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Use a Twinject Autoinjector


Updated August 28, 2008

Use a Twinject Autoinjector

The Twinject device contains a syringe pre-filled with an additional dose of epinephrine if needed for severe or recurrent allergic reaction symptoms.

Daniel More, MD
Twinject is a epinephrine-delivering device. Twinject can be used to treat extreme allergic reactions until help arrives. Knowing how to use a Twinject before it's actually needed will ensure that the medication is delivered correctly and safely.


If you would like to be able to fully practice with a Twinject, check with your doctor or pharmacist for a training Twinject; it contains no needle or medication, so it can be practiced with safely.

Difficulty: Easy
Time Required: 5 minutes

Here's How:

  1. Remove the Twinject from the carrying case by twisting and pulling apart both ends of the case.
  2. Grasp the Twinject in your dominant hand, placing your thumb over your fingers, forming a fist. Do not place your thumb over either end of the Twinject, as this could result in accidental injection of the medication into the thumb.
  3. Pull off the green safety cap labeled with the number "1" on it. There is a red tip underneath this cap from which the needle will come out of when the device is activated.
  4. Pull off the green safety cap labeled with the number "2" on it. The device is now ready to work, so be careful!
  5. Firmly push the end of the Twinject with the red tip into the side of the thigh (upper leg). When the red tip is pushed against the leg, a needle will pop out of the device, injecting the medication into the muscle of the thigh. The Twinject needle will be able to pierce through most types of clothing, so pants do not need to be removed first in an allergic emergency.

    This step is the same as is performed when using an Epi-Pen see image).

  6. Hold the Twinject device firmly against the thigh for 10 seconds while the medication is being injected. Do not bounce the device off of the thigh prior to this time.
  7. Remove the Twinject device from your thigh and set it aside.
  8. Call 911, or have another person take you to the closest emergency room. Inform medical authorities that you have injected yourself with a Twinject because you have experienced a severe allergic reaction. Be as specific as possible as to what may have caused the allergic reaction.
  9. If, within 5 to 15 minutes, your symptoms have either worsened or not improved and medical help has not arrived, you may give yourself another dose of epinephrine. The Twinject device contains 2 doses of epinephrine. Check with your doctor for when you may need a second dose of epinephrine.
  10. To use the second dose of epinephrine from the Twinject device, hold the device in one hand and unscrew the red tip where the needle is sticking out. A syringe containing the second dose of epinephrine is under this red tip.
  11. Take out the syringe and remove the stopper guard (yellow plastic cap) at the end of the syringe. The second dose of epinephrine is now ready to use.
  12. Grasp the syringe and push the needle into the side of your thigh (either thigh will do). Press the plunger of the syringe, which will inject the second dose of epinephrine into your thigh.
  13. Remove the syringe and needle from your leg and set it aside. If you have not yet called 911 or otherwise sought medical care, do so immediately. Inform medical personnel that you have used 2 doses of epinephrine from your Twinject device.

What You Need

  • Twinject

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