Tingling, itchiness, swelling of tongue and lips, metallic taste


Itchiness, redness, hives, swelling of skin, face or body


Itchiness, tightness, hoarseness, hacking cough, difficulty swallowing


Difficulty breathing, shortness of breath, repetitive coughing, wheezing


Vomiting, nausea, stomach pain, diarrhea


Dizziness, unsteadiness, drowsiness, sense of impending doom, coma

Anaphylaxis can lead rapidly to unconsciousness and death if not properly treated.

What happens during a reaction?

An allergic individual produces antibodies (IgE) which recognize specific proteins (allergens). These antibodies are on the outside of mast cells and basophils. These cells are located hroughout the body. When an allergen couples with the IgE antibodies, histamine and other mediators of anaphylaxis are released from the mast cells and basophils. These mediators cause blood vessels to leak (which leads to swelling and drop in blood pressure) and airways to narrow (wheezing).

What does a reaction look like?

Symptoms may not always appear the same way in an allergic individual.

The severity of reaction, is also unpredictable. The amount of the allergen (trigger), asthma, the use of beta-blockers (cardiovascular medication) can affect the reaction. That's why avoiding the trigger and immediate treatment are so important.

What is the best treatment for anaphylaxis?

Epinephrine (adrenaline) is a hormone produced naturally by the adrenal glands. It is released at times of stress and causes what is often called the "fight or flight" response. We all know the symptoms, the pounding heart, anxiety, tremor. It increases heart rate, sends blood to the muscles, narrows blood vessels and opens the airways. When you give yourself a dose of epinephrine, you are giving your body something that it is making already. You are just giving it faster and at a higher dose.

Minor side effects of epinephrine can include pounding heartbeat, paleness, dizziness, weakness, trembling, headache, throbbing, restlessness, anxiety and fear. Epinephrine reverses the negative effects of an anaphylactic reaction. It is well recognized that early use of epinephrine can be life-saving. Therefore, it is essential that someone who has been prescribed this medicine keep it with them at all times. A person who has had a reaction, no matter how mild, needs t be seen in an emergency department. The reaction can return and become more difficult to treat. If symptoms reoccur after the first injection, a repeat injection can be given after 10-20 minutes while en route to emergency care. Antihistamines or asthma inhalers cannot replace epinephrine in the treatment of an anaphylactic reaction, although they may be given in addition to epinephrine.

Epinephrine typically comes in an auto-injector. In Canada, the EpiPen® is the only device available. It is easy to use and if used correctly, significant injury is unlikely. Directions for use are on the package insert. The outer thigh is the safest site for injection because there are no major blood vessels or nerves in this area.