The History (and Future) of the EpiPen

Many of you probably saw the Throwback Thursday to the Ana-Kit on Our Food Allergies Aren't a Joke a while back. I found it interesting - I had never thought about what happened before EpiPens - so I Googled it a bit. Then, a few days ago, a nurse was talking to me about how much EpiPens have evolved even in the last few years. With this, I decided to do a little digging into the history of EpiPens. The pictures link back to the original source.

This case is known as an Ana-Kit, one of the first products widely available for emergency self-injection. It contained a syringe of epinephrine and chlorpheniramine tablets (an antihistamine).

This is the Ana-Kit next to the first EpiPen, which was available to the public in 1980. The EpiPen uses a spring-loaded needle activated by the pressure of a swing-and-jab motion. The concept for this device is based on a military auto-injector for nerve suppressants. Even in the early 2000s, EpiPens were still relatively new and the benefits of these two devices were highly debated, much like the current EpiPen Auvi-Q debate.

The EpiPen went through several design changes between 1980 and now. Some features were added for safety, like the automatic needle retraction after use. Others, like the flip lid and an orange needle-end, were added for convenience.

As the EpiPen was developing, the Twinject and Adrenaclick devices became available. These are similar to the old EpiPen in design, but the Twinject contains two doses of epinephrine. The Twinject is no longer sold in America, as of March 2012, but to my knowledge is still relevant in Canada. Generic auto-injectors currently come in the form of the Adrenaclick.

Late in 2012, just months after the discontinuation of the Twinject, the Auvi-Q was released. This device is smaller and a more manageable shape to carry. This device also features a recorded voice to provide verbal instructions for use. In addition, it can be released through steady and direct pressure rather than a swing-and-jab motion. It gained immediate popularity and directly contests the EpiPen.

Maria Pitallano's Epi-Inject pen was proposed in 2011, but has yet to be approved by the FDA. This pen features a carabiner clip for attachment to bags. It uses a trigger, rather than pressure, to activate the spring-loaded needle.

In the same series, Maria Pitallano proposed a version of the Epi-Inject for public use. This is a large wall-mounted device to be stored at restaurants and other places with high reaction rates and is less awkward for a stranger to use on a person having a reaction. The design features audio and visual instructions and a refillable cartridge to withstand multiple uses.

All of these devices are evolving constantly. We have gone from a vial and exposed needle to devices anyone can use immediately without prior knowledge or training. Until a cure can be found for allergies, I'm glad so many innovations have shaped the way we treat life-threatening reactions.