If a rash suddenly spreads over the body with trouble breathing or dizziness, treat it as anaphylaxis, and call 120 (China's ambulance number) at once and say so clearly

In a real emergency, call 911 first, then read this.

Cost

Free. For people with a known severe allergy, keeping an epinephrine pen of their own costs money, and it is a prescription drug.

What you get

Epinephrine is the drug of first choice (first-line drug) for anaphylaxis of grade 2 and above, and the guideline gives it a strong recommendation. Allergy pills and steroids work slowly and cannot take its place. The 2025 first aid guidelines of the International Red Cross state that an epinephrine auto-injector can be used through clothing, as long as the clothing is not thick. If a doctor has prescribed it and local law allows, someone else can help give it when the patient can't do it themselves

Notes

This allergy guideline (EAACI) itself says that in this field "the evidence mostly stays at a very low level." It gives a strong recommendation because the benefit far outweighs the risk, not because of large trials. Epinephrine is a prescription drug in China, and ordinary people usually don't have it. What you can do is call 120 and say "suspected anaphylaxis," so the ambulance brings the drug. If you have had a severe allergic reaction once, ask a doctor to prescribe an auto-injector pen, and learn to inject into the middle of the outer thigh (the outer side, slightly toward the front), which can be done through trousers that are not thick.

Evidence grade

B : Supported by research but without a precise number, or based on small or single studies.

Sources

1. China Medicine Education Association and others (2022). Clinical Practice Guideline for Emergency Treatment of Anaphylactic Shock (2020). Frontiers in Pharmacology: "Epinephrine is the first-line medicine in GRADE II to IV anaphylaxis" "Intramuscular epinephrine should be injected in the mid-anterolateral thigh"; the maximum intramuscular dose is 0.5 mg for adults and 0.3 mg for children under 14, and it may be repeated every 5–15 minutes if there is no response; "If an epinephrine pre-filled injector/auto-injector is available, they should follow the instructions written on the packaging or insert". https://doi.org/10.3389/fphar.2022.845689
2. Muraro A, et al. (2022). EAACI guidelines: Anaphylaxis (2021 update). Allergy. https://doi.org/10.1111/all.15032
3. International Federation of Red Cross and Red Crescent Societies (2025). International First Aid, Resuscitation and Education Guidelines 2025, page 376: "The epinephrine auto-injection may be administered through the person's clothing if the clothes are not thick". https://www.ifrc.org/sites/default/files/2026-03/IFRC%20International%20First%20Aid,%20Resuscitation%20and%20Education%20Guidelines%202025.pdf

Translated from the Chinese original. Original book, section 13, tip 15. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer