Severe Asthma and EpiPens

I have some questions about the use of EpiPens for a severe asthma attack.

Background Information: My past two allergists, who have now retired, said I should use an EpiPen for a severe asthma attack if my Albuterol inhaler or Albuterol nebulizer treatments were not giving me any relief. My new allergist does not agree with the use of an EpiPen for a severe asthma attack. She wants me to just to go straight to the hospital. She said the EpiPen should only be used if I have a severe allergic reaction. This concerns me greatly because several times in the past the EpiPen was the only medication that gave me some relief. Also when we are at our cabin we are 45 minutes from a hospital. During my last severe asthma attack which was caused by second hand smoke, I had to have three breathing treatments and two EpiPens. I had some relief from the EpiPens but I was still having trouble breathing when I arrived to the hospital. The ER doctor was happy with the medications I had already taken.

Do you carry EpiPens that you use for severe asthma attacks? 

What does your allergist or pulmonologist say about the use of EpiPens for a severe asthma attack?


Comments 7

  • Jen

    I do know that prior to albuterol inhalers becoming more commonplace, epinephrine was the standard of care for a severe attack.   Would you feel comfortable discussing this further with your doctor?

  • LK

    That is interesting about the previous use of epi-pens before albuterol inhalers.

    Does using your epi-pen for a severe asthma attack depend on if the asthma attack is triggered by an allergic reaction?  As in allergic asthma? 

  • Shea

    I feel treatment should be a two-way conversation, and that the plan should be one you are both comfortable with and that takes into account your personal history (not just their typical treatment plan). Maybe you can try another doctor in the same specialty for a second opinion, or specialist in a different area like an allergist who is familiar with prescribing epipens?

  • K8sMom2002

    Hugs on the change in what has worked for you in the past … do you have an allergy that could cause anaphylaxis? Is that why you were prescribed the epinephrine?

    The reason I ask is that because my DD does have a life-threatening food allergy and a latex allergy, our docs suggest we err on the side of caution and use the epinephrine auto-injector first if she has sudden and severe breathing problems. They say it's hard to tell an allergic reaction from a severe asthma attack at times.

    But her asthma is well-controlled and has a very predictable pattern. Each person's asthma is unique and different and requires a different .

    I agree with Jen and Shea … Could you talk with your doctor and explain what you have with us, and ask her to go through your asthma action plan? It's good, too, to point out that you are 45 minutes away from emergency care. Maybe she thought you would just use the epinephrine and not go to the hospital? 

    What would be her suggestion for how to avoid the attack to begin with? Are you on a long-term controller? Could she look at your meds and tweak them?

  • MMKB

    Thanks for your replies. Yes, I have allergic asthma. I have food, environmental and latex allergies. My doctor does not want me to use an EpiPen if I know the trigger is not allergy based. If I'm 45 minutes away from the hospital, I was instructed I can use my nebulizer all the way to the hospital if I'm not getting relief. My long term controller medications are – Xolair injections, Qvar 80mcg 2 puffs 2x a day, Spiriva 1.25 mcg 2 puffs 1x a day,  Breo 200mcg/25mcg 1 puff 1x a day, Patanase nasal spray, Nasonex nasal spray, Atrovent nasal spray. The only oral antihistamine that is currently effective for me is 75mg of Benadryl which I can only take at bedtime. Currently I'm still having daily asthma and allergy problems. In the past my allergies have been less active at this time of year. The plan is for me to restart allergy shots again on Tuesday, even though I could not tolerate them in the past due to allergy and asthma reactions.

  • Pljohns

    I too carry an epi pen and am not sure why-except for anaphylactic reactions to some meds and I never really know how new meds are going to act on me. My current list of meds that I had reactions to take is about 19 long and unfortunately growing.  I am not allergic to anything else-no foods, environmental or anything else-I’ve been stuck, scraped and everything else enough to believe them when they tell me everything comes back clean.  Non-allergic asthma sucks!  I know several of us here have this lovely type.  A few years ago my doc insisted that I begin carrying an eye pen and I have ever since-they usually expire before I know it as I’ve never had to use one-and hope I don’t.  I guess better safe than sorry-