Severe Allergies in China: Epinephrine Import Rules and Auto-Injector Access
China's air quality, food labelling gaps, and medication import rules create specific challenges. Here's what travellers with allergies should prepare.
Severe allergies in China: what changes when you travel
China's poor urban air quality, allergen-dense cuisine, and limited English-language food labelling create a challenging environment. Epinephrine auto-injectors are not widely stocked in Chinese retail pharmacies, and foreign prescriptions are not accepted in Chinese hospitals or pharmacies without additional documentation.[5][2][1]
This guide covers epinephrine import rules, auto-injector availability, Chinese pharmacy access, emergency communication in Mandarin, and how your International Patient Summary can speed up care in a Chinese hospital.
Medical disclaimer: This guide is for informational purposes only and does not constitute medical advice. Always consult your specialist before travelling, particularly regarding changes to your treatment schedule and travel insurance.
Key risks for severe allergies travellers in China
Epinephrine auto-injectors are not reliably available in retail pharmacies
EpiPen and its generic equivalents are not consistently stocked at Chinese retail pharmacies. Bring your full trip supply, plus at least one spare device, and carry both at all times.[1]
Food labelling gaps and hidden allergens
Chinese food labelling standards require disclosure of eight major allergens on packaged foods, but enforcement at restaurants and street stalls is inconsistent. Cross-contact in wok cooking is pervasive, particularly with peanuts, sesame, and shellfish.[2]
Air pollution as an anaphylaxis trigger compound
PM2.5 concentrations in Beijing, Shanghai, and Guangzhou regularly exceed WHO guideline levels, which can lower the threshold for allergic reactions. Check the China National Environmental Monitoring Centre air quality index daily.[5]
Foreign prescriptions are not accepted
Chinese hospitals and pharmacies require a prescription issued by a licensed Chinese physician. Bring your entire supply from home and carry a specialist letter to facilitate any emergency consultation.[1]
Communication barriers in emergency settings
English proficiency among emergency department staff outside of major international hospitals is limited. A Nomedic IPS with Mandarin-readable allergy details and your epinephrine auto-injector list significantly reduces communication risk.
Preparation checklist
- Book a pre-travel allergy specialist review — confirm your current auto-injector prescription and action plan are up to date for a China trip.
- Check China's air quality index before arrival — download the China National Environmental Monitoring Centre app or a compatible AQI app for daily checks.
- Obtain a specialist letter in both English and Mandarin — covering your diagnosis, allergens, medications, and instructions for administering epinephrine.
- Download an offline Mandarin phrase set — for communicating your allergy in settings without Wi-Fi or mobile data.
- Register your insurance policy in your Nomedic profile — include the 24-hour assistance line with Mandarin support.
- Store your IPS on Nomedic before departure — your allergy list, medications, and emergency contacts are accessible offline and readable by Chinese clinicians.
- Bring at least two epinephrine auto-injectors — Chinese retail pharmacies cannot be relied upon for emergency replacement, so pack a spare device.
- Pack antihistamines and any prescribed oral corticosteroids as backup — keep all medications in original labelled packaging for customs.
- Research the nearest international hospital to each destination — facilities such as Beijing United Family Hospital and Shanghai United Family Hospital have allergy-experienced staff.
- Carry a personal allergen card in Mandarin — listing all your specific allergens with a request to avoid cross-contact; show it to restaurant staff before ordering.
Documents to carry when travelling to China with severe allergies
Chinese emergency departments and customs officers respond faster when you can present clear documentation. The Nomedic app consolidates your most critical documents in one offline-accessible place.
Your International Patient Summary (IPS)
Your Nomedic IPS contains your allergen list, current medications, emergency contacts, and allergy action plan in a format any clinician can read. In China, where English proficiency in emergency departments can be limited, the IPS's structured data transfers your clinical history without verbal explanation. Share it via QR code or offline PDF at triage.
Full document checklist
Keep the following accessible on your phone and ready to share. Your Nomedic IPS covers items 1 and 6 automatically.
- ·Your Nomedic IPS Covers your allergy diagnosis, specific allergens, epinephrine auto-injector details, and emergency contacts. Offline and QR-shareable.
- ·Bilingual specialist letter Must state your specific allergens, your current auto-injector brand and dosage, and your anaphylaxis action plan, in both English and Mandarin Chinese.[4]
- ·Prescriptions using INN names Carry the original prescription listing epinephrine (adrenaline) by INN alongside any brand name, to aid identification at any Chinese hospital.[1]
- ·Allergen card in Mandarin A wallet-sized card listing your specific allergens in simplified Chinese characters, including a request to avoid cross-contact during food preparation.[2]
- ·Travel insurance schedule Policy number and insurer's 24-hour line saved in your Nomedic profile, accessible without mobile data.
- ·China emergency numbers Ambulance: 120. Police: 110. Fire: 119.[4] Saved offline in Nomedic.
Bringing your severe allergy medications to China
China's National Medical Products Administration (NMPA) permits travellers to import a personal-use quantity of prescription medications for the duration of their stay[1]. Epinephrine auto-injectors (adrenaline auto-injectors) are prescription-only in China.
Carry your devices in original packaging with your specialist letter and prescription. Oral antihistamines and corticosteroids do not require import permits but must remain in original labelled packaging.
Do not post your medication to China.
Postal importation of prescription medications, including epinephrine auto-injectors, is prohibited under Chinese customs regulations. Carry all devices in your hand luggage with you on the flight.
Severe allergy medications: brand names, INNs, and China availability
The table below lists common severe allergy-related medications with their INN and any NMPA-registered brand names used in China.
Pre-filled auto-injectors are not consistently stocked in Chinese retail pharmacies; bring full supply from home.
Prescription required; not available OTC.
Prescription required.
Sedating antihistamines and Chinese OTC formulations
Some Chinese OTC antihistamine products contain chlorphenamine (chlorpheniramine), a first-generation sedating antihistamine. Check the Chinese-language ingredient list (活性成分) before purchasing any local antihistamine product if sedation is a concern for your daily activities.
Travelling with epinephrine auto-injectors
These steps apply regardless of which city or region you visit within China.
Your medication list, ready to share.
Nomedic stores your medication name, INN, dosage, and frequency, readable by any clinician worldwide.
Healthcare and prescriptions in China
China's healthcare system is a mixed public-private model. International travellers without a Chinese social insurance card are expected to pay for all treatment at the point of care, in advance at most facilities. Nomedic's China travel guide covers the broader healthcare system.
Emergency department consultations at international hospitals in Beijing and Shanghai typically cost ¥800 to ¥2,500 (~$119 to ~$373 / ~€104 to ~€325) for initial assessment[3], before any treatment costs. Foreign prescriptions are not accepted by Chinese pharmacies; only prescriptions issued by a licensed Chinese physician are valid.
Epinephrine auto-injectors are not carried by most Chinese retail pharmacies (药店, yào diàn). Hospital emergency departments (急诊, jí zhěn) stock injectable epinephrine for in-hospital use, but this is a different formulation from consumer auto-injectors. Oral antihistamines such as cetirizine and loratadine are available OTC at most pharmacies.
Epinephrine for severe allergy is dispensed differently in China
Auto-injectors are not reliably stocked in retail pharmacies. For any emergency supply need, go directly to the emergency department of an international hospital (国际医院急诊) and bring your IPS and specialist letter. Hospital pharmacies occasionally stock adrenaline vials for professional use but not consumer auto-injectors.
Finding a severe allergies specialist
Allergists and immunologists (变态反应科医生, biàntài fǎnyìng kē yīshēng) practise within allergy and immunology departments (变态反应科) at major university hospitals including Peking Union Medical College Hospital in Beijing and Ruijin Hospital in Shanghai. International hospitals such as Beijing United Family Hospital and Guangzhou United Family Hospital employ English-speaking allergy physicians and accept walk-in urgent appointments. Identify the nearest facility before travel and save the address and phone number offline using Nomedic's provider search.
Search for providers near your destination
Use Nomedic's provider search to find allergy specialists in China. Save the address and phone number offline before you travel.
If your auto-injector is used or lost in China
Using an auto-injector is a medical emergency and the next step is always a hospital emergency department, not a pharmacy. Once you are stable, the priority is restoring your supply before the situation repeats.
Managing air quality, food, and allergen triggers day to day[5]
Urban air quality is the primary environmental trigger in China. Beijing's annual average PM2.5 concentration was 32 micrograms per cubic metre in 2023[5], roughly three times the WHO annual guideline of 5 micrograms per cubic metre. Pollen season peaks in spring (March to May) in northern China and in autumn (September to October) in the south.[6]
Check the China National Environmental Monitoring Centre AQI app (中国环境监测总站) each morning before going outdoors. On days with an AQI above 150, consider wearing a well-fitting FFP2 or N95 mask outdoors.
Chinese cuisine relies heavily on peanuts, sesame, shellfish, and soy across all regions; cross-contact in wok cooking is the norm, not the exception. Show your Mandarin allergen card before ordering at any food outlet, including hotel restaurants. International hotel chains in major cities can often arrange allergen-aware meal preparation with advance notice.
Increased respiratory symptoms are not always anaphylaxis
High-pollution days can worsen nasal and respiratory allergic symptoms without triggering anaphylaxis. If symptoms such as itching, urticaria, throat tightening, or hypotension develop, follow your written action plan. If symptoms persist or worsen beyond 15 minutes of initial management, follow the guidance in the Emergency tab.
Mandarin phrases for clinicians
Show your Nomedic IPS first, it removes the need to explain your diagnosis verbally. If verbal communication is needed:
“我有严重过敏症。”
I have severe allergies.
“我正在发生过敏性休克。”
I am having an anaphylactic reaction.
“我需要肾上腺素。”
I need epinephrine (adrenaline).
“我需要变态反应科医生。”
I need an allergist.
“最近的急诊科在哪里？”
Where is the nearest emergency department?
“我需要紧急补充肾上腺素自动注射器。”
I need an emergency supply of epinephrine auto-injector.
Insurance considerations
What to know about travel insurance
Many standard travel policies treat anaphylaxis events as arising from a pre-existing condition and exclude or limit cover. Emergency allergy treatment at an international clinic in China, including epinephrine administration, observation, and a specialist consultation, can cost ¥8,000 to ¥30,000 (~$1,190 to ~$4,470 / ~€1,040 to ~€3,895) without insurance.
What to look for in a policy
Not just 'pre-existing conditions covered'. Your specific condition should be named on the policy schedule.
Covers repatriation if local anaphylaxis management is insufficient.
Covers emergency replacement if your epinephrine auto-injector is lost, damaged, or used.
So someone can communicate with Chinese clinicians on your behalf in real time.
What to declare at application
Declare thoroughly. Incomplete disclosure can invalidate your entire policy, not just the allergy-related claim.
State whether you have had prior anaphylaxis, and the most recent episode date.
Use the INN alongside the brand name for all allergy-related medications.
Insurers classify risk differently for a single mild episode versus repeat or hospitalisation-requiring events.
Declare asthma, eczema, or other atopic conditions if present, as they affect underwriting.
Your policy number and emergency assistance line, saved alongside your IPS and accessible offline.
China has no reciprocal healthcare agreement with EU or EEA countries, and EHIC and GHIC cards provide no cover in China. EU and EEA travellers must arrange comprehensive private travel insurance before departure. All medical costs will be out-of-pocket without adequate private cover.
Emergency protocol
When to go to a Chinese emergency department
Use your epinephrine auto-injector as per your action plan, then call 120 or get to the nearest emergency department (急诊科). Symptoms requiring immediate hospital attendance include throat tightening, difficulty breathing, severe urticaria, hypotension, or loss of consciousness after allergen exposure. Contact your travel insurer's 24-hour line as soon as you are safe to do so.
When you arrive, follow in order
Full clinical picture in seconds, no verbal explanation needed.
Hand your phone to the triage nurse:
我有严重过敏症，正在发生过敏性休克，我需要肾上腺素。
I have severe allergies and I am having an anaphylactic reaction. I need epinephrine.
The bilingual letter lists your allergens, your auto-injector details, and your action plan for the treating physician.
Tell the clinician when and whether you used your auto-injector before arrival, so they can determine if a second dose is required.
Calls and location
Call 120 for an ambulance in China. Police: 110. Share your GPS location via your phone's map app if you cannot describe your location in Mandarin. In major cities, international hospitals with English-speaking staff include Beijing United Family Hospital (+86 10 5927 7000) and Shanghai United Family Hospital (+86 21 2216 3900).
In hospital
If surgery or sedation is required following an injury, inform the anaesthetist of your allergy status and all current medications, including antihistamines and corticosteroids. These interactions affect anaesthetic management and the clinician must know before any procedure.
After any emergency
Before you leave the hospital if possible.
Required for insurer reimbursement and continuity of care on your return.
Open Nomedic and tap Share to generate a QR code any clinician can scan.
Frequently asked questions
Is it legal to bring an EpiPen (epinephrine auto-injector) into China?
Yes. Epinephrine auto-injectors are legal to bring into China for personal medical use when carried in hand luggage with the original prescription and a doctor's letter. Keep devices in their original packaging and declare them at airport security. Postal importation of prescription medications is not permitted.
Is EpiPen available at pharmacies in China?
EpiPen and equivalent epinephrine auto-injectors are not reliably stocked at Chinese retail pharmacies. Hospital emergency departments carry injectable epinephrine for in-hospital use, but consumer auto-injector formats are not routinely available for purchase. Bring your full supply from home plus at least one spare device.
Are antihistamines available over the counter in China?
Cetirizine and loratadine are available without a prescription at most Chinese pharmacies (药店). Fexofenadine is also available. Some formulations contain first-generation antihistamines such as chlorphenamine; check the Chinese-language ingredient label before purchase.
How do I communicate a severe allergic reaction in Chinese?
Show your Nomedic IPS first. If verbal communication is needed:
“我有严重过敏症，正在发生过敏性休克。”
I have severe allergies and I am having an anaphylactic reaction.
“我需要肾上腺素。”
I need epinephrine.
Does air pollution in Chinese cities trigger allergic reactions?
High PM2.5 concentrations can lower the threshold for allergic reactions and worsen respiratory allergy symptoms. Beijing's annual average PM2.5 was 32 micrograms per cubic metre in 2023, well above the WHO guideline of 5 micrograms per cubic metre. Check the daily AQI via the China National Environmental Monitoring Centre before going outdoors.
On high-pollution days
Wear a well-fitting FFP2 or N95 mask outdoors when the AQI exceeds 150. Avoid outdoor exercise during peak pollution hours, typically 7 am to 9 am and 6 pm to 8 pm in major cities.
Do I need specialist travel insurance for China with severe allergies?
Yes. China has no reciprocal healthcare agreement with most countries, so all treatment costs are out-of-pocket without private insurance. Standard policies may exclude anaphylaxis as a pre-existing condition, and emergency allergy treatment at an international hospital can cost ¥8,000 to ¥30,000 (~$1,190 to ~$4,470 / ~€1,040 to ~€3,895).
Declare thoroughly
State your specific allergens, last anaphylactic episode, current medications, and any associated conditions such as asthma. Incomplete disclosure can invalidate the entire policy.
What are the emergency numbers in China?
Ambulance
120
Police
110
Fire
119
Sources
- [1] National Medical Products Administration (NMPA) — Personal import of medications
- [2] Chinese National Standard GB 7718-2011 — General rules for food labelling (allergen requirements)
- [3] Beijing United Family Hospital — International patient services and emergency care
- [4] WHO — China health profile and healthcare system overview
- [5] China National Environmental Monitoring Centre — National real-time air quality index
- [6] Chinese Center for Disease Control and Prevention — How to deal with pollen allergies
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