Public Health Alert from BCHHS: Prescribing epinephrine for students

September 7, 2016

It has been brought to my attention by school nurses in Buncombe County that some medical providers have been prescribing students epinephrine in a vial versus in an auto-injector (e.g., EpiPen®).
While we understand that the cost savings of epinephrine in a vial versus an auto-injector can be tremendous for families, you need to know that per NC law (NCGS § 115C-375.2115C-375.2), a student can only carry a epinephrine auto-injector, which is defined as “a disposable drug delivery system with a spring-activated, concealed needle that is designed for emergency administration of epinephrine to provide rapid, convenient first aid for persons suffering a potentially fatal reaction to anaphylaxis.”
If you have prescribed epinephrine in a vial for a student, a school nurse will be contacting you with this information and asking you to provide a different prescription for the student.
A few options to help families obtain less expensive epinephrine auto-injectors:
•         Generic epinephrine auto-injector (0.15 mg or 0.3 mg) discount card available at  
•         EpiPen® and EpiPenJr®  Savings Card available at   
•         North Carolina Drug Card at 
o   Free Statewide Prescription Assistance Program
o   Consumers can download a card online and look up medication costs ahead of time to see what pharmacies offer the lowest price.
Contact Dr. Mullendore with any questions.