Twinject Auto-Injector Dosage

The physician who prescribes Twinject should review this Prescribing Information insert in detail with the patient. This review should include the proper use of Twinject to ensure that subcutaneous or intramuscular injections are given into the anterolateral aspect of the thigh, through clothing if necessary. The accompanying Patient Information Leaflet and Wrap Label should also be reviewed with the patient.

Twinject is capable of delivering two doses of either 0.15 mg or 0.3 mg (0.15 mL or 0.3 mL of 1:1000 dilution of epinephrine) each. The first dose is available for auto-injection by the patient, and the second dose is available for manual injection by the patient following a partial disassembly of Twinject.

Selection of the appropriate Twinject dosage strength is determined according to patient body weight.

The usual dose of epinephrine for allergic emergencies in patients who weigh 30 kilograms or greater is 0.3 mg (0.3 mL of 1:1000 dilution of epinephrine).

Since the doses of epinephrine delivered from Twinject are fixed, the physician should consider other forms of injectable epinephrine if doses lower than those available from Twinject are felt to be necessary. The prescribing physician should carefully assess each patient to determine the most appropriate dose of epinephrine, recognizing the life-threatening nature of the reactions for which this drug is being prescribed.

Patients should be instructed to periodically visually inspect the epinephrine solution for particulate matter and discoloration. If the solution contains particulate matter or develops a pinkish color or becomes darker than slightly yellow, the patient should immediately contact their physician for a replacement, since these changes indicate that the effectiveness of the drug product may be decreased.