Children and adults with severe allergies are living in a state of anxiety as Malta is one of several countries hit by a shortage of the EpiPen, a life-saving medication in the event of an attack.

EpiPens, the leading brand of epinephrine autoinjectors used to treat anaphylaxis, are in low supply internationally and Malta’s supplier is finding difficulty securing any from the international supplier.

The product, which administers epinephrine intramuscularly, is simple enough to be used by parents, teachers or friends at the first sign of anaphylaxis. EpiPens deliver a shot of epinephrine in a potentially fatal situation. 

One patient who spoke to the Times of Malta on condition of anonymity said he was literally living “minute-by-minute” as the EpiPen that he relies on is not available and does not seem to be available anytime soon. “I had two allergic reactions in quick succession and I am now without an EpiPen,” he said.

If something happens, only God knows what my future holds

“If something happens, only God knows what my future holds. We literally depend on the EpiPen. Our lives depends on it.”

Another patient explained that while he only needed an EpiPen once in all of last year, this year he had to use two in the space of just nine days after suffering successive allergic reactions.

“It’s a matter of life or death. Without the EpiPen, death is closer unless you have someone to get the help you need as quickly as possible,” he added.

“I have none left but luckily I have relatives coming to Malta from abroad so they’re bringing me two along with them,” he said.

Each EpiPen costs €70 and has a shelf-life of just three to four months. EpiPens are usually prescribed in two doses – for adults and children. It is recommended that people carry two pens as the first one may not work on its own.

The main supplier of EpiPens in Malta, JV Pharma, told the Times of Malta when contacted that there was an international shortage and they were having difficulties securing stock from its own suppliers abroad.

Sources said the manufacturer was acquired by another company and there was a drop in production during the changeover.

The sources said that since it has such a short shelf life, many pharmacists do not stock them unless they know they have a steady request for them from their loyal customers.

According to pharmacists, even though the expiry date will state a particular month, the device will be valid until the last day of that month.

Even if a device is out-of-date, it can still be used in an emergency as long as the liquid inside is not cloudy or discoloured, according to pharmacists. A spokeswoman for the Health Ministry said that while the State did not import the EpiPen directly, it still had a stock for emergency use.

What to do?

• If a patient suffers an attack and has no EpiPen, he/she or a relative should immediately call 112. In severe cases, untreated anaphylaxis can lead to death within half an hour.
• Have the person lie still on his or her back.
• Loosen tight clothing and cover the person with a blanket. Don’t give the person anything to drink.
• If there’s vomiting or bleeding from the mouth, turn the person on his or her side to prevent choking.
• If there are no signs of breathing, coughing or movement, begin CPR. Do uninterrupted chest presses – about 100 every minute – until paramedics arrive.