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San Diego Study Finds EpiPens Are Still Potent Long After Their Expiration Date

A pair of EpiPen auto-injectors is shown, Jan. 13, 2016

Credit: Nic McVicker

Above: A pair of EpiPen auto-injectors is shown, Jan. 13, 2016

The auto-injectors can be lifesaving. But their price has more than quadrupled over the last 10 years, making them expensive to replace.

San Diego researchers have found that EpiPens can still work long after their official expiration date.

The auto-injectors can be lifesaving in cases of severe allergic reaction. But their price has more than quadrupled over the last 10 years. They now cost hundreds of dollars each, and need to be replaced about once a year.

For a new study published Monday in the Annals of Internal Medicine, researchers collected dozens of expired EpiPens in San Diego, some of them four years past their expiration date. Testing revealed they all still contained a potent amount of epinephrine.

"I'm not advising people to not replace their expired medications," said lead researcher Lee Cantrell, director of the San Diego division for California Poison Control. "But in a situation where you're having a potentially life-threatening reaction, like anaphylaxis or something, it's better to use an expired EpiPen than no EpiPen."

People often call poison control with concerns about using expired medication, according to Cantrell. And he says his wife Patricia Cantrell — a study co-author and local pediatrician — hears from families concerned about the high cost of replacing expired EpiPens.

Cantrell and his colleagues found that epinephrine concentrations in EpiPens did decline over time. But none of the EpiPens they studied were discolored, and more than half contained at least 90 percent of the product's stated amount of epinephrine. The researchers say this dose would likely be enough to help patients.

Cantrell says it may be time to reevaluate expiration dates for EpiPens, as well as many other prescription drugs.

"I think it could be significantly advantageous if we extended expiration dates on medications," said Cantrell. "It would be a potentially huge financial advantage to consumers."

Mylan, the company that manufactures EpiPens, emailed KPBS a statement about their expiration dating.

"Given the life-threatening nature of anaphylaxis, patients are encouraged to refill their EpiPen auto-injector upon expiration," spokeswoman Julie Knell wrote.

She wrote that Mylan "continues to invest in product improvements" and has "filed an application with FDA for a new formulation that will extend the product shelf life."

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