If you’ve been managing serious allergies for a while and carry an autoinjector like an EpiPen®, you’ve probably had many reach their expiry date. So what can you do with the old ones once you get a new prescription filled? Can you keep them as spares or use them for practise? Learn about your options for expired EpiPens, including the best ways to dispose of any that are no longer needed.
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Keep your EpiPens current
When you fill a script for your EpiPens or other autoinjectors, take note of the expiry date. I always write the expiry date in permanent marker on the cap of the carrying case as a visual reminder, as well as recording the expiry date in my calendar. In Australia you can also register your devices with My EpiPen, and you’ll receive a reminder when they are about to expire. This way, you’ll always remember to get a replacement before the current set expires.
Should you keep expired EpiPens as spares?
Are expired EpiPens still effective? Studies have shown that many epinephrine autoinjector brands including EpiPen still contain high levels of epinephrine (adrenaline) well after their expiry dates. researchers collected expired devices from volunteers for testing. Many retained 100% of their epinephrine content up to 6 months after the expiry dated and 95% or better up to 12 months after the expiry date.
ASCIA, the peak allergy body in Australia and New Zealand, advises that expired adrenaline devices are not as effective when used for treating anaphylaxis. However, if no other device is available, a recently expired one is better than not using one at all. Of course it’s always best to discuss your own emergency allergy medication requirements with your doctor.
What we do with recently expired EpiPens
Whenever we fill a prescription for our 2 new EpiPens, we keep the recently expired ones at home as a back up for another 6 months or so. We keep them separately in a zip lock bag that’s clearly marked as “expired” and make sure to carry our 2 current in-date autoinjectors wherever we go.
We’ve never had to use an expired pen, but find it reassuring to have them available “just in case”. Just in case:
- we accidentally leave our usual set behind somewhere;
- we use both our devices and need a third dose while waiting for an ambulance;
- there is a short term shortage of EpiPens at pharmacies (as there has been occasionally in the past) and we can’t replace ours immediately when they expire.
We also sometimes take recently expired devices with us travelling as spares, especially when travelling overseas to countries when it may be harder to replace a used EpiPen.
Of course, check your expired EpiPens by inspecting liquid through the viewing window. If it’s cloudy or discoloured, dispose of it and don’t keep it as a spare. If you do decide to keep your recently expired pens, make sure to store them properly, clearly mark them as expired/spares and always use your in-date devices first in the event of a reaction.
Practising with an expired EpiPen
You’ve probably heard of some people using an expired EpiPen to practise with, perhaps on an orange or lemon. Often people suggest this to experience what a real EpiPen feels like. Using a real EpiPen is different from a training device as it has a stronger ‘kick’ from the spring mechanism.
Of course the safest option is to use a training device instead. You can purchase training devices for autoinjectors like EpiPen and AnaPen to practice administering, without any active dose of epinephrine. This avoids any risk of accidentally injecting yourself or someone else.
If you do decide to practice on an orange or something similar with a real EpiPen, Allergy & Anaphylaxis Australia advises:
- .practice at a quiet time when you can concentrate and are less likely to be distracted
- keep you fingers and thumb away from the needle end (orange) and away from the spot you are injecting, so you don’t accidentally inject yourself.
Disposing of expired EpiPens
If you need to dispose of expired EpiPens, don’t just put them in the bin or your general household rubbish or recycling. The device contains epinephrine and should be disposed of safely. The safest option is to take any unused, expired autoinjectors to your local community pharmacy, who can arrange for safe disposal. Many Australian pharmacies participate in the Return Unwanted Medicines (RUM) program and often have a drop box for unwanted medicines.
What to do with used EpiPens
Once an EpiPen has been used, it needs to be disposed of safely. While the needle of an EpiPen is covered by the plastic sheath after use, it is still a sharps hazard. Other types of autoinjectors can also leave the needle exposed. Once used, autoinjectors need to be disposed of in an appropriate rigid sharps container.
If you’ve used your autoinjector to treat a reaction, keep it with you. If someone is with you they can put it back in its case, mark it with the time it was given and hand it to the ambulance officer to bring with you to hospital. That way the hospital will know the dose and the time it was given. It can be placed in a sharps container at the hospital.
More about staying safe with allergies
If you carry EpiPens or other epinephrine devices for your allergies, make sure people know. Check out some of the other things you can do to help in the event of an allergic reaction including:
- wearing a medical alert. This could be a traditional bracelet or dog tag necklace, or even a silicone sleeves for your watchband with a QR code for easy access to medical information.
- enter any allergies and emergency contact information on your phone for easy access to by first responders.
- use an EpiPen bag tag on a backpack or purse to let people know that there is life saving autoinjector inside.
And learn about this easy way to remember your EpiPens, every time.
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References And More Information
To read more about expired EpiPens from allergy researchers and peak allergy bodies, see the following references referred to in this post:
- Australasian Society of Clinical Immunology & Allergy, “Adrenaline device storage, expiry and disposal“
- Amercian Academy of Asthma Allergy & Immunology, “Epinephrine Auto-injectors Retain High Levels of Epinephrine Years After Expiration Date, Study Finds“
- Weir, WB et al, “Expired Epinephrine Maintains Chemical Concentration and Sterility“, Prehosp Emerg Care 2018 Jul-Aug:22(4)414-418
*Disclaimer: Allergy Spot does not provide medical advice. You should always consult a suitably qualified medical practitioner in respect of your own medical conditions, symptoms or concerns. See our Website Terms for more details.
