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- Page navigation anchor for Adrenaline auto-injector prescribing may be putting patients at riskAdrenaline auto-injector prescribing may be putting patients at riskAdrenaline auto-injector (AAI) prescribing for children in UK primary care increased dramatically since 2000.1 As these young patients grow older an increasing number of adults will require AAIs to mitigate their risk of an anaphylactic reaction.Current National Institute for Health and Care Excellence (NICE) guidance advises that adults and children aged over 12 years should receive 500 micrograms adrenaline intramuscularly at the onset of suspected anaphylaxis, with doses of 300 micrograms and 150 micro advised for children aged six to 12 years and under six years respectively.2A recent audit of AAI prescribing I undertook while working at a West London surgery found 100% adherence to these doses for patients aged under six years, but adherence fell to 62% in children aged six to 12 years and to just 3% in patients aged over 12 years.The current lack of a 500 microgram AAI in the popular 'Epipen' range may be a factor in the under dosing of adults at risk of anaphylaxis (96% of AAIs prescribed were from this range). 500 microgram AAIs are available as part of the local formulary at a similar price to 'Epipen' products but appear to be seldom prescribed despite this.Care should also be taken to ensure that the dose of AAI prescribed is increased appropriately as young patients turn six and 12 to avoid the p...Show MoreCompeting Interests: None declared.