What's the right time to use an EpiPen?

CINCINNATI -- Food allergies are a comparatively small problem for the United States' population as a whole -- around 3.6 percent of us have them, which is lower than rates of heart disease, depression and cancer. That doesn't make them any less deadly.

Ivan Mercado's family members have carried EpiPens in their day-to-day lives since his fourth birthday. The 17-year-old is allergic to tree nuts and soy milk, and an accidental bite of either could send him into anaphylactic shock.

"It's hard to grow comfortable eating food," he said. "It could just end the whole day for you."

Epinephrine auto-injectors such as the EpiPen can be the difference between life and death for young people such as Mercado, but Children's Hospital allergy and immunology specialist Dr. Amal Assa'ad said less than 50 percent of children who arrive there with anaphylaxis have already received epinephrine.

"Over the years, people have looked at the allergic reaction specifically with life-threatening events or even death," she said. "The one common factor was delaying administering the epinephrine."

So that means you should deliver the shot as soon as you or your loved one takes a bite of a dubious food, right? Not quite. Administering it too early can be just as useless as administering it too late, Assa'ad said.

Instead, she recommended administering it when the person first starts to show signs of a severe allergic reaction.

"If you have the skin involved with a lot of rashes and the person is sneezing, that's an indictation that maybe they'll go into anaphylaxis," she said. "And that's an indication to use epinephrine."

Assa'ad also recommended that anyone with a child who has food allergies should make sure that child's teacher keeps an epinephrine auto-injector in the classroom and knows how to use it.

Although EpiPen, an epinephrine auto-injector manufactured by Mylan, is the best-known product of its class, it's far from the only one. Mercado noted that the price of the name-brand Epi-Pen can be genuinely exorbitant to families whose insurance might not help them out.

"I know there are many families who suffer and aren't able to get this for their kids, which is scary," he said. "Imagine not being able to take care of your kid. I don't know if I'd be here today if these weren't invented."

He's not the only one upset by this. Although EpiPens only contain about $1 of epinephrine, Mylan punted its price up to a peak of $609 per box in 2016, sparking a congressional inquiry and widespread public chastisement of the company. Despite that, the New York Times reported June 4 that prices remained exorbitantly high.

So what can you do? Sadly for families like Mercado's, there's no way to get epinephrine auto-injectors at the same price you'd buy Advil. However, CVS charges $109.99 -- still a hefty purchase, but nowhere near Mylan's asking price - - for Adrenaclick, a generic competitor that contains the same medicine.

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