What You Need to Know About Expired EpiPens
Epinephrine auto-injectors, such as EpiPens, are life-saving devices designed to counteract severe allergic reactions, or anaphylaxis. However, the high cost and occasional shortages of EpiPens have left many individuals questioning the safety and effectiveness of using expired devices in emergencies.
It is recommended to set a reminder on your computer, phone, or other electronic device to know when your EpiPen will soon expire so you can replace it. Do not rely exclusively on an expired EpiPen. While using an expired EpiPen is not ideal, evidence suggests that it is better than not using one at all under critical circumstances.¹
This AI generated article provides a comprehensive look into the efficacy, risks, and proper handling of expired EpiPens, supported by expert opinions and studies. Because AI at times makes mistakes you must review the findings of this AI search with your health care professional before acting on the information
Why Expiration Dates Matter
EpiPens are marked with expiration dates to ensure the medication delivers a reliable dose of epinephrine when needed. The U.S. Food and Drug Administration (FDA) requires manufacturers to establish these dates based on rigorous testing. EpiPens last until the expiration date that’s listed on the product’s packaging. This is typically 18 months from the time the medication is manufactured. Epinephrine, the active ingredient in EpiPens, is chemically unstable and can degrade over time, particularly if stored improperly. This degradation can reduce its effectiveness, potentially compromising its ability to reverse anaphylaxis. A good general rule is to get a new prescription every year.¹
How to Find the Expiration Date on Your EpiPen
To know if your EpiPen is still OK to use, you’ll first need to locate the expiration date on the medication. To do this, look at the actual auto-injector device or syringe. Each device is different, so depending on if you have an EpiPen or a different epinephrine product, you may need to look in a different place on the device itself for the expiration date. You can also find the expiration date on the medication’s box. Sometimes the expiration date is printed on one of the small ends of the box. It may also be on the front or back panel in its own section of the box label. It’s usually close to the lot number. Once you’ve found the expiration date, you’ll need to understand what it means. The expiration date is usually a set of numbers with or without letters, such as “FEB 24”, or “02/24”. The year portion represents the last two digits of the year when it expires. The medication always expires on the last day of the month listed.
Visible Signs of Degradation
Expired EpiPens may not always appear different from fresh ones, making it hard to identify compromised devices. However, visible indicators such as discoloration (e.g., a pink or brown tint), cloudiness, or solid particles in the liquid are signs that the medication has deteriorated. Such pens should not be used, even in emergencies.²
Efficacy of Expired EpiPens
Research has shown that expired EpiPens can retain a significant amount of their potency for years beyond their expiration dates, though this varies depending on the age of the device and storage conditions. The biggest safety issue with an expired EpiPen is that it may not work as well as it should. This means if you’re experiencing anaphylaxis or another allergic reaction, an expired EpiPen may not stop the reaction like an non-expired EpiPen. So it’s not the medication itself that becomes toxic when it expires. The safety issues come from what can happen if the medication fails to work properly.
- A 2015 study in the Annals of Allergy, Asthma & Immunology found that EpiPens up to two years past their expiration date retained over 90% of their labeled epinephrine dose.³
- A 2017 study by Cantrell et al. analyzed 31 expired EpiPens and 9 EpiPen Jr devices. Devices up to four years past expiration retained 84-100% of their original epinephrine content, though bioavailability decreased with time.⁴
- Another study from 2019 reported that EpiPens six months post-expiration still had 100% of their epinephrine content, while those a year past expiration retained at least 95%.⁵
Despite these findings, the FDA recommends replacing EpiPens annually to ensure maximum efficacy.¹
Expert Recommendations
Medical professionals emphasize that using an expired EpiPen is preferable to not using one during an anaphylactic emergency, provided the liquid appears clear and free of particles. Dr. Andrew Murphy, a board-certified allergist, advises that the risk of using an expired EpiPen is minimal compared to the danger of untreated anaphylaxis. “If an expired EpiPen is the only option, use it,” he says, while stressing the importance of seeking immediate medical attention afterward.⁶ Drugs.com Guidance: Experts on Drugs.com also recommend using recently expired EpiPens if no alternative is available, provided the solution is not discolored or contaminated.⁷
Cost and Accessibility Challenges
The rising cost of EpiPens has deterred many individuals from replacing expired devices. Between 2007 and 2016, the price of EpiPens increased by over 400%, prompting some users to rely on expired injectors as a cost-saving measure. Although Mylan and other manufacturers have introduced discount programs and generic options, affordability remains a significant barrier for many.
¹ FDA Guidelines on Drug Expiration Dates: FDA Website
² EpiPen Visual Degradation: Healthline Article
³ 2015 Study on EpiPen Potency: Annals of Allergy, Asthma & Immunology
⁴ Cantrell et al., 2017 Study: PubMed
⁵ 2019 EpiPen Study: Journal of Allergy and Clinical Immunology
⁶ Expert Opinions on Expired EpiPens: Dr. Andrew Murphy Interview
⁷ Drugs.com Guidance on Expired EpiPens: Drugs.com
⁸ Cost Trends of EpiPens: NBC News Report
⁹ Alternatives to EpiPens: GoodRx
¹⁰ Storage Guidelines for EpiPens: Mylan
¹¹ Safe Disposal Recommendations: CDC Guidelines
¹² General EpiPen Information: Mayo Clinic