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Emerging Therapies in Anaphylaxis: Alternatives to Intramuscular Administration of Epinephrine

  • Anaphylaxis and Drug Allergy (BT Kelly and M Castells, Section Editors)
  • Published:
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Abstract

Purpose of Review

Anaphylaxis is a severe, life-threatening, systemic allergic reaction that should be recognized and treated promptly. Intramuscular (IM) epinephrine is the first-line treatment for anaphylaxis and there are no absolute contraindications to its use. Despite its established track record of efficacy and safety, physicians and patients face barriers in the recognition and treatment of anaphylaxis, including the maintenance and appropriate use of epinephrine auto-injectors. This has led to investigation into potential alternatives to IM epinephrine administration in anaphylaxis.

Recent Findings

This review investigates the current standard of care in the treatment of anaphylaxis, barriers to IM epinephrine use, and alternative therapies under investigation for administration in anaphylaxis. Alternative routes under investigation include intranasal, sublingual, inhaled, and needle-free intramuscular administration of epinephrine.

Summary

There are currently numerous investigational alternatives to IM epinephrine therapy which could hold promise as future effective treatments in the emergent management of anaphylaxis.

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Authors and Affiliations

  1. Seattle Children’s Hospital, Seattle, WA, USA

    Brittany Boswell & Julie C. Brown

  2. Division of Emergency Medicine, Department of Pediatrics, University of Washington, Seattle, WA, USA

    Brittany Boswell & Julie C. Brown

  3. Boston Children’s Hospital, Boston, MA, USA

    Susan A. Rudders

  4. Division of Immunology, Department of Pediatrics, Harvard Medical School, Boston, MA, USA

    Susan A. Rudders

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  1. Brittany Boswell
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Boswell, B., Rudders, S.A. & Brown, J.C. Emerging Therapies in Anaphylaxis: Alternatives to Intramuscular Administration of Epinephrine. Curr Allergy Asthma Rep 21, 18 (2021). https://doi.org/10.1007/s11882-021-00994-0

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