Category: Using of expired Epipen

So if it’s common for people to have expired injectable epinephrine kits, would it be OK to use them for the treatment of anaphylaxis? This exact question was studied by a group of researchers in Canada and published in the year 2000.

The group collected expired EpiPens and determined the potency of the epinephrine contained within them. The potency of the epinephrine was determined by two methods: Taking blood samples from rabbits after they were injected with the expired EpiPens, as well as performing chemical tests on the residual amount of solution left in the EpiPens after they were used. The measurements found in the expired EpiPens were compared to measurements from non-expired EpiPens.

While both methods studied showed that the expired EpiPens contained less epinephrine compared to the non-expired EpiPens, there was still a surprisingly high amount of epinephrine in the expired EpiPens.

The treatment of choice for anaphylaxis from all causes, including as a result of food allergy, is injectable epinephrine. In fact, most cases of fatal anaphylaxis are linked to the lack of, or delay in, the administration of epinephrine.



Injectable epinephrine kits come in various brands, including EpiPen, Twinject, and Avi-Q. All of these devices have a relatively short shelf life due to the instability of epinephrine: approximately one year from the date of manufacture. Epinephrine breaks down with exposure to light, air, and high temperatures. Therefore, manufacturers recommend that epinephrine is stored in a dark place at room temperature, but not refrigerated.

Unfortunately, because injectable epinephrine kits are rarely used and are relatively expensive, it’s common for people to (knowingly or unknowingly) keep expired epinephrine kits.

The prevalence of food allergies, particularly to peanuts and tree nuts, is on the rise, with rates doubling to tripling in many countries over the past 10 to 15 years. Food allergies, particularly to nuts and seafood, can be severe and life-threatening, with more cases of fatal food allergy reactions being reported every year. For the most part, there is no cure for food allergies, although a small number of research centers are performing studies on immunotherapy for certain food allergies, such as peanuts, milk, and eggs. The standard treatment for food allergies is the avoidance of the culprit food, as well as the treatment of allergic reactions that may occur from the accidental ingestion of the food.

In March 2013, a teenage college student with a severe nut allergy accidentally ate a cookie containing nuts. He then developed severe anaphylaxis, but his family did not use his Epi-Pen because the expiration date had already passed, and a 911 operator told them over the phone not to use it. While the teen finally did receive an Epi-Pen injection from a neighbor’s device, it was too late: the student died later that evening at a local hospital. (It is important to realize that it is not clear if using the expired EpiPen would have changed the outcome of this tragic event.)