CDO's letter on adrenaline for anaphylaxis kits

News Published: 
10 October 2018

FGDP(UK) wishes to draw Members' attention to a letter to dentists from the Chief Dental Officer for England. In response to the disruption in the supply of EpiPen and EpiPen Junior adrenaline auto-injectors, practices are requested to re-stock with ampoules, needles and syringes when renewing the adrenaline in their anaphylaxis kits.

The CDO’s letter reads:

You will be aware of the recent DHSC Supply Disruption Alert on EpiPen® and EpiPen Junior® adrenaline auto-injectors (AAIs) that advises conserving supplies for patients who truly need them. Some healthcare professionals, including dental practitioners, may be holding EpiPens or other AAIs, in preference to adrenaline ampoules, to treat anaphylactic reactions; this should not be necessary. 

All healthcare professionals providing services where anaphylaxis treatment may be required should have the competency to draw up and administer adrenaline from ampoules with a normal syringe and needle.  

Due to the shortage, we ask that when you renew the adrenaline in your anaphylaxis kits, you alert all your staff to please stock ampoules (ensuring you also include dosing charts, needles and syringes) and not AAIs. This will reduce the reliance on AAIs and therefore preserve essential EpiPen stocks for patients, parents, carers, teachers, etc. who, as lay persons, cannot be expected to administer adrenaline via a needle and syringe.

The Green Book and Resus Council guidance provides additional advice to healthcare professionals on the use of adrenaline in response to anaphylaxis. 

Supplies of adrenaline ampoules are currently available and there is an expectation that dental practitioners should use these in preference to the EpiPen or similar devices.  

All enquiries relating to this issue should be sent to the DH Supply Resilience Team at

We are working to resolve the EpiPen® and EpiPen Junior® shortage as fast as possible. Thank you in advance for all your help.