Medical Experts Urge Immediate Use of EpiPens for Anaphylaxis

A recent article published in the Canadian Medical Association Journal emphasizes the critical role of epinephrine in managing anaphylaxis, a severe allergic reaction that can be life-threatening. The piece highlights that epinephrine, delivered via an auto-injector such as the epi-pen, is the only treatment that can prevent fatalities during such emergencies.

The article asserts that “Intramuscular epinephrine rapidly reverses airway edema and shock,” and warns against relying on less effective alternatives. Current medical evidence indicates that antihistamines and corticosteroids do not prevent the progression of anaphylaxis or subsequent biphasic reactions. This underlines the importance of administering epinephrine without delay, as waiting for other medications could prove dangerous.

Anaphylaxis is often triggered by common allergens, including peanuts, tree nuts, milk, eggs, fish, shellfish, and sesame seeds. Alarmingly, Health Canada estimates that approximately 600,000 Canadians are at risk for life-threatening allergic reactions, a figure that is on the rise, particularly among children.

As some patients are hesitant to use needle-based treatments like the epi-pen, an intranasal epinephrine spray is being explored as an alternative. Although this option is currently unavailable in Canada, the article notes that it has been approved in the United States. “Intranasally delivered epinephrine could benefit those with needle phobia or other limitations,” the article states, highlighting the potential for broader access to life-saving treatments.

While the nasal spray remains under review in Canada, officials are considering it for patients aged four years and older who weigh at least 15 kilograms. As of November 2025, the status of this option is still pending approval.

The article also discusses varying recommendations for emergency medical services (EMS) following the administration of epinephrine. A 2023 update on anaphylaxis practice parameters suggests that home observation may be appropriate if symptoms completely resolve within 10 to 15 minutes after a single dose. However, the Canadian Paediatric Society advises that all children who receive epinephrine should be assessed in an emergency department.

Auto-injectors are recommended for all individuals experiencing anaphylaxis for the first time, as well as those with a history of prior reactions. The article adds that individuals exhibiting less severe allergic reactions, those with certain risk factors such as mast cell disorders or uncontrolled asthma, and those living more than 30 minutes away from EMS should also be provided with self-injectable epinephrine.

For more detailed information, the full text of the article can be accessed online.