The Evolution of Epinephrine
In today’s post, we’re going to walk through the history of epinephrine, the various vessels that carry this drug, and what’s on the horizon for this life-saving technology.
First, let’s talk about what it is.
Epinephrine is the drug form of adrenaline: a hormone naturally produced in the body. Adrenaline is released from the adrenal glands when your body is in “fight or flight” mode and perceives a threat.
For the food allergy community, this medication has life-saving potential and is the first line of defense for treating anaphylaxis—a life-threatening allergic reaction marked by constricted airways that occurs when an over-release of histamine and other chemicals flood the body.
The History of the EpiPen
In the 1970s, auto-injector technology was developed for military use as an antidote to nerve gas. This breakthrough led to the creation of the EpiPen, the first epinephrine auto-injector.
In 1987, the FDA approved the EpiPen and the company was eventually acquired by Mylan, a pharmaceutical company that partners with Pfizer to produce the product. For a time, the EpiPen was the only epinephrine auto-injector on the market—that has since changed.
The Rise of Competition
There are four main epinephrine auto-injector brands on the market today: EpiPen, Auvi-Q, Adrenaclick, and Symjepi. They all come in packs of two and have a shelf life of around 6-12 months.
Each is designed with a spring-loaded, one-time-use needle to inject a dose of either 0.15mg or 0.30mg of epinephrine into a person’s thigh. Why the thigh? Learn about it here!
In addition, they are portable and meant to be carried around at all times for those who are at risk of an anaphylactic reaction. Even with all of their similarities, each brand does have at least one key differentiator they can tout:
Auvi-Q
Gives auditory instructions to user and guides them through injecting epinephrine.
Small and compact design.
Adrenaclick
Similar design and shape as EpiPen, but less expensive.
Symjepi
A smaller needle & user-controlled injection that reduces product-related injury.
Small and compact design.
The Future of Epinephrine Auto-injectors
All of the current options available provide single-use needles injected into the thigh and have a shelf life of 6-12 months. Looking to the future, three companies are positioned to revolutionize the industry by addressing product-related injury and shelf life.
The first product, Utuly, is an intranasal epinephrine nasal spray that would require no needles—making it pain-free and easy to administer. The FDA granted the company Fast Track designation to work through the FDA approval process.
The second product, Neffy, is also an intranasal epinephrine nasal spray. Right now, they are also working their way through the FDA approval process.
The third and final product, Andi, is an epinephrine auto-injector that has almost twice the shelf life of the current competition. Through the use of a dual-chambered system separating the wet and dry injection ingredients, the product becomes temperature stable and longer-lasting. Andi is also in the middle of securing FDA approval.
For the past 40 years, the epinephrine auto-injector industry has been dominated by the EpiPen. As someone who has been lugging around large epinephrine auto-injectors all throughout childhood, it’s exciting to see newer, easier, and less expensive solutions on the horizon as I head into my post-college years.
Benjamin Gordon is a senior at the University of Wisconsin-Madison studying Consumer Behavior & Marketplace Studies with certificates in Entrepreneurship and Business. He’s had allergies to dairy, peanuts, tree nuts, fish, shellfish, and legumes since he was less than a year old, and he is a strong advocate for food allergy safety and awareness on campus. When he’s not figuring out what to eat, he loves to rock climb, play board games, and host barbecues. Benjamin is a summer intern for Amulet.
Disclosure: The CEO and co-founder of Windgap Medical, the maker of Andi, is a minority investor in Amulet.