Using Epipen Jr. for backup in over 40 lb child

Posted on: Wed, 08/08/2001 - 4:44pm
Kim M's picture
Joined: 06/09/2001 - 09:00

My three year old daughter just passed 40lbs, so our allergist gave us a new prescription for full strength Epipens. I had recently refilled the Rx for Epipen Jrs because the pens I had were expiring. So now I have 4 Jr pens that are good for about another year.

I hate to throw them away. Does anyone know if it is OK to use them as backup? They are half the strength of the adult pens, so I would probably need to use two pens if it ever came to that. As I was typing this post I had the thought that maybe I should ask my pharmacist if I can return them, and get a refund. I have no idea if it is even legal to take back medication. Has anyone else had this situation? What did you do?

Posted on: Wed, 08/08/2001 - 9:44pm
jh5000's picture
Joined: 03/02/2000 - 09:00

This is the first I've ever heard of prescribing a full-strength Epi-pen for a child at 40 pounds (!). The literature that comes with the Epi-pen, Jr. says it's to be used until the child is 66 pounds (30 kg). I'd double check with your doctor, a pharmacist, or the manufacturer (Dey) itself.

Posted on: Wed, 08/08/2001 - 10:41pm
torontosue's picture
Joined: 06/08/2001 - 09:00

The Epipen Jr in my kitchen says for kids under 15 kg in weight....converted that would be just under 35 lbs. I think I remember switching to the full strength Epi's when Taran was about 40 lbs, but what the doctor did was tell us to get 2 Jr's instead of one full strength, and use first a jr, but we'd have the other one there if it wasn't enough medication to do the trick.
Taran now weighs 58 lbs and is into the adult strength. I'd talk to my doctor again if I were you.

Posted on: Thu, 08/09/2001 - 7:29am
Kim M's picture
Joined: 06/09/2001 - 09:00

I have read several other posts on this site that speak of full strength epi's for children over 40 lbs. As a matter of fact, when the doctor told me he was giving us a prescription for the full epi I said, "Oh, that's right; she's 40 pounds." He was surprised that I knew that, and when he asked how I knew, I told him through this web site.
I checked the info insert with the epipen. It states that the recommended dosage of epinephrine is .01 mg/kg. At 42 lbs my daughter is about 19 kg, and therefore over the .15 mg in the junior epi, but under the .3 in the adult strength. I like what torontosue's doctor advised her about using one jr pen and if more is needed then a second. I will talk to my doctor about that option. Thanks!

Posted on: Thu, 08/09/2001 - 11:18am
Anonymous's picture
Anonymous (not verified)

The last time we went to the allergist (a few months ago) he told us that we would soon have to change to Adult strength Epi's also. Jacob weighs 44lbs right now. Guess I should be calling them back soon.

Posted on: Thu, 08/09/2001 - 12:17pm
Laura Joy's picture
Joined: 01/23/2001 - 09:00

I don't know about using two epi pen jrs. but I refilled my son's perscription for soon to expire epi pens and took them home without opening them up. I opened them at home to find the expiration date to be only one month later than the soon to expire pens. The pharmacy said that we could not return epi pens which had left the pharmacy. I quess that is understandable because I could have disabled them or tampered with them somehow. However, I assumed that the new epi pens would be good for a year and if they were not someone should point this out. The pharmacy said they are at the mercy of the epi pen manufacturer and that this is all they have available and couldn't give me anything with a later expiration date. And they also had no idea when another shipment would come in. I need to complain to my allergist and should probably call the epi pen company as well . There is probably a phone number on it. That's my little tidbit of annoying and expensive and dangerous information. It is hard enough to make sure you don't miss the expiration dates since our health plan only allows us to purchase thru the plan two or three epi pens at a time. Then we must wait several months to refill. If we could buy them all the same time every year it would be safer and more efficient.

Posted on: Thu, 08/09/2001 - 12:49pm
Kim M's picture
Joined: 06/09/2001 - 09:00

I think there was another thread about Epipen expiration dates. Until I read about other peoples' problems I didn't even think to ask the pharmicist for as long an expiration date as possible. One time when I refilled them I got one with a date six months out, which I thought was a bit short. But one month! I would make a huge stink about that. It is basically a waste of your money. Did you talk to the pharmacy manager? I don't actually think they are at the mercy of the manufacturer, I think it is probably their supplier. I am having a similar discussion with my pharmacy about my albuterol inhaler. They are telling me that the only brand of generic they can get is one that I hate, and it is the supplier who is telling them they can't get anything else. I am going to call some other pharmacies and find one who will offer another brand. I don't believe they can't get them; I think they just want to buy the cheapest brand. If you can't get a satisfactory answer from your pharmacy, I would do the same thing, and let them know why you are taking your business elsewhere.

Posted on: Sun, 08/12/2001 - 7:33am
jh5000's picture
Joined: 03/02/2000 - 09:00

Well, given that so many allergists seem to be in agreement on this one, I guess I'll be checking with my 35-lb daughter's allergist come Monday regarding the need to switch to adult Epi's at 40 lbs. I'm still confused, however, since the info with my EpiJrs says the following: "A dosage of 0.01 mg/kg body weight is recommended. Epipen, Jr., which provides a dosage of 0.15 mg, may be more appropriate for patients weighing less than 30 kg (66 lbs.)" and also states "Some patients may be at greater risk of developing adverse reactions after epineprhine administration. These include ....pediatric patients under 30 kg (66 lbs) body weight using EpiPen, and pediatric patients under 15 kg (33 lbs) using Epipen, Jr." It does give great latitude in allowing for the physician's judgement, however, so I guess most physicians don't agree with Dey's recommendation.

Posted on: Sun, 08/12/2001 - 11:00am
Kim M's picture
Joined: 06/09/2001 - 09:00

I found that wording very confusing, also. I guess the bottom line is that for a 40 lb child the .15 mg Jr. pen is less than the recommended dosage. It's unfortunate that there isn't a dosage in the middle somewhere. It is definitely not something that you want to take chances with if you are in a situation where you need to use an epipen.

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