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Currently available epinephrine autoinjectors all come with a maximum expiration date of 18 months (local pharmacies usually fill pen prescriptions with devices that have expirations about 1 year out). Researchers examined the contents of expired EpiPen devices to see how well they retained their potency.
A total of 40 EpiPen and EpiPen Jr devices that were between 1 and 50 months past expiration were analyzed using liquid chromatography; 61% of the EpiPens and 56% of the EpiPen Jrs contained at least 90% of their labeled epinephrine concentrations. All of the devices contained at least 80% of their stated doses — for as long as 50 months past expiration for EpiPens and 30 months past expiration for EpiPen Jrs.
Cantrell FL et al. Epinephrine concentrations in EpiPens after the expiration date. Ann Intern Med 2017 May 9; [e-pub]. (http://dx.doi.org/10.7326/L16-0612)
Comment
Before the generic EpiPen was released, many of my patients were paying US$1200 annually for two EpiPen two-packs. Even now, the generic autoinjectors cost $300 per two-pack. Patients hate to throw away the devices and frequently ask, “Do EpiPens really go bad after 1 year?” or “Will they still work after they're expired?” I encourage them to get fresh epinephrine autoinjectors when their devices expire, but this small study reassures us that, even if a device is 4 years past expiration, it probably is still efficacious. We should instruct patients that if they experience anaphylaxis and only have an out-of-date device, they should use it, no matter how old it is.