Epinephrine Concentrations in EpiPens After the Expiration Date
Authors: F. Lee Cantrell, Patricia Cantrell, Anita Wen, Roy Gerona
Journal: Annals of Internal Medicine (2017)

Letters20 June 2017Epinephrine Concentrations in EpiPens After the Expiration DateF. Lee Cantrell, PharmD, Patricia Cantrell, MD, Anita Wen, BS, and Roy Gerona, PhDF. Lee Cantrell, PharmDFrom California Poison Control System, San Diego, California; Kaiser Permanente, San Diego, California; and University of California, San Francisco, San Francisco, California., Patricia Cantrell, MDFrom California Poison Control System, San Diego, California; Kaiser Permanente, San Diego, California; and University of California, San Francisco, San Francisco, California., Anita Wen, BSFrom California Poison Control System, San Diego, California; Kaiser Permanente, San Diego, California; and University of California, San Francisco, San Francisco, California., and Roy Gerona, PhDFrom California Poison Control System, San Diego, California; Kaiser Permanente, San Diego, California; and University of California, San Francisco, San Francisco, California.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-0612 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Interest and outrage have been mounting over dramatic price increases for the emergency-use epinephrine autoinjection device EpiPen (Mylan). Since 2007, the price of this potentially lifesaving medication has risen more than 400%. This sharp increase has caused patients to ask health care practitioners whether they can use expired EpiPens because they cannot afford to replace them.Objective: To determine whether EpiPens expired up to 50 months retain their stated potency.Methods: Over 2 weeks, patients and practitioners at a community clinic were asked to provide unused, expired EpiPens. All pens were examined for color changes and expiration date. Two ...References1. Cantrell L, Suchard JR, Wu A, Gerona RR. Stability of active ingredients in long-expired prescription medications [Letter]. Arch Intern Med. 2012;172:1685-7. [PMID: 23045150] CrossrefMedlineGoogle Scholar2. Simons FE, Gu X, Simons KJ. Outdated EpiPen and EpiPen Jr autoinjectors: past their prime? J Allergy Clin Immunol. 2000;105:1025-30. [PMID: 10808186] CrossrefMedlineGoogle Scholar3. Rachid O, Simons FE, Wein MB, Rawas-Qalaji M, Simons KJ. Epinephrine doses contained in outdated epinephrine auto-injectors collected in a Florida allergy practice [Letter]. Ann Allergy Asthma Immunol. 2015;114:354-6. [PMID: 25707326] doi:10.1016/j.anai.2015.01.015 CrossrefMedlineGoogle Scholar4. U.S. Food and Drug Administration. Questions and answers on levothyroxine sodium products. 3 October 2007. Accessed at www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm161266.htm on 21 October 2016. Google Scholar5. Simons FE. First-aid treatment of anaphylaxis to food: focus on epinephrine. J Allergy Clin Immunol. 2004;113:837-44. [PMID: 15131564] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From California Poison Control System, San Diego, California; Kaiser Permanente, San Diego, California; and University of California, San Francisco, San Francisco, California.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L16-0612.This article was published at Annals.org on 9 May 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEpinephrine Concentrations in EpiPens After the Expiration Date Carolyn L. Taylor and Thomas M. Ellington Epinephrine Concentrations in EpiPens After the Expiration Date David Stepensky and Pavel Gorenbein Epinephrine Concentrations in EpiPens After the Expiration Date F. 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Taylor, BS and Thomas M. Ellington, PharmD, MAMin 20 June 2017Volume 166, Issue 12Page: 918-919KeywordsAnaphylaxisAttentionChromatographyConflicts of interestDisclosureEpinephrineEpipensFood and Drug AdministrationHealth careOutpatients ePublished: 9 May 2017 Issue Published: 20 June 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...