The manufacturer states EpiPen autoinjectors should not be used after the expiration date as the epinephrine has been shown to lose its potency.1 Epipens are used in life-threatening situations like anaphylaxis, so there can be a major health threat with an expired EpiPen.
However, 2017 research on expired EpiPens has been published.11 A small evaluation of almost 40 expired, unused EpiPens gathered from patients showed that the pens retained 80% of their initial dose of epinephrine, some for up to four years past the expiration date on the device. The lowest level of epinephrine was found in an EpiPen Jr. 30 months past its expiration date; it retain over 80% of it’s original epinephrine dose. About 65% of the EpiPens and 56% of the EpiPen Jrs. contained at least 90% of their initial dose.
In a life-threatening allergic situation, if there is no other option, use of an expired EpiPen should be considered if it is the only auto-injector available and there are no discoloration or precipitates seen in the solution. In this case, the potential benefit of saving a life is greater than the potential risk of death by not using it all.