What are “spare” pens?

In 2017 it was made legal for schools to buy their own backup supply of adrenaline pens under the Spare Pens in Schools initiative.

Schools can buy these from a pharmacy without the need for a prescription. Spare pens are for use in an emergency and should be held by the school in addition to pupils carrying their own, prescribed, adrenaline pens.

This template letter makes it easy to request spare pens from your pharmacy.

When can schools use spare pens?

Spare adrenaline pens can be used:

  • To treat pupils who have been prescribed adrenaline pens but whose own devices are not available*. For example, they are broken, out of date, can’t be accessed or have misfired.
  • If a pupil is known to be at risk of anaphylaxis but hasn’t been prescribed their own adrenaline pens*.

*Medical authorisation and parental consent must have been obtained.

What if the school doesn’t have medical and parental authorisation?

  • If you don’t have medical and parental authorisation to use spare pens, call 999, inform the call handler you suspect anaphylaxis and explain that spare adrenaline pens are available. They can authorise use.
  • In exceptional circumstances, where someone experiences anaphylaxis unexpectedly, the spare adrenaline pens can be given to anyone for the purpose of saving their life**.

**The Medicines and Healthcare products Regulatory Agency (MHRA) clarified its Guidance in relation to this point in March 2023. Read the MHRA’s clarification in full.


I’m concerned about getting this wrong

Teachers and other non-healthcare professionals are allowed to administer adrenaline pens.

These videos will take you through how to deliver adrenaline to someone else, using EpiPen or Jext auto-injectors. (Please note that in May 2023, Emerade adrenaline pens were recalled and should be replaced with a different brand.)

You should practice using a trainer pen so you feel confident if you are ever faced with an emergency. Trainer pens can be obtained via the EpiPen and  Jext websites.


Does it matter if our spare pens are a different brand to those prescribed to our pupils?

In an emergency, you can use a spare pen which is a different brand to that prescribed to a pupil. However, it is important that you give the correct dose of adrenaline – this is determined by a person’s weight (see below).

Each brand of adrenaline pen is administered slightly differently so make sure you watch our videos to familiarise yourself with how to use your spare pens.


How do we know which size/adrenaline dose we need when we buy spare pens?

Government guidance:

“The Resuscitation Council (UK) recommends that healthcare professionals treat anaphylaxis using the age-based criteria as follows:

  • For children age under 6 years: a dose of 150 micrograms (0.15 milligram) of adrenaline is used (e.g. using an EpiPen Junior (0.15mg) or Jext 150 microgram device).
  • For children age 6-12 years: a dose of 300 micrograms (0.3 milligrams) of adrenaline is used (e.g. using an Epipen (0.3mg) or Jext 300 microgram device).
  • For teenagers age 12+ years: a dose of 300 [as above] can be used.

In the context of supplying schools rather than individual pupils with AAIs for use in an emergency setting, using these same age-based criteria avoids the need for multiple devices/ doses, thus reducing the potential for confusion in an emergency.

Schools should consider the ages of their pupils at risk of anaphylaxis when deciding which doses to obtain as the spare AAI. Schools may wish to seek appropriate medical advice when deciding which AAI device(s) are most appropriate.”


How do I get spare pens for my school?

Schools can buy spare pens from their local pharmacy without a prescription from around £45 each.

You can use this template letter from Spare Pens in Schools to request yours, their website is a great resource if you are looking for further information about spare pens.

Date published: April 2023

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