Life-saving adrenaline auto-injectors could become available in public places

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A public consultation will be needed before a decision can be made on the wider availability of adrenaline auto injectors (AAIs) in public places, along with legislative change.

Today’s landmark report outlines recommendations for the safe and effective use of AAIs, including quicker treatment, to help save lives. The Medicines and Healthcare products Regulatory Agency (MHRA) is taking forward these recommendations, some of which are already in place.

The recommendations follow the most thorough and rigorous scientific review of the products to date by the MHRA and the CHM’s Adrenaline Auto-injector Expert Working Group, with wide-ranging input from patient groups, leading allergy experts and healthcare professionals to make sure people have the best and latest safety information.

Health Minister, Lord Kamall said:

Access to adrenaline auto injectors is vital for many people in this country with potentially serious allergies.

This report has opened up the possibility of life-saving adrenaline shots being available in public spaces such as restaurants, which would give people with serious allergies access to treatment they need most, no matter where they are.

Professor Sir Munir Pirmohamed, Chair of the Commission on Human Medicines said,

Today’s report would not be possible without the continued engagement and support from patients, experts and healthcare professionals. I’d like to thank them for their valuable contribution, time and commitment on this important public health issue.

People with life-threatening allergies have the right to the best possible access to AAIs, as well as their use, in the safest and most effective way. They must be protected and these recommendations are designed to do just that.

Dr June Raine, MHRA Chief Executive said,

Our advice to those with life-threatening allergies is, make sure you know how to use your adrenaline auto-injector and that you have two with you at all times as a second dose of adrenaline may be needed if symptoms don’t improve after 5 minutes.

Your safety is always our priority. That is why, together with the healthcare system, we are implementing the report’s recommendations to improve the safe and effective use of AAIs, and to widen their access where they may be most needed, to help save lives.

Carla Jones, CEO of Allergy UK said,

It was a privilege to be a member of the Expert Working Group which produced this important report for our allergic community. These recommendations are absolutely fundamental in improving the understanding and use of AAIs – the first line of treatment for someone experiencing anaphylaxis, a condition that can be unpredictable and fatal.

These recommendations cover the full spectrum of correct anaphylaxis management, from the importance of early administration of adrenaline and the posture of the patient to timeframes and dose. And they also explore the case for making AAIs available in public spaces, presenting the key considerations for this innovation.

Crucially, the report emphasises the importance of understanding how to use the different brands of AAIs, given that a lack of confidence in and understanding of their use could quite simply be a matter of life or death and it reinforces the importance of carrying two AAIs at all times.

As the leading charity for people living with allergic disease we welcome this report and its recommendations which we believe will increase safe outcomes for people experiencing anaphylaxis.

Sarah Baker, Interim CEO of the Anaphylaxis Campaign said,

We welcome this report. This is a significant report which draws on learning from inquests following fatalities from anaphylaxis. The report also draws attention to pharmacokinetic data demonstrating how different AAI’s work and their respective benefits.

The overarching key messages for ‘What to do in an Emergency’ and how the allergic Individual can ‘Be prepared’ are messages that we should all be promoting.

An excellent report that should be bought to the attention of everyone in the world of allergy.

Notes to Editor

  1. The CHM’s report and recommendations can be viewed here

  2. In an emergency, if you have a severe allergic reaction:

    • Use your adrenaline auto-injector immediately if you have any signs of anaphylaxis. If in doubt use. 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.
  3. If you could have a severe allergic reaction:

    • 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. Get familiar with it. Get a trainer auto-injector from the manufacturer. Practise. If you change brand, get familiar with the new one. Each one is used differently.
  4. Epipen, Jext and Emerade are three brands of AAI licensed in the UK.

  5. More information about the treatment of anaphylaxis can be found on the NHS website here.

  6. The Commission on Human Medicines (CHM) advises ministers on the safety, quality and effectiveness of medicines. The CHM is an advisory non-departmental public body, sponsored by the Department of Health and Social Care.

  7. The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for regulating all medicines and medical devices in the UK. All our work is underpinned by robust and fact-based judgements to ensure that the benefits justify any risks.

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