Prescribing and Medicines Optimisation Guidance Bulletin 62

MHRA recommendations to support the effective and safe use of adrenaline auto-injectors (AAIs) from Hampshire, Southampton and Isle of Wight CCG and Portsmouth CCG

New recommendations from MHRA for patients using AAIs include:

  • Early administration of adrenaline
  • Posture of the patient in anaphylaxis
  • Two AAIs should be carried at all times
  • Training devices and instructions for use should be familiar before the requirement arises.

Key messages that should be conveyed to patients about what to do in an emergency:

  • Use your adrenaline auto-injector immediately if you have any signs of anaphylaxis. If in doubt use it. Don’t delay
  • Dial 999 – say anaphylaxis (“ana-fill-axis”) – straight after using your auto-injector
  • Lie down and raise your legs
  • Sit up if you are struggling to breathe but don’t change position suddenly
  • Lie down again as soon as you can
  • Stay lying down even if you are feeling better
  • You must not stand up even if someone encourages you to
  • Use your second auto-injector if you haven’t improved after 5 minutes

Be prepared – information for the patient:

  • Carry two adrenaline auto-injectors with you at all times.
  • You must use your auto-injector as soon as you notice any signs of anaphylaxis.
  • Make sure you know beforehand what the signs are so you can act swiftly.
  • Make sure you know how to use your auto-injector before you need to use it. Get a trainer auto-injector from the manufacturer if needed.

Trainer devices are available by requesting from the manufacturer. Patients and carers are strongly encouraged to obtain these to ensure familiarity with the brand supplied as there are differences in the way each is used.

The trainer devices do not contain a needle or adrenaline but otherwise mimic the functionality of a real device. Importantly, trainer devices can be re-used, allowing the patients and carers to practise the action of administration as many times as they need to.

Full Medicines Optimisation Bulletin can be viewed here: