Twinject Injection : Uses, Side Effects, Interactions & More
Why is this medication prescribed?
Twinject injection (Epinephrine injection) is used in conjunction with emergency medical treatment to treat life-threatening allergic reactions caused by insect bites or stings, food, medications, latex, and other causes. Twinject belongs to a class of medications called alpha and beta adrenergic agonists (sympathomimetic agents). It works by relaxing the muscles in the airways and tightening the blood vessels.
How should this medicine be used?
Twinject injection (Epinephrine injection) is presented as a pre-filled automatic injection device containing a solution (liquid) and in vials to be injected subcutaneously (under the skin) or intramuscularly (into the muscle). It is usually injected as needed at the first sign of a severe allergic reaction. Use Twinject injection exactly as directed; do not inject it more often or inject more or less than prescribed by your doctor.
Ask your doctor or pharmacist to show you and any of your caregivers who may be injecting the medication how to use the pre-filled automatic injection device. Training devices are available to practice how to use the automatic injection device during an emergency. The training devices contain no medications and are needleless. Before using Twinject injection for the first time, read the patient information that comes with it. This information includes instructions on how to use the pre-filled automatic injection device. Be sure to ask your pharmacist or doctor if you or your caregivers have any questions about how to inject this medication.
You should inject your Twinject injection as soon as you suspect that you may be experiencing a severe allergic reaction. Signs of a severe allergic reaction include airway closure, wheezing, sneezing, hoarseness, hives, itching, swelling, redness of the skin, rapid heartbeat, weak pulse, anxiety, confusion, stomach pain, loss of control urine or bowel movements, fainting, or loss of consciousness. Talk to your doctor about these symptoms and make sure you understand how to tell when you have a severe allergic reaction and should inject Twinject.
Keep your automatic injection device with you or available at all times so that you can inject Twinject quickly when an allergic reaction begins. Please note the expiration date printed on the device and replace it when this date passes. Look at the solution on the device from time to time. If the solution is discolored or contains particles, call your doctor to obtain a new injection device.
Twinject injection helps treat serious allergic reactions, but is not a substitute for medical treatment. Get emergency medical treatment immediately after injecting Twinject. Rest quietly while waiting for emergency medical treatment.
Most automatic injection devices contain enough solution for one dose of Twinject. If your symptoms continue or return after the first injection, your doctor may direct you to use a second dose of Twinject injection with a new injection device. Make sure you know how to inject the second dose and how to know if you should inject a second dose. Only a healthcare provider should administer more than 2 injections for a single allergic episode.
Twinject should be injected only in the middle of the outer side of the thigh, and can be injected through clothing if necessary in an emergency. If you are injecting Twinject into a young child who can move during the injection, keep the leg firmly in place and limit the child’s movement before and during the injection. Do not inject Twinject into the buttocks or any other part of your body, such as your fingers, hands, or feet, or into a vein. Do not put your thumb, fingers, or hand over the needle area of the automatic injection device. If Twinject is accidentally injected into these areas, get emergency medical treatment right away.
After injecting an injection dose of Twinject, some solution will remain in the injection device. This is normal and does not mean that you did not receive the full dose. Do not use the extra liquid; dispose of the remaining liquid and device properly. Take the used device to the emergency room or ask your doctor, pharmacist or healthcare provider how to safely dispose of used injection devices.
Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before using Twinject injection,
- Tell your doctor and pharmacist if you are allergic to Twinject, any other medications, sulfites, or any of the other ingredients of Twinject injection. Your doctor may tell you to use Twinject injection even if you are allergic to one of the ingredients because it is a life-saving medicine. The automatic Twinject injection device is latex free and is safe to use if you are allergic to latex.
- Tell your doctor and pharmacist what other prescription and over-the-counter medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: certain antidepressants such as amitriptyline, amoxapine, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), maprotiline, mirtazapine (Remeron), nortriptyline protripriprine (nortriptyline protripriprine) ) and trimipramine (Surmontil); antihistamines such as chlorpheniramine (Chlor-Trimeton) and diphenhydramine (Benadryl); beta-blockers such as propranolol (Hemangeol, Inderal LA, Innopran XL); digoxin (Lanoxicaps, Lanoxin); diuretics (‘water pills’); ergot medications such as dihydroergotamine (D.H.E. 45, Migranal), ergoloid mesylates (hydergine), ergotamine (Ergomar, in Cafergot, in Migergot), and methylergonovine (methergine); levothyroxine (Levo-T, Levoxyl, Tironsint, others); medications for irregular heartbeats such as quinidine (in Nuedexta); and phentolamine (Oraverse, Regitina). Also tell your doctor if you are taking a monoamine oxidase inhibitor such as isocarboxazide (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar) and tranylcypromine (Parnate) or have stopped taking it in the last two weeks. Your doctor may need to monitor you carefully for side effects.
- Tell your doctor if you have or have ever had chest pain, irregular heartbeat, high blood pressure, or heart disease; asthma; diabetes; hyperthyroidism (an overactive thyroid); pheochromocytoma (tumor of the adrenal gland); depression or other mental illness; or Parkinson’s disease.
- Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. Talk to your doctor about whether you should use Twinject injection and when you should use it if you are pregnant.
What side effects can this medication cause?
Twinject injection may cause side effects. When you get emergency medical treatment after you inject Twinject, tell your doctor if you are experiencing any of these side effects:
- skin redness, swelling, warmth, or tenderness at the site of injection
- difficulty breathing
- pounding, fast, or irregular heartbeat
- nervousness, anxiety, or restlessness
- pale skin
- uncontrollable shaking of a part of your body
What should I know about storage and disposal of this medication?
Keep this medicine in the plastic tube it came in, tightly closed, and out of the reach of children. Keep it at room temperature and away from light, excess heat, and moisture (not in the bathroom). Do not refrigerate Twinject injection or leave it in your car, especially in hot or cold weather. If the pre-filled automatic injection device falls off, check whether it is broken or leaking. Throw away any medicine that is damaged or should not be used otherwise and make sure you have a replacement available.
Unnecessary medications must be disposed of in a special way to ensure that pets, children and others cannot consume them. However, you should not flush this medicine down the toilet. Instead, the best way to get rid of your medication is through a medication take-back program. Talk to your pharmacist or contact your local garbage / recycling department for information on return programs in your community. Consult the FDA’s Safe Drug Disposal website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.
It is important to keep all medications out of the sight and reach of children, as many containers (such as those for taking pills weekly and those used for eye drops, creams, patches, and inhalers) are not resistant to children and children. young children can easily open them. To protect young children from poisoning, always close the safety caps and immediately put the medicine in a safe place, one that is up and away and out of your sight and reach. http://www.upandaway.org
In case of emergency/overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim collapsed, had a seizure, is having trouble breathing, or cannot wake up, call 911 immediately.
Symptoms of overdose may include the following:
- sudden weakness or numbness on one side of the body
- sudden difficulty speaking
- slow or fast heart rate
- shortness of breath
- fast breathing
- tiredness or weakness
- cold, pale skin
- decreased urination
What other information should I know?
Keep all your appointments with your doctor.
Do not let anyone else take your medicine. If you use a pre-filled automatic injection device, be sure to get a replacement right away. Ask your pharmacist any questions you have about refilling your prescription.
It is important that you keep a written list of all prescription and over-the-counter (non-prescription) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should carry this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
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Disclaimer: We have made every effort to ensure that all information is factually accurate, comprehensive and up-to-date. However, this article should not be used as a licensed health care professional’s choice of knowledge and expertise. You should always consult your doctor or other health care professional before taking any medication. The information given here is subject to change and it has not been used to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions or adverse effects. The lack of warning or other information for any drug does not indicate that the combination of medicine or medication is safe, effective or appropriate for all patients or all specific uses.