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Ask the Allergist

Can I Use an EpiPen for a Severe Asthma Attack?

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I had a doctor in the past tell me to use an epi-pen for a severe asthma attack if my Albuterol inhaler wasn’t working. He’s retired and my new pulmonologist told me to just go straight to the hospital. Is it unsafe to use the epi-pen for an asthma attack?

In the past, injectable epinephrine was used in the emergency room as a treatment for acute asthma attacks or exacerbations that were not responding to standard treatments. Today, there are many new quick relief and controller medicines available to manage asthma symptoms.

In situations where typical asthma treatments are not working to control symptoms, epinephrine may help patients with severe asthma exacerbations. This would be a unique situation. This would typically be done in the emergency room while the patient is monitored.

If no other treatments are working to control asthma symptoms and an Epi-Pen is available, it could be administered. 9-1-1 should be called to activate Emergency medical services. The patient will need to be evaluated and managed in an emergency room.

Finally, there are some patients who have a history of anaphylaxis (e.g. due to a food, venom, or medication) and asthma. It would be fine for these patients to use epinephrine first and then appropriate asthma medications if the patient is not sure if their symptoms are due to an anaphylactic reaction, asthma, or both. Again, the patient would need to be evaluated in the emergency room after these treatments.

Allergy, Asthma, Medicines, Treatment
Answered by

John M. James, MD, is a board-certified allergist. He is also President of Food Allergy Consulting and Education Services, LLC. He has worked as a medical specialist in the field of allergy, asthma, and immunology for over 30 years. Dr. James received his bachelor’s degree from the University of Arkansas and his Doctor of Medicine degree from the University of Tennessee. He is board certified by the American Board of Allergy and Immunology.

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