wherever you go,” Robinson said.

“Always have a second dose with you and, when in doubt, administer it too,” Stukus said.

Know how to use it

Become familiar with how to use an EpiPen. Practice with the trainers in your allergist’s office, and have a Food or Anaphylaxis Action Plan in place.