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Are you at increased risk for a life-threatening allergic reaction? Anaphylaxis (an-a-fi-lax-is) is the medical term for a life-threatening (severe) allergic reaction. Anaphylaxis occurs rapidly—within minutes to hours— after exposure to an allergen. Anaphylaxis can be hard to predict. You may be at risk even if you’ve never had a severe allergic reaction before. To help understand your risk and develop an action plan with your doctor, complete this 4-step process. step 1 step 2 Have you ever had an increased sensitivity to any of these potential triggers? Check or circle any item you had a reaction to after you were exposed. PEANUTS TREE NUTS MILK EGGS SHELLFISH FISH WHEAT LATEX RADIOLOGY TESTING DYES MEDICATIONS STINGING INSECTS EXERCISE OTHER SUBSTANCE NONE SOY (WHETHER OR NOT YOU’VE BEEN DIAGNOSED WITH AN ALLERGY TO IT) What were the symptoms of your reaction? Check or circle all that apply. throat mouth Itching welling of lips S and/or tongue lungs Shortness of breath Itching Coughing Tightness/ closure heart/blood vessels Coughing Wheezing skin Weak pulse Passing out Dizziness stomach Itching Redness Vomiting Diarrhea Hives Swelling Nausea Cramps If you selected one item in step 1 and multiple items in step 2, you could be at increased risk for anaphylaxis and should talk to your doctor as soon as possible. Please turn over to complete your risk assessment. indications EpiPen® (epinephrine injection) 0.3 mg and EpiPen Jr® (epinephrine injection) 0.15 mg Auto-Injectors are for the emergency treatment of life-threatening allergic reactions (anaphylaxis) caused by allergens, exercise, or unknown triggers; and for people who are at increased risk for these reactions. EpiPen® and EpiPen Jr® are intended for immediate administration as emergency supportive therapy only. Seek immediate emergency medical help right away. important safety information EpiPen® and EpiPen Jr ® Auto-Injectors contain a single dose of epinephrine, which you (or your caregiver or others who may be in a position to administer EpiPen® or EpiPen Jr ®) inject into the middle of your outer thigh (upper leg) (through clothing, if necessary). Get emergency medical help right away. You may need further medical attention. Only a healthcare professional should give additional doses of epinephrine if you need more than two injections for a single anaphylactic episode. DO NOT INJECT INTO YOUR VEINS, BUTTOCKS, FINGERS, TOES, HANDS OR FEET. Please see additional Important Safety Information on the back. Please see accompanying full Prescribing Information and Patient Information. step Are there other factors that may affect anaphylaxis? Check or circle all that apply. Factors that may increase anaphylaxis likelihood: You have asthma You have a mental illness You have eczema Y ou’ve had a previous generalized, systemic reaction (i.e., anaphylactic reaction) You have seasonal allergies (symptoms include sneezing, runny nose, watery eyes, itchy nose and/or eyes) You have heart or lung problems Y ou take a beta-blocker and/or blood pressure medicine Factors that may increase anaphylaxis severity: Exercise Acute infection (e.g., a cold or fever) Change in routine (e.g., travel) Premenstrual status step Emotional stress Share these results with a healthcare professional After looking at your results, he or she may suggest an anaphylaxis action plan. LIFE HAPPENS. Be Prepared.® Being prepared means having a plan to: • Avoid known allergens • Know what symptoms to watch for • Use an EpiPen® (epinephrine injection) Auto-Injector if a life-threatening (severe) allergic reaction occurs • Get emergency medical help right away ASK YOUR DOCTOR IF EPIPEN® MAY BE RIGHT FOR YOU Every anaphylaxis action plan depends on allergen avoidance and access to an epinephrine auto-injector. Only epinephrine injection—not antihistamines—is effective at treating the life-threatening symptoms of anaphylaxis. For more than 25 years, the epinephrine auto-injector doctors prescribe most is EpiPen®. So ask your doctor if EpiPen® is right for you. For more information about anaphylaxis, go to www.epipen.com important safety information (continued) In case of accidental injection, please seek immediate medical treatment. Epinephrine should be used with caution if you have heart disease or are taking certain medicines that can cause heart-related (cardiac) symptoms. Tell your doctor if you have certain medical conditions such as asthma, depression, thyroid disease, Parkinson’s disease, diabetes, high blood pressure or heart disease, have any other medical conditions, are pregnant or plan to become pregnant, or are breastfeeding or plan to breastfeed. Be sure to also tell your doctor all the medicines you take, especially medicines for asthma. If you have certain medical conditions, or take certain medicines, your condition may get worse or you may have longer lasting side effects when you use EpiPen® or EpiPen Jr®. The most common side effects may include increase in heart rate, stronger or irregular heartbeat, sweating, nausea or vomiting, difficulty breathing, paleness, dizziness, weakness, shakiness, headache, EpiPen®, EpiPen Jr®, EpiPen 2-Pak®, EpiPen Jr 2-Pak® and LIFE HAPPENS. Be Prepared.® are registered trademarks owned by the Mylan companies. The Mylan logo is a registered trademark of Mylan Inc. ©2016 Mylan Specialty L.P. All rights reserved. 2/16 EPI-2016-0036 apprehension, nervousness or anxiety. These side effects may go away if you rest. Tell your healthcare professional if you have any side effect that bothers you or that does not go away. Please see accompanying full Prescribing Information and Patient Information. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. For additional information, please contact us at 800-395-3376.