The Food and Drug Administration (FDA) has approved a 0.15mg dose of Symjepi (epinephrine; Sandoz) to treat pediatric patients who weigh between 33 and 65 pounds. Symjepi is an emergency treatment for allergic reactions (Type 1) including anaphylaxis to stinging and biting insects, allergen immunotherapy, foods, drugs, diagnostic testing substances and other allergens, as well as idiopathic or exercise-induced anaphylaxis.
The 0.3mg dosage strength of Symjepi was approved in June, 2018 for patients who weigh ≥30kg. Both doses will be supplied in single-dose, prefilled syringes for manual injection. Symjepi can be injected intramuscularly or subcutaneously, and through clothing if necessary.
Epinephrine acts on both alpha and beta-adrenergic receptors. Through its action on alpha-adrenergic receptors, epinephrine lessens the vasodilation and increased vascular permeability that occurs during anaphylaxis, which can lead to loss of intravascular fluid volume and hypotension. Through its action on beta-adrenergic receptors, epinephrine causes bronchial smooth muscle relaxation and helps alleviate bronchospasm, wheezing and dyspnea that may occur during anaphylaxis. When given subcutaneously or intramuscularly, epinephrine has a rapid onset and short duration of action.
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