Research shows epinephrine auto-injectors potent years after expiration dates
Epinephrine is the standard treatment for many people with severe allergies and like other medicines, the auto-injectors that deliver the drug come with an expiration date. But research shows those dates may be too short, leading families to throw out medicines that are close to full strength.
Aiden Segool looks just like any other kid about to start school. What can't be seen is that the 7-year old from North Andover has a life-threatening allergy to dairy and eggs.
"Everyone gets to eat around me but I can't," Segool said.
It's something his parents discovered the first time he tried yogurt as a baby.
"All of a sudden, something didn't seem right. I got really nervous, I took his shirt off and he was just covered in hives," Aiden's mom, Alyson Segool, said.
Aiden was prescribed an epinephrine auto-injector and Alyson was trained how to use it. She also learned to ask the pharmacy about its expiration date.
"They're grabbing one off the shelf that's expiring in four months. Not only do you have to go back in four months, but you've spent the money for something that's not even lasting you the year," Segool said.
Expiration dates vary by brand but most expire after 12 to 18 months. However, a recent study in the Journal of Allergy and Clinical Immunology: In Practice found the medicine in the auto-injectors was potent years after the date on the package.
"By the definition of the FDA, this is something that's viable, something that isn't yet expired," said Dr. Michael Pistiner, director of Food Allergy Advocacy Education and Prevention at Massachusetts General Hospital.
He says this study adds to a growing body of research with similar findings. Of the 46 auto-injectors tested, the devices that were six-months expired had 100% of the concentration of epinephrine. Those expired a year had a 95% concentration. Even the devices 30 months expired were still 90% effective.
"It's really reassuring to know that even expired auto injectors are oftentimes going to be effective so having those is better than nothing," Pistiner said.
Based on these studies, Pistiner thinks extending expiration dates should be up for discussion.
"If there's less people needing to go to the pharmacies to pick up refills, then there will be more available auto injectors for those who need because of appropriate expiration dates," Pistiner said.
Aiden's school requires an up-to-date "epipen" and mom Alyson usually gets new ones once they've expired. Though they've had to use them twice over the years, today Aiden knows what he can eat: things like his favorite dairy-free pizza and cookies.
Sometimes, he's not that upset about the things he can't have.
"Because sometimes it's gross ... sometimes it just looks gross, so I'm happy I'm allergic to it," Aiden Segool said.
The expiration date issue is part of a larger picture concerning the availability of epinephrine. Pistiner says the bottom line is that families have an auto-injector they're trained on and comfortable using.