When should I inject the back-up dose?

Prepare the back-up dose immediately and call 911 or contact a medical facility. Inject the back-up dose if the symptoms have not subsided within 10 minutes of the first dose or have recurred.

When should I inject the first dose?

Talk with your doctor about when you should inject with epinephrine and always follow your doctor’s instructions. Most people will be told to inject Twinject just as soon as they or their loved one feel the first symptoms of an allergic reaction. For those with a history of severe cardiovascular reactions to an allergen, your physician may recommend to inject Twinject immediately after exposure to the allergen and before any reaction has begun.

How can I tell that I’ve injected the epinephrine properly?

Lift the auto-injector from the injection site and check the red cap. If the needle is exposed, the epinephrine has been injected. You should also feel the injection.

The package says to store the epinephrine at between 20°-25°C/68°-77°F. What if I’m in activities at temperatures outside those margins?

During excursions, epinephrine may be kept at a temperature of 15°-30°C/59°-86°F . Do not allow it to freeze and do not refrigerate it.

What should I do with expired Twinject?

Never throw Twinject in the trash. Bring expired and used Twinject to your pharmacist or physician.

What are common side effects?

The most common side effect is the sensation of a more forceful heartbeat. There might also be anxiety and restlessness. See the Package Insert that came with your Twinject. People who have heart disease, diabetes, hypertension and hyperthyroidism, patients who are on medications that may sensitize the heart to arrhythmias, the elderly, and pregnant women should consult with their doctor before using Twinject.

If I’m traveling abroad, will I be able to carry Twinject with me?

Traveling with medication and syringes has become more complicated in the last few years due to heightened security. You are allowed to travel by land or air with medication if it is in its original packaging. If you are traveling by air, tell the security personnel that you are carrying Twinject in your carry-on luggage. These guidelines are subject to change. Call either your airline or Canada Border Services (1 800 461-9999) for an update before you travel.

For Canadians returning to Canada they should fill the I38 formulary available at any Canadian customs offices before leaving Canada.

For Canadians crossing the USA border they must carry Twinject in its original packaging with the pharmacist sticker mentioning the name of the patient, the dosage and the name of the Doctor who prescribed Twinject.

Because epinephrine injectors are available without a prescription in Canada, a patient that bought Twinject without a prescription should go to a physician’s office and request a justification letter to carry an epinephrine injector.

How much does Twinject cost?

The retail price for Twinject 0.15mg auto-injector and Twinject 0.3mg auto-injector can vary between $95.00 & $115.00.

What is the size of Twinject?

The size of Twinject is 15 cm (6 in) in length and 1.5 cm (0.5 in) in diameter. Twinject can easily be carried with current epinephrine auto-injector carrying devices like the Ana-Tote™.

Do I need a physician prescription for Twinject?

No. In Canada, all epinephrine auto-injectors can be purchased at a pharmacy without a prescription. Epinephrine auto-injectors must be stored behind the pharmacy counter, available for purchase on request. However, most private insurance plans and provincial government plans will require a physician prescription for reimbursement of the auto-injector cost.

Is Twinject reimbursed by public and private plans?

Twinject is covered by all provincial formularies in Canada as well as most private insurance plans.