The quick answer is that no, Epipen and Auvi-Q are not the same, but they are very similar. Although containing the same medication, they deliver the medication via two different devices. These products are not interchangeable (meaning your pharmacist couldn't give you Auvi-Q instead of Epi-Pen without a new Rx or the doctor's approval); however, since they only differ in the delivery device, your doctor may choose to substitute one for the other to ensure you have access to this life-saving medication.
In a true anaphylactic emergency, there may be the rare instance where the patient prescribed Auvi-Q doesn't have it available, or vice-versa. If, for whatever reason, an unexpired, unused Epi-Pen or similar generic were immediately at-hand, I wouldn't hesitate to administer it to the victim if the alternative is to do nothing and wait for EMS.
Epinephrine is a safe enough medication that, when administered correctly in an allergic emergency, the risk of harm to the patient is minuscule compared to the very real risk of death if left untreated. It's worth pointing out that in providing reasonable assistance to a person in distress or danger, you are legally protected from liability for any unintended consequences of the help you provide. This is called a Good Samaritan law, and these laws exist in one form or another in all 50 states in the US.
Anaphylaxis is a life-threatening emergency where the body has an allergic reaction that's severe enough to cause swelling with the potential to totally close off aperson's airway. Epinephrine is a medication that can partially reverse this process and save the person's life, but it has to be given as soon as possible, and can only be given by injection. Also, because epinephrine can cause serious damage to areas with very small blood vessels like ones in your skin, the injection has to be made into a large muscle.
Intramuscular (IM) injections require a pretty big needle that can be very intimidating to draw up and give a dose of epinephrine with. In a emergency, the person giving the injection likely doesn't have the training or experience to do this manually under pressure, so the auto-injection device helps alleviate a lot of these problems by making the injection process as quick and fool-proof as possible.
Epinephrine auto-injectors are devices containing a premeasured dose of epinephrine in a small reservoir. Attached to this is a large intramuscular needle, which is coupled to a compressed spring and release mechanism. All of this is hidden in a neat device that is designed to be "not terrifying" to use. The outside of these devices is where the main differences between Epi-Pen and Auvi-Q occur; otherwise, they're very similar.
EpiPen & Friends
EpiPen, as well as its official "generic" version, and other pen-type auto-injectors like AdrenaClick are all the size of a big Sharpie marker. To use:
- Remove the device from its carrier tube and hold it in a fist with the orange end down.
- After pulling the safety guard off the opposite blue end, position the orange end perpendicularly over the injection site on the middle of the outer thigh.
- Swing the pen and push firmly into the thigh until a click is heard, which starts the injection.
- Count 3 seconds, then firmly pull the device straight out and away from the thigh, and massage the injection site for 10 seconds to help move the medication. The orange tip should extend to automatically cover the needle as you pull the device away; however, be aware that it may not do this completely, and the device should be treated as sharps waste as appropriate.
Auvi-Q is a similar concept taken one step further to try to make the auto-injector easier to use for people with no training on these devices. The device is a little bigger than a deck of cards. To use:
- Removing the outer plastic case activates recorded verbal instructions, "If having an allergic emergency, pull red safety guard down and off of Auvi-Q."
- Remove the guard and the voice instructs you to place the black end over the injection site (again, middle of the outer thigh) and push straight in firmly until a click is heard then hold for 2 seconds. The voice will count off "2...1...injection complete," and instruct you to seek medical attention.
During the 2-second injection process, the needle is discharged into the thigh, the medication is injected in half a second, and the needle fully retracts back into the device housing before the device is brought away from the skin.
This serves a couple purposes; not only is the needle never actually visible, but because it auto-retracts, the person administering it doesn't have to pull the needle out of the skin. If you've never given an IM injection, you likely won't know how much force to use to remove the needle; if you wiggle or twist the needle while removing, you can cause damage and bruising that can be pretty serious.
Finally, you may not know what to do with a used auto-injector, and might handle it without realizing the needle might be exposed. Auvi-Q tries to eliminate this possibility, and the device is immediately safe to handle and transport. It also prevents inadvertent reuse by ensuring no needle is available (it also verbally tells you that it's been used already).