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How does an EpiPen work?

When someone has a life-threatening reaction that is allergy-related, they are usually given an auto-injectable pen of epinephrine. The question, what does this pen do?

First, we need to understand what is happening in a life-threatening reaction. 2 types of immune cells called basophils and Mast cells, have become activated to a substance the body has deemed a threat, and thus created antibodies to. These cells release a heavy amount of inflammation-causing cytokines to kill this perceived intruder. These cytokines include leukotrienes and histamine. They cause large system wide-body effects including hives, vomiting, wheezing, swelling, low blood pressure, and rarely: death. This system-wide reaction is called anaphylaxis.

Epinephrine is a hormone our body produces, which gives us bursts of energy. It also has the effect of stopping mast cells and basophils from releasing their contents. Epinephrine has system-wide effects including opening the lungs, increasing blood pressure, decreasing swelling, and thus reversing anaphylaxis. And thus its a life-saving injection in times of acute severe allergic reactions.


There is no contraindication to epinephrine and should be used at first signs of life-threatening reactions due to an allergy. 

Dr. Waseem Imam Dr. Imam is board certified in several fields, including Allergy, Asthma, Immunology, Internal Medicine, and Obesity Medicine. His main focus is Allergies, Asthma, and Food allergies.

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