Anaphylaxis in infants and toddlers:
The rising rates and treatment challenges.
Not only can anaphylaxis be difficult to identify in infants and toddlers, but many caregivers are often unprepared to treat an allergic emergency. Learn more about the special challenges associated with this patient group.
Anaphylaxis has increased among infants and toddlers.
In a study of more than 56,000 emergency department visits for anaphylaxis in the United States from 2005 to 2014, the overall increase in the rate of visits for children aged 0 to 4 years was almost 130%.20
In a study† describing age-related patterns in the symptoms of children (≤18 years) presenting with food-related allergic reactions at 2 emergency departments over 6 years, the largest proportion of patients with symptoms of anaphylaxis were younger than 2 years old.21
Infants less frequently had a history of known allergy to the offending food or allergic disorder when compared with children ages 2 to 18.21
AUVI-Q® (epinephrine injection, USP) is indicated in the emergency treatment of allergic reactions (Type I) including anaphylaxis to allergens, idiopathic and exercise-induced anaphylaxis. AUVI-Q is intended for patients with a history of anaphylactic reactions or who are at increased risk for anaphylaxis.
Important Safety Information
AUVI-Q is intended for immediate self-administration as emergency supportive therapy only and is not a substitute for immediate medical care. In conjunction with the administration of epinephrine, the patient should seek immediate medical or hospital care. Each AUVI-Q contains a single dose of epinephrine for single-use injection. More than two sequential doses of epinephrine should only be administered under direct medical supervision. Since the doses of epinephrine delivered from AUVI-Q are fixed, consider using other forms of injectable epinephrine if doses lower than 0.1 mg are deemed necessary.
AUVI-Q should ONLY be injected into the anterolateral aspect of the thigh. Do not inject intravenously, or into buttock, digits, hands, or feet. Instruct caregivers to hold the leg of young children and infants firmly in place and limit movement prior to and during injection to minimize the risk of injection-related injury.
Rare cases of serious skin and soft tissue infections have been reported following epinephrine injection. Advise patients to seek medical care if they develop any of the following symptoms at an injection site: redness that does not go away, swelling, tenderness, or the area feels warm to the touch.
Epinephrine should be administered with caution to patients with certain heart diseases, and in patients who are on medications that may sensitize the heart to arrhythmias, because it may precipitate or aggravate angina pectoris and produce ventricular arrhythmias. Arrhythmias, including fatal ventricular fibrillation, have been reported in patients with underlying cardiac disease or taking cardiac glycosides or diuretics. Patients with certain medical conditions or who take certain medications for allergies, depression, thyroid disorders, diabetes, and hypertension, may be at greater risk for adverse reactions. Common adverse reactions to epinephrine include anxiety, apprehensiveness, restlessness, tremor, weakness, dizziness, sweating, palpitations, pallor, nausea and vomiting, headache, and/or respiratory difficulties.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
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All eligible patients with commercial insurance, including those with high-deductible plans, can get AUVI-Q® (epinephrine injection, USP) in 2 easy steps through the direct delivery service. To get started, simply download and fill out your information, then bring the form to your physician and/or designated retail pharmacies to complete.
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Camargo CA Jr., Guana A, Wang S, Simons FER. Auvi-Q versus EpiPen: preferences of adults, caregivers, and children. J Allergy Clin Immunol Pract. 2013;1(3):266-272.e1-3.
Ma L, Danoff TM, Borish L. Case fatality and population mortality associated with anaphylaxis in the United States. J Allergy Clin Immunol. 2014;133(4):1075-1083.
Gupta RS, Springston EE, Warrier MR, et al. The prevalence, severity, and distribution of childhood food allergy in the United States. Pediatrics. 2011;128(1):e9-17.
Blue Cross Blue Shield Association (BCBSA). The health of America report: childhood allergies in America. https://www.bcbs.com/the-health-of-america/reports/childhood-allergies-america. Published March 13, 2018. Accessed August 15, 2018.
Parlaman JP, Oron AP, Uspal NG, DeJong KN, Tieder JS. Emergency and hospital care for food-related anaphylaxis in children. Hosp Pediatr. 2016; 6(5):269-274.
Tang ML, Mullins R. Food allergy: is prevalence increasing? Intern Med J. 2017; Mar; 47(3):256-261.
Rudders SA, Arias SA, Camargo CA. Trends in Hospitalizations fro Food-Induced Anaphylaxis in US Children, 2000-2009. J Allergy Clin Immunol. 2014; 134(4): 960-962.
Clark S, Espinola J, Rudders SA, Banerji A, Camargo CA Jr. Frequency of US emergency department visits for food-related acute allergic reactions. J Allergy Clin Immunol. 2010;127(3):682-683.
Lieberman P, Nicklas RA, Randolph C, et al. Anaphylaxis—a practice parameter update 2015. Ann Allergy Asthma Immunol. 2015;115(5):341-384.
Kelly KJ, Kurup VP, Reijula KE, Fink JN. The diagnosis of natural rubber latex allergy. J Allergy Clin Immunol. 1994: 93(5):813-816.
Bock SA, Muñoz-Furlong A, Sampson HA. Fatalities due to anaphylactic reactions to foods. J Allergy Clin Immunol. 2001;107(1):191-193.
Sampson HA, Mendelson L, Rosen JP. Fatal and near-fatal anaphylactic reactions to food in children and adolescents. N Engl J Med. 1992;327(6):380-384.
Bock SA, Muñoz-Furlong A, Sampson HA. Further fatalities caused by anaphylactic reactions to food, 2001-2006. J Allergy Clin Immunol. 2007;119(4):1016-1018.
Kim H, Fischer D. Anaphylaxis. Allergy Asthma Clin Immunol. 2011;7(Suppl 1):S6
Hochstadter E, Clarke A, De Schryver S, et al. Increasing visits for anaphylaxis and the benefits of early epinephrine administration: A 4-year study at a pediatric emergency department in Montreal, Canada. J Allergy Clin Immunol. 2016;137(6):1888-1890.
Edwards ES, Edwards ET, Gunn R, Patterson P, North R. Design validation and labeling comprehension study for a new epinephrine autoinjector. Ann Allergy Asthma Immunol. 2013;110(3):189-193.
Simons FER. Anaphylaxis in infants: can recognition and management be improved? J Allergy Clin Immunol. 2007;120(3):537-540.
Motosue M, Bellolio MF, Van Houten HK, Shah ND, Campbell RL. Increasing emergency department visits for anaphylaxis, 2005-2014. J Allergy Clin Immunol Pract. 2017;5(1):171-175.e1-3.
Rudders S, Banerji A, Clark S, Camargo CA Jr. Age-related differences in the clinical presentation of food-induced anaphylaxis. J Pediatr. 2011;158(2):326-328.
Terms and Conditions
Only valid for commercially insured patients in the 50 United States and DC through the direct delivery service and/or designated retail pharmacies. Not eligible if prescriptions are paid for in part/full by state or federally funded program(s), like Medicare Part D, Medicaid, Vet. Aff., Dept. of Def., or Tricare, and where prohibited by law. OFFER IS NOT INSURANCE. Offer cannot be sold, purchased, traded, transferred, and cannot be combined with any other offer. Cash discount cards are not commercial payers and are not eligible to be used for this program. Offer provided by kaléo, and it may change at any time without notice. Call 1-877-30-AUVIQ for questions regarding offer eligibility.