Who needs to carry an epinephrine autoinjector?

Patients who have had anaphylaxis or who are at risk of it (eg, due to food allergy or Hymenoptera hypersensitivity) should carry an epinephrine autoinjector at all times. However, the risks and benefits must be considered on an individual basis, especially in patients with atherosclerotic heart disease, elderly patients on polypharmacy, patients receiving allergen immunotherapy, those with large local reactions to insect stings, and individuals with oral allergy syndrome.