Can you use an expired EpiPen in an emergency?
If someone is having an anaphylactic reaction, and all you have on hand is a recently expired EpiPen, then use it so long as it is not discolored and does not contain any particles.
There is minimal risk in using a recently expired EpiPen, but the benefits are significant. But check the clear viewing window of the pen and if you notice it is discolored or contains particles then don’t use it as the solution may have oxidized, making it less effective.
How long does an EpiPen last after expiration?
At least two studies have investigated expired EpiPens and how much epinephrine remains past the expiry date, and both concluded that a significant amount of epinephrine remains in an expired EpiPen, years past its expiry date.
Simons reported that Epipens that were 2 to 3 years past their expiry date contained more than 90% of the original dose and those 5 to 7 years past expiry, more than 70%.
In the study by Cantrell et al, the concentration of active epinephrine in pens that were 1 to 50 months (4 years) past their expiry date, ranged from 84 to 100%, with concentrations more likely to be less the older the EpiPen was.
On June 5, 2019, the FDA in the U.S. extended the expiry date on all EpiPens because of a shortage of auto inhalers.
Twenty-eight EpiPen and 6 EpiPen Jr autoinjectors were studied 1 to 90 months after the stated expiration date. Most were not discolored and did not contain precipitates. Epinephrine bioavailability from the outdated EpiPen autoinjectors was significantly reduced (P <.05) compared with epinephrine bioavailability from the in-date autoinjectors. The inverse correlation between the decreased epinephrine content of the outdated autoinjectors, assessed with an HPLC-UV method,
Ideally, Epipen autoinjectors should be replaced before the last day of the month when they expire. For example, if your Epipen expires in June 2024, then it will expire on June 30th, 2024, and you should arrange a replacement before this date, so you have a new Epipen on hand before it expires.
Be aware, that a recently expired Epipen may not be as effective for treating anaphylaxis, as one that is in date. Always seek emergency medical help ASAP, just as you would do if you have used an in-date injection.
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How long do Epipens usually last?
Epipen autoinjectors usually have a shelf life of 12 to 18 months, but always check the label for the expiry date to see how long your Epipen lasts because it may have been sitting on the store’s shelf for a while. Write the expiry date on a calendar or in a diary and replace the EpiPen before it expires.
If your EpiPen is out of date you should replace it immediately.
Where is the expiration date on EpiPen?
The expiry date for EpiPen is in a black box on the side of the autoinjector device. It is preceded by the word 'EXP. ' There is also an expiry date on the carton on the left flap with a black background.
References
- Adrenaline (Epinephrine) Injector storage, expiry, and disposal. September 2021. https://www.allergy.org.au/hp/anaphylaxis/adrenaline-injector-storage-expiry-and-disposal#:~:text=Expired%20adrenaline%20injectors%20are%20not,not%20using%20one%20at%20all.
- Simons FE, Gu X, Simons KJ. Outdated EpiPen and EpiPen Jr autoinjectors: past their prime? J Allergy Clin Immunol. 2000;105(5):1025-30. doi:10.1067/mai.2000.106042
- Cantrell F, Cantrell P, Wen A, Gerona R. Epinephrine Concentrations in EpiPens After the Expiration Date. Ann Intern Med. 2017;166(12):918-919. [PubMed]
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