EpiPen or EpiPen Jr.

28 replies [Last post]
By n5vox on Tue, 01-15-02, 20:40

Which pen should a 10 year child have? It seems most people here refer to the Jr. and I have a regular pen? Did my pediatrician prescribe the wrong one? He did not even question me about my sons allergies - just took my word for it and gave me a prescription???

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By smack on Tue, 01-15-02, 21:03

Hi,
My son is 4, and has had the regular epipen for about a year now. I believe it has to do with weight. Your 10 year old would have a regular epipen so your ped. is right.

[This message has been edited by smack (edited January 15, 2002).]

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By n5vox on Tue, 01-15-02, 21:07

Thank you for replying to my question! I have ask a lot of questions and for some reason I never seem to get any responses. Do you think it is my username?

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By BENSMOM on Tue, 01-15-02, 21:13

smack, how much does your 4-yo weigh? I think you get the epi jr under 50 or 60 lbs (but not sure.) Ben is 6 and has the jr still, but he's still under 40 lbs.

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By smack on Wed, 01-16-02, 00:21

BENSMOM,
You just totally freaked me out, I went up to check and the epipen jr. says 15kg and less so that x2.24=33.6lbs. I called the pharmacist and he wasn't speaking English very well so I passed him on to my husband. He totally freaked me out because he said my son should be on the jr. and I told him "Why the heck have I had regular epipens for a year Now!!!" Anyway, after my husband talked to the pharmacist he concluded they make only 2 epipens. One is for 15kg and under the other is for over 15kg which is 33 lbs and up. My son is 39lbs, so he is on the right one,
Anyway, THANKS for mentioning this because it makes me aware to NEVER use this regular one on a little person if ever I had to, I couldn't anyway.
P.S. N5vox, I wish everyone would go by first names when ending their responses, it would help. I wonder if anyone else feels the same? Thanks for bringing up this post anyway, you kept me on my toes!

[This message has been edited by smack (edited January 15, 2002).]

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By joeybeth on Wed, 01-16-02, 00:57

smack...okay, now I'm confused. we have several epipen jr's for our two PA daughters ages 3 and 6 (weights about 29 lbs and 40+ lbs respectively). Should I have regular epipens for the older child???? I just assumed 6 was still young enough that an adult sized pen shouldn't be used. If the wt limit is somewhere around 33 or 34 lbs then the jr. is not going to be enough for my 6 yr old. someone please advise me on this one...Joey

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By Carefulmom on Wed, 01-16-02, 01:05

Actually, the cutoff is not 33 pounds. Epipen Jr. correlates with a weight of 33 pounds, and regular Epipen correlates with a weight of 66 pounds. Between 33 and 66 pounds is a judgment call. Some doctors make the switch at 50 pounds which is right in between. If your child is near 33 pounds, he should be on Junior. If he is around 66, he should be on full strength. In between, you should check with your doctor. My daughter is 6 and three quarters years old and 40 pounds and still on Junior. The person who has a 4 year old should probably be on Junior unless he is really big for his age. There was a discussion about adverse affects of epinephrine, and although I wouldn`t hesitate to give it, I definitely wouldn`t want to give the wrong dose! The doctor should get it right. I have access to a PDR, so I will look up what they say between 33 and 66 pounds and post again.

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By n5vox on Wed, 01-16-02, 01:07

Thanks for the responses. let me start over - my name is Amy and my sons name is Matthew. All of the user names I picked come up as already being registered. So - I went to my old standby - n5vox is my amatuer radio call sign - it is the one user name that is never used anywhere I go. I will try to remember to sign Amy from now on. Thanks again.

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By Carefulmom on Wed, 01-16-02, 01:07

Smack, just reread your post. If your son is 39 pounds, he should definitely be on Junior! I say this because 39 is much closer to 33 than it is to 66. Also, the full strength is twice as much epi.

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By Carefulmom on Wed, 01-16-02, 01:35

Per 2002 PDR, page 1236...usual adult dose is 0.3 mg. For pediatric uses, the appropriate dosage may be 0.15 or 0.30 mg depending upon the body weight...A dosage of 0.01 mg/kg/ body weight is recommended. Epipen Junior which provides a dosage of 0.15 mg may be more appropriate for patients weighing less than 30 kg (66 pounds). However the prescribing physician has the option of prescribing more or less than these amounts, based on careful assessment of each indiviual patient and recognizing the life-threatening nature of the reactions for which this drug is being prescribed....

As far as converting your child`s weight from pounds to kilos, you divide by 2.2. For example, my daughter is 40 pounds, which divided by 2.2 is about 18 kilos. Her dose should therefore be 0.18 mg. Since full strength is 0.30mg, and Junior is 0.15 mg, she is closer to 0.15 and gets Junior. Hope the above is helpful.

[This message has been edited by Carefulmom (edited January 15, 2002).]

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By smack on Wed, 01-16-02, 02:14

Hi guys,
I just read all the responses, Thanks again Amy for bringing this up.
My son's allergist changed him in October last year...he would have been around 33 lbs then, he is very slender and almost 5 now. I also remember the allergist saying when he was on the jr's that I may need to use 2 juniors if I were to have to use them and found that he wasn't responding with just one.
I agree that 39 lbs is closer to 33 lbs than 66 lbs and would feel more comfortable using the juniors one at a time and if need be using another if I had to rather than giving too much of the epinephrine as may be the case.
Man, either I have a really incompetent allergist, or one that believes that he needs a full blast of epinephrine if he has a reaction. I will definitely ask when we go on Jan 31st.
P.S.--Thank you Carefulmom for all your help, for all your insight! You gave us more info than the pharmacist.
Joeybeth, as you can gather I'm still at lost as to why my son has regular epipens so I would conclude yours is probably safer!

[This message has been edited by smack (edited January 15, 2002).]

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By Boone on Wed, 01-16-02, 02:22

My son is 5 1/2 and a very tall and slender 48 pounds. Our ped allergist will not switch him to the Epi until he is over 50 lbs. I totally agree with this. I would much rather give him two Epi Jr's than risk too much Epi with an adult pen. I think that this boils down to what each Dr is confortable with.

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By Carefulmom on Wed, 01-16-02, 02:34

Smack, one more thought. You could always call Dey --their number is probably somewhere on the insert--and talk to someone about the dose. Let us know if you do.

I hate to open up another can of worms, but for those who might give two doses of Junior would you do it in the same thigh or one in each thigh? I`m thinking two different thighs. What do the rest of you think?

[This message has been edited by Carefulmom (edited January 15, 2002).]

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By Kim M on Wed, 01-16-02, 15:26

Our allergist switched my daughter to regular epipen when she was over 40 lbs. I believe the thinking goes like this: the junior dosage is good for up to about 33 lbs. Since administration of the epipen can be crucial to survival in an emergency situation, it is better to give a dosage that may be a little high than not to give enough to do the job. I would not want to take the chance of giving the junior, waiting to see if that worked, and giving another if it didn't. But as we have seen here, different doctors think differently.

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By smack on Wed, 01-16-02, 17:23

Hi guys,
I just called the allergist and talked with the secretary. She said I would get a different answer as to when to switch from all the 3 allergists there however they would only be within 3to5lbs. So, she did ask my allergist and got back to me. She said the allergist switches around 35lbs because the epipens do indicate that the juniors are for 15kg and under so if your in the mind frame that the regular is too much for say 39lbs or 40lbs if you do use the junior are you going to feel comfortable giving 2? He just said people feel uncomfortable giving one and doesn't want the fear too be worse to have to give 2 if need be. So that is why he switches when kids are 35lbs and over to the regular.
I feel comfortable with his decision. I don't want teachers at school accessing his reaction and wondering if they need to give him another epipen. I would rather he is given enough to help the first time around.

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By PeanutKate on Thu, 01-17-02, 01:17

It is my understanding that there are instances where the epi-pen rather than the epi-pen jr. is medically necessary and is therefore prescribed by the doctor. Question your doctor about his/her reasons before panicing about carrying an epi-pen rather than an epi-pen junior for a child who is more than 30 pounds.

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By Carefulmom on Thu, 01-17-02, 03:38

Everyone seems to have different opinions about this. I do have to say that having used the Epipen, Junior once, it is very obvious when it works because it really does work RIGHT AWAY (within sixty seconds or less). So if you were to give one dose of Junior and then if it doesn`t work give a second dose, you really wouldn`t lose much time. You would definitely know within one minute after injecting it whether it was a big enough dose or not. My concern is that .30 mg (full strength) seems like a really high dose for my 18 kg (40 pound ) child and that is when you see adverse effects, especially cardiac. SO... I am going to call Dey and get the complete answer as soon as I get a chance. I`ll post what they say after I do.

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By PeanutKate on Thu, 01-17-02, 15:17

I did call both Dey and Allerex and the answer I got was that their guidelines are typical recommended dosages but that it is not always a one size fits all solution. They recommended talking to the doctor or having the doctor call them if I was concerned.

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By Austins mom on Thu, 01-17-02, 16:36

My son turned 9 on August 31st. Before then he was on EpiPen Jr. His ped. switched him to the regular one right before school started last Sept. He weighed 60 lbs. at the time, the pharmist informed me that he weighed enough for the reg. one now. Hope this helps

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By smack on Thu, 01-17-02, 16:53

My question to Dey is: Why don't they just say on the junior 30kg or less if the Doctor's are keeping them on the junior ones until that weight anyway?
I still dont't feel 100% on this. I will talk face to face with our allergist at the end of the month.
It doesn't make sense that Dey make a junior for 15kg and under then a regular thats double the dosage. I think if the questions are about too much epinephrine going into someone just over 15kg then they should CHANGE the 15kg on the JUNIOR TO 30KG

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By booandbrimom on Thu, 01-17-02, 17:24

I was trying to find the source (and couldn't) before posting on this one, but I have read or heard that epinephrine is actually prescribed on the basis of body surface area. The weight is given as a guideline because it's so hard to quantify surface area.

That's why some older (bigger) children are on the regular Epi even though they don't meet the weight requirement. If I find the source I'll let you know - it may be in the new allergy book by Marian someone that has the foreword from Sampson.

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By becca on Fri, 07-29-05, 00:13

raising. I am thoroughyl confused now. I may bring it up with the pharmacist when I fill it. They are well versed on the risks. becca

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By ralarson on Fri, 07-29-05, 01:20

Yep. Pharmacists know a lot more about drugs than doctors. (In general.) I bet your pharmacist won't even flinch at the question. Good luck!

------------------
For more thoughts:
[url="http://ralarson.blogspot.com"]Ruth's blog[/url]

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For more thoughts
[url="http//ralarson.blogspot.com"]Ruth's blog[/url]

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By becca on Fri, 07-29-05, 04:28

Yes, I *know* this for a fact, and I think they would have an obligation to phone the Dr, if it were a dangerous dose as well. So, I plan to ask, for my knowledge, and to be sure it is safe for dd and that a professional with the correct knowledge addresses it with the Dr., if need be. becca

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By on Fri, 07-29-05, 05:22

I was just speaking about this with another PA parent the other day.

Jesse has had an Epi-pen (full strength) since he was 33 pounds or thereabouts -
3-1/4 years old I know we used the full strength Epi with him.

I just had to re-order an Epi-pen this past week and was speaking with the pharmacist about a special form that no pharmacy in Toronto appears to have that I have always had to use to order them when not living in Toronto and it's the same Province I've always lived in, so the discussion was centered on whether or not he had gotten that form, rather than the other form, which takes about two months for you to get your Epi-pen (with my insurance).

At any rate, he called me back to check to see if Jess got a Jr. or the regular strength one and I told him the regular strength one.

He then said that he's not even clear why they make a Jr. size one at all.

Jess weighs in right now at about 55 pounds (the day he gains any weight, I'll be in heaven [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] ).

There has also been much discussion here about Epi-pen Jr. versus Epi-pen and I always found that there was a difference in Canadian and American prescribing habits and I'm not clear why. [img]http://uumor.pair.com/nutalle2/peanutallergy/confused.gif[/img]

Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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By saknjmom on Fri, 07-29-05, 10:59

my son's dr raised his epi to regular a couple of years ago. i think he was in the 4- to 50 lb range.
I really trust our allergist and feel good about the info and advice he gives me. i went to the pharmacy to fill the regular epi and the pharmacist red flagged it. he was asking me how much he weighed (he was four at the time). he recommended that i stay with JR for awhile. so, he was saying that if i gave adult dose he could have a blood pressure issue and the adult dose could make him very jittery etc, but if i chose to stay with JR that he may require two shots.
So, i called dr and he was adamant that the regular epi was correct for DS based on his weight etc.
So, we stayed with regular. i also think that on epi pen website there is info about JR and Regular.

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By mom2gracie on Fri, 07-29-05, 15:16

Here is the info from the EpiPen website. Hope it helps.

EpiPen

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By Q'sMommy on Fri, 07-29-05, 18:24

First, I am in Ontario, Canada.

The 3 epi pen jr. I have in my house right now say for 15 kg and under (roughly 33 lb.)

I have always wondered why it is such a big difference in Canada and the U.S. when the epipen jr. dose is the same in both countries!?

Ali [img]http://uumor.pair.com/nutalle2/peanutallergy/cool.gif[/img]

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By happycat on Fri, 07-29-05, 22:39

I've been confused about this for about a year now.

When I got refills last summer, I mentioned my DS was over the 15kg limit for the epipen junior. I was told that his doctor doesn't like to precribe a regular epipen until his patients are much heavier, which seems to be the norm in the U.S. - at least it seems that way from what I've read here (I'm in Canada).

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