Living with Food Allergies
Epinephrine
Epinephrine is the first-line treatment for a severe allergic reaction known as anaphylaxis [anna-fih-LACK-sis].
Epinephrine comes in the form of easy-to-use auto-injectors or a nasal spray. It is only available through a prescription from your doctor.
If you or your child have severe food allergies, you need to have epinephrine quickly and easily available at all times. For children, this might mean having extra epinephrine devices. For example, your child may need to keep epinephrine at school, as well as at after-school care. You may also want additional epinephrine devices that remain at home or travel with you when you go out. For adults, two devices might be enough.
Epinephrine Devices Available With a Prescription in the United States
Epinephrine is the first-line treatment for anaphylaxis. Several epinephrine options are now available in the United States. There are also generic versions. Each contains the drug epinephrine. But, each device has its own unique set of instructions for use. Understanding the differences is important so that you get the device you want and you know how to properly use it.
The information below summarizes the key facts about each of the available epinephrine devices. More details are available at the manufacturers’ websites. These websites also have videos that show you how to use them.
Pharmacists must follow state and federal regulations when filling your prescription. You should keep this in mind when filling your prescription.
There are many states the pharmacist can substitute a generic form of the prescription. This must be on the prescription in writing. The pharmacist must also get a verbal approval from the doctor. If you or your doctor prefer to receive a specific brand name, your doctor must write the brand name and “DAW” (dispense as written) or “do not substitute” on the prescription. This note prevents the pharmacist from filling a generic form of the prescription.
Before you leave the pharmacy, make sure the pharmacy fills your prescription exactly as you expect.
What’s the Difference Between Brand Name, Generic, and Authorized Generic Drugs?
Brand name drugs: When a new medicine is created and approved by the Food and Drug Administration (FDA), it is marketed under a brand name. The company that makes it patents the drug. This means this company is the only company that has the right to make and market this drug for a certain number of years, as noted in the patent.
Generic drugs: When a drug patent expires, other companies can make generic versions of the medicine if it follows certain standards set by the FDA. The generic medicines must have the:
- Same active ingredient as the brand name drug
- Same benefits and risks as the brand name drug
- Same strength, dosage, and route of administration as the brand name drug
- Same quality and manufacturing standards as the brand name drug
Generic drugs may be different from brand name drugs in the following ways:
- May be made by the same company or by a different company
- Different look and size, including packaging
- Different inactive ingredients (side effects may vary from the brand name drug because of the inactive ingredients, but this is uncommon)
- Lower costs (most of the time but not always)
Authorized generic drugs: This type of generic medicine is the same as the brand name medicine but without the brand name label. It will have the same active and inactive ingredients as the brand name drug. Authorized generic medicines may also cost less.
If a generic or authorized generic version of a drug exists, health insurance companies may cover those instead of the brand name medicine. Generic drugs can offer the same treatment at a lower cost than brand name.
When it comes to medicines like asthma inhalers and epinephrine devices, the active ingredient and doses will be the same, but the device may look and operate differently. It is very important for you to learn how to use the device prescribed to you even if it is the authorized generic of a brand name device.
AUVI-Q®
Product Name: AUVI-Q®
Manufacturer: kaléo
Available Strengths: 0.1 mg, 0.15 mg and 0.3 mg
Generic available: No
Includes trainer: Yes
Talking feature: Yes
Needle exposed after injection: No
Injection hold time: 2 seconds
Refill reminder: Yes
Discount Program: AUVI-Q has 2 assistance programs. If you have commercial insurance (such as through your job or HealthCare.gov) that covers AUVI-Q, you may be able to get AUVI-Q for $35 or less. If your insurance doesn’t cover it or if you have a high-deductible plan, you’ll pay no more than $150. Once you meet your deductible, you may be able to get AUVI-Q for $35.
If you don’t have commercial insurance or are on Medicaid may be able to get AUVI-Q for no cost through the Kaléo Patient Assistance Program.
Call 502-213-7601 for questions (9 a.m. – 5 p.m. ET, Monday-Friday).
EpiPen® and EpiPen Jr®
Product Name: EpiPen® and EpiPen Jr®
Manufacturer: Mylan Inc., a VIATRIS™ company
Available Strengths: 0.15 mg and 0.3 mg
Generic available: Yes, see below
Includes trainer: Yes
Talking feature: No
Needle exposed after injection: No
Injection hold time: 3 seconds
Refill reminder: No
Discount Program: Use The EPIPEN® Savings Card® to save up to $300 on your out-of-pocket cost per EPIPEN 2-PACK® and/or EPIPEN JR 2-PACK® carton per prescription refill (up to 3 cartons per prescription) and can be used for 6 cartons per calendar year. If you have questions, call 1-800-657-7613 (8 a.m.-8 p.m. ET, Monday-Friday). VIATRIS™ also has a patient assistance program for EPIPEN® Auto-Injector and its authorized generic.
Epinephrine Injection, USP Auto-Injector, Authorized Generic (AG) of EpiPen® and EpiPen Jr®
Product Name: Epinephrine injection, USP auto-injector, authorized generic (AG) of EpiPen® and EpiPen Jr®
https://www.epipen.com/en/about-epipen-and-generic
Manufacturer: Mylan Inc., a VIATRIS™ company
Available Strengths: 0.15 mg and 0.3 mg
Generic available: N/A
Includes trainer: Yes
Talking feature: No
Needle exposed after injection: No
Injection hold time: 3 seconds
Refill reminder: No
Discount Program: Use the Epinephrine Injection, USP Auto-Injector Savings Card to save up to $25 on your out-of-pocket costs per generic 2-pack. It can be redeemed for up to 3 cartons per calendar year. If you have questions, call 1-800-657-7613 (8 a.m.-8 p.m. ET, Monday-Friday). VIATRIS™ also has a patient assistance program.For more information, call 888-417-5782 (8 a.m.-5 p.m. CST, Monday-Friday).
Epinephrine Injection, USP Auto-Injector, Generic
Product Name: Epinephrine injection, USP auto-injector, generic
Manufacturer: Teva Pharmaceutical Industries
Available Strengths: 0.15 mg and 0.3 mg
Generic available: N/A
Includes trainer: Yes
Talking feature: No
Needle exposed after injection: Yes
Injection hold time: 3 seconds
Refill reminder: Yes
Discount Program: If you have commercial insurance may save up to $30 per carton, up to 3 cartons per prescription. If you have any questions, call 1-844-248-7949.
Epinephrine Injection, USP Auto-Injector, Authorized Generic (AG) of Adrenaclick™
Product Name: Epinephrine injection, USP auto-injector, authorized generic (AG) of Adrenaclick™
Manufacturer: Distributed by Amneal Pharmaceuticals
Available Strengths: 0.15 mg and 0.3 mg
Generic available: N/A
Includes trainer: Training devices are available for free via web or telephone
Talking feature: No
Needle exposed after injection: Yes
Injection hold time: 10 seconds
Refill reminder: No
Discount Program: If you have commercial insurance, you may get up to $10 off per pack. If you have any questions, call 330-757- 8402.
CVS Health sells these generic epinephrine auto-injectors at all CVS Pharmacy locations. Find a CVS location near you.
neffy® Epinephrine Nasal Spray
Product Name: neffy® epinephrine nasal spray
Manufacturer: ARS Pharmaceuticals
Available Strengths: 2 mg for people 66 pounds (30 kilograms) and more
Generic available: N/A
Includes trainer: No
Talking feature: No
Refill reminder: N/A
Discount Program: If you have commercial insurance, you can pay $25 for each filled prescription of 2 devices. If you don’t have insurance coverage, your plan doesn’t cover neffy, or if you have a high-deductible plan, you can pay a cash price of $199 for 2 doses of neffy using BlinkRx or GoodRX.
The ARS Pharma Patient Assistance Program (PAP), neffyconnect™, may provide neffy at no cost if you:
- Have a valid prescription for neffy
- Are a resident of the U.S, Puerto Rico, or the U.S. Virgin Islands
- Don’t have insurance or you have government or commercial insurance that doesn’t cover neffy
- Meet certain income criteria
If you have any questions, call 1-877-696-3339.
Other Epinephrine Options
There are other options that do not auto-inject the epinephrine. Glass vials of epinephrine with needles/syringes may be in emergency kits as seen on airplanes. The first epinephrine nasal spray was approved by the Food and Drug Administration in August 2024. Other types of epinephrine devices are being developed and are going through clinical trials.
What If You Can’t Afford Your Epinephrine Auto-Injectors?
Unfortunately, some people cannot afford to buy this potentially life-saving medicine. If this is the case for you, there are options to help. On our blog, we offer up-to-date details about:
- Savings programs
- Pharmacy differences
- Insurance preferences
- Other sources of assistance
Read our blog post: What to Do If You Can’t Afford Epinephrine
Stocking Epinephrine in Schools and Public Places
Around 45% of severe allergic reactions severe allergic reactions in schools begin in the classroom. Since these people (children, staff, and visitors) have not been previously diagnosed with allergies, they may not have their own epinephrine auto-injectors on hand. Most states have passed legislation to allow schools to stock undesignated epinephrine as a part of their emergency medical kits. This allows specified staff to treat someone suffering anaphylaxis, even for their very first allergic reaction. Many states are looking beyond the classroom to other areas where food allergy triggers could be present. In any public space where food is present – such as sports and recreation venues, summer camps, amusement parks, movie theaters – there is a risk for an allergic person to come in contact with their allergen. To find out the status of epinephrine laws in your state, visit aafa.org/epinephrine.
Related Epinephrine Resources
- Researchers Review Effects of Heat, Cold, on Epinephrine
Researchers looked at what is known about the effects of extreme temperatures on epinephrine. - Guidelines for the Diagnosis and Management of Food Allergy in the United States (Leave KFA website)
The NIH guidelines provide steps for parents and medical providers on how to manage and treat food allergies and severe allergic reactions. - Anaphylaxis Action Plan from the American Academy of Pediatrics
(Leave KFA website) - What Is Anaphylaxis? Take Steps to Prevent Allergic Reactions
Learn how to recognize symptoms and treat anaphylaxis.
Updated January 2025
Medical review: “What’s the Difference Between Brand Name, Generic, and Authorized Generic Drugs?” reviewed January 2024 by Jerry Shier, MD
Ask the Allergist
Have a question on managing food allergies, asthma, other allergic conditions? Our allergist can help.
