If you are having a severe allergic reaction now, use your adrenaline pen and call SAMU on 192. Anaphylaxis is a life-threatening allergic reaction, and emergency anaphylaxis treatment is adrenaline given by an auto-injector pen. If a doctor has already diagnosed your risk and prescribed pens before, you can request a prescription for replacement or spare adrenaline pens online in Brazil. You complete a secure questionnaire, a licensed doctor reviews your answers, and if treatment is clinically suitable the doctor issues a digital prescription (receita digital) that you receive in your Global Health account and can present at a pharmacy in Brazil. If it is not suitable, the doctor explains why and suggests what to do next.
What is included
- A review of your medical questionnaire by a licensed doctor
- A prescription for replacement or spare adrenaline auto-injector pens, if clinically suitable
- A digital prescription (receita digital) in your Global Health account, to present at a pharmacy in Brazil; availability of pens can vary, and the doctor will advise how to obtain them
- Written advice on carrying, storing and using your pens
- Secure messaging with the doctor about your request
The service fee covers the doctor's review. The medicine is paid for separately at the pharmacy.
Who this service is not suitable for
This service is only for people who already have a diagnosed risk of anaphylaxis. Our doctors cannot safely prescribe adrenaline pens online if you:
- have never been prescribed an adrenaline pen by a doctor before
- have a new allergy or a first allergic reaction, which needs a proper allergy assessment
- have had a reaction since your last review that was more severe or needed hospital treatment
- are under 18 or are requesting pens for a child, because the dose depends on body weight and must be set by the child's own doctor
- have asthma that is not well controlled, as this raises the risk of a severe reaction
- have symptoms of an allergic reaction right now (call SAMU on 192)
If any of these apply, please book a video consultation with a GP or see your own doctor so your situation can be assessed properly.
How it works
- Complete the questionnaire. Answer questions about your allergy diagnosis, previous reactions, your current pens and any medication you take.
- Doctor review. A licensed doctor reviews your answers against clinical guidance and may message you if more information is needed.
- Digital prescription. If suitable, the doctor issues a digital prescription, which appears in your Global Health account for you to present at a pharmacy in Brazil. Availability of pens can vary, and the doctor will advise how to obtain them. If it is not suitable, the doctor explains why and suggests a next step.
What is anaphylaxis?
Anaphylaxis happens when the immune system overreacts to a trigger and releases large amounts of histamine and other chemicals. It usually develops within a few minutes but can take longer. It affects the airway, breathing or circulation, and may come with a rash, hives or swelling, although skin symptoms are not always present. When blood pressure falls sharply, it is called anaphylactic shock.
Signs of anaphylaxis
- swelling of the throat or tongue, difficulty swallowing or a hoarse voice
- difficulty breathing, wheeze, a persistent cough or noisy breathing
- feeling faint or dizzy, pale and clammy skin, confusion or collapse
Common triggers
Common triggers include foods such as peanuts, tree nuts, shellfish, fish, milk and eggs, bee, wasp and ant stings, some medicines and latex. Exercise or alcohol can sometimes make a reaction more likely in people who are already allergic.
Anaphylaxis treatment with an adrenaline pen
Adrenaline works quickly to open the airways, raise blood pressure and reduce swelling. An adrenaline auto-injector delivers a measured dose into the muscle. Antihistamines and inhalers can ease milder symptoms but do not replace adrenaline in anaphylaxis.
Carrying and storing your pens. Carry two pens with you at all times, because a second dose may be needed. Check the expiry date regularly and replace pens before they expire. Store them at room temperature, out of direct sunlight, and never in the fridge or a hot car. If your device has a viewing window, check the liquid is clear.
How to use an adrenaline pen. Devices differ, so read the instructions on your own pen and practise with a trainer device if one is available. In general:
- Remove the safety cap as shown on your device.
- Press the tip firmly into the outer thigh. You can inject through clothing.
- Hold it in place for the time stated on your device, then remove it.
- Call SAMU on 192 and say "anaphylaxis", even if you start to feel better.
Lie down with your legs raised, or sit up if breathing is difficult. Do not stand or walk, even if you feel better. If there is no improvement after five minutes, use the second pen. Always go to hospital after using a pen, because symptoms can return hours later.
Side effects and safety
Adrenaline can cause a fast or pounding heartbeat, shaking, paleness, anxiety and headache. These effects are short-lived. If you are unsure whether a reaction is anaphylaxis, use the pen: the risk of not using it is far greater than the side effects. If you accidentally inject into a finger, thumb or hand, seek urgent medical help.
When to see a doctor in person
See your doctor or an allergy service after any reaction where you needed to use your pen, if your reactions are changing, or if you have not had an allergy review in the last year. Your doctor can update your allergy action plan and refer you to an allergy specialist if needed. You can also meet our doctors or see all online prescription services.