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PostPosted: Tue Jul 05, 2011 6:27 pm 
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Quote:

J Allergy Clin Immunol. 2000 May;105(5):1025-30.
Outdated EpiPen and EpiPen Jr autoinjectors: past their prime?
Simons FE, Gu X, Simons KJ.
Source


Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, Faculty of Medicine, University of Manitoba, Winnipeg, Canada.


Abstract

BACKGROUND:
EpiPen and EpiPen Jr autoinjectors are often recommended for prehospital treatment of anaphylaxis. When these units become outdated, there may be a delay in replacing them.


OBJECTIVES:
Our purpose was to evaluate unused, outdated EpiPen and EpiPen Jr autoinjectors, obtained from patients at risk for anaphylaxis, for epinephrine bioavailability and epinephrine content.


METHODS:
We conducted a prospective, randomized, cross-over study of epinephrine bioavailability after injection from outdated autoinjectors in rabbits; controls included EpiPen and EpiPen Jr autoinjectors that had not expired ("in-date" autoinjectors) and intramuscular injection of 0.9% saline solution. In addition, the epinephrine content of the outdated EpiPen and EpiPen Jr autoinjectors was measured by a spectrophotometric method and an HPLC-UV method.


RESULTS:
Twenty-eight EpiPen and 6EpiPen Jr autoinjectors were studied 1 to 90 months after the stated expiration date. Most were not discolored and did not contain precipitates. Epinephrine bioavailability from the outdated EpiPen autoinjectors was significantly reduced (P <.05) compared with epinephrine bioavailability from the in-date autoinjectors. The inverse correlation between the decreased epinephrine content of the outdated autoinjectors, assessed with an HPLC-UV method, and the number of months past the expiration date was 0.63.


CONCLUSIONS:
For prehospital treatment of anaphylaxis, we recommend the use of EpiPen and EpiPen Jr autoinjectors that are not outdated. If, however, the only autoinjector available is an outdated one, it could be used as long as no discoloration or precipitates are apparent because the potential benefit of using it is greater than the potential risk of a suboptimal epinephrine dose or of no epinephrine treatment at all.


PMID: 10808186 [PubMed. - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/10808186

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Daughter: asthma, allergies to egg, milk, peanuts, tree nuts, most legumes (not soy) & penicillin. Developing hayfever type allergies.
Husband: no allergies
Me: allergies to some tree that flowers in May
Cat: allergic to beef, pork and lamb


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PostPosted: Tue Jul 05, 2011 6:54 pm 
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Joined: Thu Feb 26, 2009 12:05 am
Posts: 636
Location: AB, Canada
Thanks for posting this, very interesting. I had found an article in the UK where they said the effectiveness of outdate epipens was suprisingly high, even with poor storage practices (left in hot cars etc..). I'm can't remember the details of how they tested though.

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DSs 7,7,9 all PA


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PostPosted: Tue Jul 05, 2011 10:26 pm 
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Joined: Tue Mar 22, 2005 11:17 pm
Posts: 6429
Location: Ottawa
I once heard that an epipen is dosed to be enogh for a 250lb man. If it's only half viable and you're giving it to a child, it's probably still got enough to do the trick.

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Daughter: asthma, allergies to egg, milk, peanuts, tree nuts, most legumes (not soy) & penicillin. Developing hayfever type allergies.
Husband: no allergies
Me: allergies to some tree that flowers in May
Cat: allergic to beef, pork and lamb


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PostPosted: Wed Jul 06, 2011 1:11 am 
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Joined: Mon Jul 05, 2010 11:37 am
Posts: 1523
Location: Alberta
_Susan_ wrote:
I once heard that an epipen is dosed to be enogh for a 250lb man.

Wow, DD was prescribed the adult one when she was about 60 lbs soaking wet, even now she only weights a little over 100.

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Myself - Seasonal, cats
dd-asthma (trigger - flu) anaphylactic to eggs, severe allergies to bugspray and penicilin,pulmicort
ds-Seasonal, cats and OAS
dh-allergy cats, bugspray and guava, outgrew egg allergy


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PostPosted: Wed Jul 06, 2011 7:27 am 
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Joined: Tue Mar 22, 2005 11:17 pm
Posts: 6429
Location: Ottawa
Yeah, too much for an infant/toddler but OK for her. Remember that epinephrene wont harm you. Too much is better than too little.

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Moderator
Daughter: asthma, allergies to egg, milk, peanuts, tree nuts, most legumes (not soy) & penicillin. Developing hayfever type allergies.
Husband: no allergies
Me: allergies to some tree that flowers in May
Cat: allergic to beef, pork and lamb


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 Profile  
 
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