Epinephrine Instructions for Providers

1. Patients at risk of exposure to the trigger causing should have a prescription for an autoinjector and education on use prior to discharge. 2. Epinephrine can be hard to find in and expensive on many insurance plans. 3. Current options for autoinjectors are: Product NDC Weight/Age Additional info Generic 49502-101-02 0.15mg 7.5 to <25 kg Comes as 1 or 2-pak, 49502-102-02 0.3mg ≥ 25 kg 2-pak comes with trainer EpiPen Jr. 49502-501-02 0.15mg 7.5 to <25 kg Comes as 2-pak with trainer EpiPen 49502-500-02 0.3mg ≥ 25 kg Auvi-Q 60842-021-02 0.1mg 7.5 to <15 kg Comes as 2-pak with trainer 60842-022-02 0.15mg 15 to <30 kg Contains electronic voice 60842-023-01 0.3mg ≥ 30 kg instruction Adrenaclick 52054-803-02 0.15mg 7.5 to <25 kg Comes as 2-pak 52054-804-02 0.3mg ≥ 25 kg Latex free

4. Currently, most insurance plans will cover the generic pen although this is inconsistent and can change every 6 months. The preferred epinephrine autoinjector will vary by the patient’s insurance plan. 5. It is recommended to write prescriptions for epinephrine autoinjector (without brand specified) and a note added that the pharmacist “may substitute brand product as needed/preferred by the patient’s insurance”. 6. Patients who are seen at the Dell Children’s Emergency Room or a provider in the Specially For Children Office Building may have their epinephrine autoinjectors filled at the Dell Children’s Outpatient during business hours (M-F, 9am-5pm). Outside of business hours, prescriptions can be dropped off anytime and will be filled the following business day (then can be picked up any time after filled). 7. When prescriptions for autoinjectors filled at Dell Children’s Outpatient Pharmacy are rejected, the pharmacist will contact the provider and/or case manager to change to a different brand name or obtain prior authorization. Case management can also assist with funding issues for prescriptions. 8. Case management can contact the clinic at 512-628-1870 for further assistance if there is a problem filling a prescription for an epinephrine autoinjector.

Updated: 5/3/2019