In this video, Joe Alton, MD, aka Dr. Bones, discusses the recent scandal where Mylan corporation, the company that markets the life-saving autoinjector “Epi-Pen“, raised prices on a pack of two from $100 in 2007 to $600 today. Although the company has given out some savings cards for up to $300, only a certain few are eligible and definitely not if you’re on Medicaid. Indeed, now it appears that Mylan had been gouging the federal government as well, and is being investigated. Guess that’s proof that all publicity isn’t good publicity.
Joe Alton looks for an alternative and one option is to get vials of 1:1000 epinephrine, insulin syringes, and some alcohol wipes. In the video, Joe Alton describes the process for using prefilled epinephrine for a severe allergic reaction or anaphylactic shock, and the formula for adult and pediatric use.
Adult dose from drugs.com for anaphylaxis: “30 kg (about 66 pounds) or greater: 0.3 to 0.5 mg (0.3 to 0.5 mL 1:1000 epinephrine solution) of undiluted drug IM or subcutaneously into anterolateral aspect of the thigh; repeat every 5 to 10 minutes as needed. Maximum dose per injection: 0.5 mg (0.5 mL of 1:1000 epinephrine solution).”
Pediatric dose from drugs.com for anaphylaxis: “Less than 30 kg (about 66 pounds): 0.01 mg/kg (0.01 mL/kg) of undiluted drug IM or subcutaneously into anterolateral aspect of thigh; repeat every 5 to 10 minutes as needed. Maximum dose per injection: 0.3 mg (0.3 mL of 1:1000 epinephrine solution).”
To take an example, a 20 kg child (about 44 pounds) would, using the 0.01 mg/kg formula would need 0.2 mg, which translates in a 1:1000 epinephrine solution to 0.2 ml injected in the anterior/lateral aspect of the thigh.
There’s more to know, though, so check out Dr. Alton’s video. To watch, click the image below:
Wishing you the best of health in good times or bad,
Joe and Amy Alton