Key takeaways:
EpiPens and other epinephrine injection devices, such as Auvi-Q, Adrenaclick, and Symjepi, are life-saving medications that can treat severe allergic reactions.
Epinephrine can break down quickly after its expiration date. It’s safest to use it before it expires so it works properly when it’s needed.
You should dispose of used or expired epinephrine devices and get refills as recommended by your healthcare provider. A good general rule is to get a new prescription every year.
Save on related medications
All medications have an expiration date. And while these dates are always important to be aware of, there are a few medications you should especially avoid using after their expiration date. One of those is an EpiPen (epinephrine). The same is true for Auvi-Q, Adrenaclick, and Symjepi — comparable epinephrine alternatives.
An EpiPen is a life-saving medication. You need to be able to count on it when you need it. An EpiPen can treat a severe allergic reaction called anaphylaxis. This reaction can happen to some people with severe allergies to certain foods, insect bites, and medications.
However, EpiPens can be a hard thing to budget for, and they’re only used in certain situations. If you keep an EpiPen on hand for allergic reactions or other health conditions, you’ve probably wondered if you can use it after the expiration date.
Read on to learn how to make sure your EpiPen is not expired, and what to do if it is.
How long do EpiPens last?
EpiPens last until the expiration date that’s listed on the product’s packaging. This is typically 18 months from the time the medication is manufactured.
This isn’t always set in stone though. In the past, the FDA has extended this timeframe to 20 months and 24 months for certain batches of medication. This was done to reflect epinephrine shortages at the time.
As a best practice, try to replace your EpiPen roughly every year. Your healthcare provider can tell you if you can wait longer between refills.
How do you read your EpiPen’s expiration date?
To know if your EpiPen is still OK to use, you’ll first need to locate the expiration date on the medication. To do this, look at the actual auto-injector device or syringe. Each device is different, so depending on if you have an EpiPen or a different epinephrine product, you may need to look in a different place on the device itself for the expiration date.
You can also find the expiration date on the medication’s box. Sometimes the expiration date is printed on one of the small ends of the box. It may also be on the front or back panel in its own section of the box label. It’s usually close to the lot number.
Once you’ve found the expiration date, you’ll need to understand what it means. The expiration date is usually a set of numbers with or without letters, such as “FEB 24”, or “02/24”. The year portion represents the last two digits of the year when it expires. The medication always expires on the last day of the month listed.
For example, if your EpiPen has an expiration date of “FEB 24”, or “02/24”, the last day it could be used before it expires is February 29, 2024. The medication would be considered expired on or after March 1, 2024.
How long is an EpiPen good for after the expiration date?
It’s not clear how long an EpiPen is good for after its expiration date.
An expiration date is determined by a medication’s manufacturer through a series of tests. The medication is guaranteed to work as expected through the expiration date as long as it’s stored in the right conditions (proper temperature, away from moisture, etc.). But this guarantee doesn’t apply after the expiration date.
Some studies have shown that certain medications can still be effective past their expiration date. But, this is mainly for solid dosage forms, like tablets. Liquid medications, like EpiPens, have a higher chance of working improperly if they’re used past the expiration date. This is because they break down faster.
With this in mind, there’s no guarantee that these medications will work if you use them past the expiration date. Without question, it’s safest to always use an EpiPen before it expires. This is because there are reports of people who have died in the past from anaphylaxis after using an expired EpiPen that wasn’t effective. You don’t want to take the chance that it may not work properly by using it after the expiration date.
Can you use an expired EpiPen?
The safest answer is no, you should not use an expired EpiPen. You also shouldn’t use an EpiPen if the liquid appears cloudy or discolored.
Understandably, it can be tempting to keep an expired EpiPen around for when it’s needed. It can be inconvenient to get a refill, and you may need to ask your healthcare provider for a new prescription. But if you need a new prescription and need quick access to a healthcare provider, you may be able to get it with a telehealth visit.
EpiPens can also have a high price tag. The average cost of an EpiPen is about $698.03 for a box of 2 injectors, and it’s close to $346.45 for the generic. Even with a GoodRx coupon, they can still be costly, with a cost as low as $355.15 ($176.37 for the generic).
Depending on your insurance coverage, you may have a lower out-of-pocket cost. But it still may not fit into your budget. If cost is still a factor, there are manufacturer programs that can help you save on these devices. EpiPen, Auvi-Q, and Symjepi all offer copay savings cards.
For example, if you have commercial insurance and meet eligibility requirements, Auvi-Q’s price is as little as $35 using a savings card from the manufacturer. Symjepi is as little as $0. And the EpiPen savings card can help you save up to $300 off each prescription.
Does an expired EpiPen have any safety issues?
As mentioned above, the biggest safety issue with an expired EpiPen is that it may not work as it should. This means if you’re experiencing anaphylaxis or another allergic reaction, an expired EpiPen may not stop the reaction like an non-expired EpiPen.
So it’s not the medication itself that becomes toxic when it expires. The safety issues come from what can happen if the medication fails to work properly.
How do you dispose of an expired EpiPen?
Since EpiPens contain needles, they have special precautions for disposal. There are a few options when it comes to getting rid of an expired or used EpiPen:
Place the device in a sharps container.
Place the device in a drug takeback box at a local pharmacy. Not all pharmacies have these, so you may need to check with the pharmacy first before you bring it in.
Staff at hospitals, doctor’s offices, and health clinics may be able to dispose of your device for you. This is because all of those locations have sharps containers.
Your local police or fire department may also offer disposal boxes that can be used by the public, so check with them to see if you can take in your device.
The Drug Enforcement Administration (DEA) offers a “National Prescription Drug Takeback Day” event 2 times a year. Check their calendar for their next event.
Can you do anything to extend your EpiPen’s shelf-life?
There’s nothing you can do to “extend” the shelf-life of your EpiPen past its expiration date. But storing it at the right temperature helps make sure the medication works properly up until its expiration date.
All of the currently available epinephrine products in the U.S. recommend storing the medication between 68ºF and 77ºF (20°C to 25°C), which is room temperature. You should avoid refrigerating or freezing them — these colder temperatures can make them ineffective.
Can you exchange an expired EpiPen for a new one?
Generally speaking, you can’t exchange an expired EpiPen for a new one. There aren’t any manufacturer-sponsored or FDA-approved programs that offer this sort of exchange.
However, there have been attempts to help lower costs for EpiPen refills. But none of them are widespread or recommended by the FDA.
For instance, one physician describes an initiative where she purchased reusable auto-injectors. The physician refilled them with epinephrine after they expired and sold them to people who needed them at a low price. But this type of program isn’t approved by the FDA and can be risky.
Are EpiPens the only epinephrine devices available?
No. As mentioned above, several others are available.
EpiPen is the most common and well-known name for this medication. But other devices, such as Auvi-Q, Adrenaclick, and Symjepi, are also epinephrine auto-injectors. There are also generics available for EpiPen, EpiPen Jr., and Adrenaclick. These all do the same thing as an EpiPen.
The bottom line
Epinephrine injections like EpiPen, Auvi-Q, Adrenaclick, and Symjepi can break down quickly after their expiration date. This means there’s a chance they may not work properly after they expire, and they could fail to treat a serious allergic reaction.
You should make sure your device isn’t expired by checking the expiration date on the box or device. If it’s expired, dispose of it properly and get a refill as directed by your healthcare provider.
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References
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Estelle, F., et al. (2000). Outdated EpiPen and EpiPen Jr autoinjectors: Past their prime? The Journal of Allergy and Clinical Immunology.
Gikonyo, D., et al. (2019). Drug expiry debate: The myth and the reality. African Health Sciences.
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Lan, J., et al. (2019). Evaluation of epinephrine's expiration date: A US Food and Drug Administration's perspective. The Journal of Allergy and Clinical Immunology.
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Posner, L. S., et al. (2017). Update on the usage and safety of epinephrine auto-injectors, 2017. Drug, Healthcare, and Patient Safety.
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