Expired EpiPens may still be usable more than four years after their expiry date. Findings of a new study that looked at the potency of auto-injectors after their expiry date suggest it may be worth using one that is past the expiration if it is all you have got.
The new study shows that long after their supposed expiration dates, the injectors still have the concentration of epinephrine potent enough to prevent potentially deadly allergic reactions.
Epinephrine
Epinephrine, more commonly known as adrenaline, is an active ingredient used in auto-injectors to help relax muscles. The hormone can counteract the symptoms of anaphylaxis, a serious, life-threatening allergic reaction, by opening the airways to reduce breathing difficulties, and reducing the swelling of the blood vessels to address low blood pressure and ease faint feelings.
EpiPen manufacturer Mylan advises patients to replace the device each year. EpiPens supposedly expire 18 months after the manufacturing date, but some pharmacists do not receive the devices until six months after these were manufactured, which means that patients only have less than a year left until the injector they purchased has to be replaced.
Purchasing life-saving EpiPens can be financially burdensome for some families since the prices of the auto-injection devices have skyrocketed by 400 percent since 2007 and because more insurance providers no longer provide coverage of the EpiPen.
Still Usable More Than 4 Years After Expiration
Concerned over the costly prices of EpiPen, which makes the device prohibitive for many families, Lee Cantrell, from the California Poison Control System in San Diego, and colleagues conducted an analysis of expired EpiPens and EpiPen Juniors.
Cantrell and colleagues found that while the auto-injectors lose their potency over time, the EpiPens still retained at least 90 percent of the stated concentration of epinephrine 29 months after the expiry date.
The devices were likewise found to contain 84 percent of the concentrations of epinephrine 50 months, or more than four years, past the stamped expiration.
Cantrell said that these concentrations are considered to be enough for preventing anaphylactic shock.
"In every pen we tested there was enough to give what would be considered a therapeutic dose," Cantrell said, adding that if his child has a life-threatening reaction and he has no alternative, he will absolutely use these expired EpiPens without hesitation. "I don't think there's a physician in the world who would rebut that."
Cantrell and colleagues reported their study in the Annals of Internal Medicine.
In a statement, Mylan encouraged patients to refill their EpiPen auto-injector when they expire given the potentially fatal threats posed by anaphylaxis. The company said that the expiration date is the last day that the medication is considered as safe and effective.
"All epinephrine products have expiration dating whether they come in an auto-injector or vial," Mylan said. "This is required by law. An expiration date is the final day, based on performed quality control tests, that a product has been determined to be safe and effective when stored under the conditions stated in the package insert."
