Epinephrine Concentrations in EpiPens After the Expiration Date
Authors: Carolyn L. Taylor, Thomas M. Ellington
Journal: Annals of Internal Medicine (2018)

Letters2 January 2018Epinephrine Concentrations in EpiPens After the Expiration DateCarolyn L. Taylor, BS and Thomas M. Ellington, PharmD, MAMinCarolyn L. Taylor, BSBernard J. Dunn School of Pharmacy, Winchester, Virginia (C.L.T., T.M.E.)Search for more papers by this author and Thomas M. Ellington, PharmD, MAMinBernard J. Dunn School of Pharmacy, Winchester, Virginia (C.L.T., T.M.E.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0495 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Cantrell and colleagues' (1) brief research report discussing the degradation of epinephrine in EpiPens and EpiPen Jrs (Mylan) is welcome information. However, we have concerns about the remaining concentrations of epinephrine in EpiPen Jrs that they have listed. Parish and associates' systematic review of epinephrine degradation discusses the findings of 1 study in which lower concentrations of epinephrine degrade more quickly than higher concentrations (2). If we apply this information to Cantrell and colleagues' report, the epinephrine in EpiPen Jrs may degrade more quickly than that in adult EpiPens.Cantrell and colleagues report 3 EpiPen Jr concentrations ...References1. Cantrell FL, Cantrell P, Wen A, Gerona R. Epinephrine concentrations in EpiPens after the expiration date. Ann Intern Med. 2017;166:918-9. [PMID: 28492859]. doi:10.7326/L16-0612 LinkGoogle Scholar2. Parish HG, Bowser CS, Morton JR, Brown JC. A systematic review of epinephrine degradation with exposure to excessive heat or cold. Ann Allergy Asthma Immunol. 2016;117:79-87. [PMID: 27221065] doi:10.1016/j.anai.2016.04.006 CrossrefMedlineGoogle Scholar3. Mylan Specialty. Highlights of prescribing information: EpiPen and EpiPen Jr. May 2016. Accessed at www.accessdata.fda.gov/drugsatfda_docs/label/2016/019430s061lbl.pdf on 1 June 2017. Google Scholar4. Sicherer SH, Simons FER. Epinephrine for first-aid management of anaphylaxis. Pediatrics. 2017;139. [PMID: 28193791] doi:10.1542/peds.2016-4006 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Bernard J. Dunn School of Pharmacy, Winchester, Virginia (C.L.T., T.M.E.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0495. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEpinephrine Concentrations in EpiPens After the Expiration Date F. Lee Cantrell , Patricia Cantrell , Anita Wen , and Roy Gerona Epinephrine Concentrations in EpiPens After the Expiration Date F. Lee Cantrell Epinephrine Concentrations in EpiPens After the Expiration Date David Stepensky and Pavel Gorenbein Metrics 2 January 2018Volume 168, Issue 1Page: 80-81KeywordsAnaphylaxisAttentionBody weightChildrenDisclosureEpinephrineEpipensPediatricsResearch reporting guidelinesSystematic reviews ePublished: 2 January 2018 Issue Published: 2 January 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...