How To Register My Epipens

Story highlights

29 months subsequently expiring, tested EpiPens independent at least xc% of the stated amount of epinephrine
"Essentially, all of these would nevertheless be in the recommended therapeutic range," expert says
"Expiration date is the final twenty-four hour period ... that a product has been determined to exist safety and constructive," company says

(CNN)EpiPen products can nevertheless deliver an effective dose long after they have expired, co-ordinate to a study published Mon.

The active ingredient in auto-injectors like the EpiPen is epinephrine, more unremarkably known every bit adrenaline, a hormone that tin can help relax muscles. Information technology can open up airways and reduce swelling during a severe allergic reaction.

The toll of the motorcar-injection devices has gone upwards 400% since 2007, drawing the ire of patients who rely on them to quickly counter life-threatening reactions. Outrage grew as more insurance providers dropped coverage of the EpiPen.

Amid the criticism, manufacturer Mylan developed a cheaper generic culling priced at $300 for two pens.

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With these patients in mind, researchers tested devices whose expiration dates had passed to determine whether they were yet potent and safe.

Study author Lee Cantrell, professor of medicine and chemist's at the University of California, San Diego, and his team measured the epinephrine concentration of 40 expired EpiPens and EpiPen Jrs. They found that 29 months after expiration, the pens contained at to the lowest degree 90% of their stated amount of epinephrine. Pens 50 months -- more than four years -- past the printed expiration engagement had more than 84% of the medication.

"Essentially, all of these would nevertheless be in the recommended therapeutic range," said Dr. Thomas Casale, a professor of medicine at the Academy of S Florida and executive vice president of the American Academy of Allergy, Asthma, and Immunology.

The new study builds on previous research finding that epinephrine car-injectors have a much longer shelf life than labels said. A 2015 written report found that some retained more ninety% of their stated dose two years later on expiring.

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Despite the findings, Casale, who was not involved in the new report, said patients probably won't desire to chance with a potentially life-saving medication.

"Until those labels are changed, patients are in a bad state of affairs, considering they're concerned nearly having a life-threatening outcome and not having a medicine that'due south effective," he said.

Both Cantrell and Casale say that if someone has an allergic reaction, expired epinephrine is meliorate than nothing at all.

"Our paper is not suggesting that people take expired medication," Cantrell said. "We can't brand that leap based on our information. But what we can say is that if you lot have naught else, and you're having a life-threatening reaction, certainly use the expired epinephrine."

Life-saving drugs

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"The most common things we would prescribe epinephrine for is food allergies, bees, wasps and other stinging insects," Casale said. "The advantage of these motorcar-injectors is that yous don't have to think near it. Yous only pop the cap, stick it right in your thigh, the needle comes out at the right depth into the muscle, and information technology delivers the correct amount of epinephrine."

In the study, all tested auto-injectors were within the therapeutic range for an effective dose. Simply using the amount of time since expiration is not always a proficient way to determine whether an EpiPen is nevertheless potent, and in the absence of testing equipment, the color of the solution might give some clues, Cantrell said.

Every pen has a pocket-sized window where the liquid medication can exist seen. It's usually articulate and colorless. The quickest and easiest indication that the drug has expired is a color modify to brownish-yellow, Cantrell said. "There's a piddling window on each ane. If it's discolored, you lot shouldn't utilise them, menses," he warned.

Good for backup

But what if your medication is past the printed expiration date and the color has not inverse? "Personally, I think it's fine. I'm not convinced information technology becomes dangerous," Cantrell said.

Merilee Hufnagel, a mother of two in Johns Creek, Georgia, has kept her daughter's quondam EpiPens and says the new study validates her belief that they can still be expert for a few years. Her 17-yr-onetime daughter has dealt with life-threatening peanut allergies since she was a toddler.

"We've been buying them for 14 years. Nosotros started with the EpiPen Jr when our daughter was iii, and once she hitting 60 pounds or so, the doctor switched her to the regular EpiPen," she said.

Luckily, the Hufnagels accept not had to use their machine-injector pens, but they follow the visitor's guidelines and replace the devices each twelvemonth.

Merilee Hufnagel keeps her family's expired EpiPens as backups.

All the same, Hufnagel says she knew that her expired pens were still good and kept them around just in case. "I keep other ones as backups considering I know in my brain that they're even so fine," she said.

"The reason I buy new ones? I desire to be a good mom and follow the recommendations. That, and the schools will not accept them if they are expired," she said.

Although some schools purchase EpiPens, about even so require students to provide their own and annals them with the nurse's function. Equally with all medications, school policy requires families to update prescriptions and replace them when they are by their expiration date.

Replacing the pens can be costly. The prescription used to be covered by Hufnagel'southward insurance, and an online co-pay carte from the company brought the total cost to zero. Simply the family'south insurance provider recently stopped roofing the name-brand device. To avoid paying $600 out of pocket, they opt for the cheaper generic device.

Mylan, which also makes the generic version, offers co-pay cards that brought the family's price downward to $10 for two pens. Any additional pens needed would be purchased at cost: $300 each.

'Prophylactic and constructive'

Since the price controversy began, the shelf life of the auto-injectors has been studied by chemists and manufacturers alike. When exposed to calorie-free, heat or air, the epinephrine can dethrone and lose its effectiveness.

In an emailed statement, Mylan said that the expiration appointment is the last day the medication is "safe and effective."

"All epinephrine products have expiration dating whether they come in an machine-injector or vial," the statement said. "This is required by constabulary. An expiration date is the last twenty-four hours, based on performed quality control tests, that a product has been determined to exist safe and effective when stored under the conditions stated in the package insert.

"Given the life-threatening nature of anaphylaxis, patients are encouraged to refill their EpiPen Auto-Injector upon expiration, approximately every 12 to 18 months. Mylan as well continues to invest in product improvements, such as a formulation with a longer shelf life."

Doctors and patients rely on information from manufacturers for the all-time information near the condom and efficacy of their medications.

Almost patients like the Hufnagels religiously follow the manufacturer's guidelines, even amidst growing evidence almost the devices' say-so.

"As far every bit agin reactions to medication beyond expiration engagement, I haven't run across any published report that shows it'south truly a danger," Cantrell said.