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Adrenaline (Epinephrine) Injector Prescription Guidelines - Summary of 2022 Updates

25 March 2022

ASCIA Adrenaline (Epinephrine) Injector Prescription Guidelines have been updated in 2022 to provide the latest information to support the appropriate prescription and dose of adrenaline injectors for use in non-medical settings, for the emergency first aid treatment of potentially life-threatening severe allergic reactions (anaphylaxis).  The three main updates are outlined in this summary.

pdfASCIA HP Guidelines Adrenaline Injector Prescription UPDATES SUMMARY 202266.98 KB

UPDATE 1: ASCIA recommends the use of adrenaline as the first line treatment for anaphylaxis using either of the following two brands of adrenaline injectors:

If you do not want brand substitution, it is important to specify brand and tick box on PBS prescription. 

EpiPen® and Anapen® are also available without prescription.

Neither brand is currently rebated by Pharmac in New Zealand.

UPDATE 2: Both EpiPen® and Anapen® devices are widely used in other countries. Multiple brands of devices are available in most countries, and this is important for the following reasons:

 UPDATE 3: ASCIA recommends the adrenaline injector doses listed below, which are consistent with several publications. These include the Acute Anaphylaxis Clinical Care Standard for Australia, Australian Prescriber Anaphylaxis Wallchart, Australian Immunisation Handbook and international recommendations from the World Allergy Organisation (WAO), Canada and the UK.  

Children 7.5-20kg (aged around one to five years):

Adults and children over 20kg (aged around five years or over):

Adults and children over 50kg (aged around twelve years or over):

*The dose of adrenaline in Anapen® 500 is consistent with the intramuscular injection (IMI) dose recommendations for people who weigh more than 50kg in the publications listed on

ASCIA guidelines should be used in conjunction with clinical judgement, with consideration of issues that include training on a new device and preference of device from the patient or their carer.

© ASCIA 2022  

ASCIA is the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand