FDA: EpiPens can be used past expiration dates

SAN MATEO, Calif. (KTVU) - EpiPens, the life-saving injection for allergic reactions, can now be used past their expiration dates. 
The U.S. Food and Drug Administration made that announcement Wednesday, due to a shortage of the medication. 

The agency posted a list of EpiPen lots, newly expired or soon to expire, that can be kept an additional four months past their stated shelf life.  

The start of school has driven up demand, as parents try to protect children from exposure to food and bee-sting risks. 

"I know I am allergic to peanuts already," shared patient Elizabeth Cresson, at a doctor's check-up before her return to college.    "Do you carry epinephrine with you ?" responded the allergist.      

Cresson was diagnosed with a half-dozen allergies as an infant. She outgrew most of her sensitivities, but an Epi-Pen has always been part of her life. The auto-injectors deliver a dose of epinephrine, which stops anaphylaxis shock. Symptoms include hives, trouble breathing, swollen lips and tongue, and loss of consciousness. Without treatment, the severe allergic reaction can be life-threatening. 

"It's not a good situation that there are not enough EpiPens to go around," allergist Steven Machtinger told KTVU, "but there are ways of getting around it until supply increases." 

Dr. Machtinger is the President of the Allergy, Asthma, and Immunology Foundation of Northern California. 

He and other physicians are well-aware of the supply and manufacturing issues at Mylan Pharmaceuticals- maker of the EpiPen.

Mylan has previously come under fire for raising the price on the device tenfold, and more recently, having to recall injectors that failed to work properly. 

Dr. Machtinger demonstrated how the EpiPen cartridge is pressed against the outer thigh, and with a click, the needle penetrates the skin through clothing. 

The drug enters the bloodstream swiftly, and the anaphylaxis shock subsides within a minute. 

"I tell my patients that epinephrine is the most expensive medication they'll never use," said Dr. Machtinger, "because so many are not used before they expire." 

Even before the advisory from health officials, Machtinger has long suspected the shelf-life on EpiPens could be stretched. 

"People may have worried if it's expired, it becomes toxic but it won't" reassured Machtinger," it will just lose some potency." 

He notes the syringes are sold in pairs, and most patients have a second to back up the first. 

"I wouldn't want to use an EpiPen that was two years old, but if I was in a tight spot, I'd use something that expired a month or two before." 

Elizabeth Cresson carried EpiPens until high school, but reluctantly. 

"Living with an allergy you already feel different," said the 20 year old, "and I felt really embarrassed that I had to carry these two giant magic markers around with me everywhere." 

Two years ago, she switched to a competing injection product, called Auvi-Q.    

"It's a smaller device, and it can fit in a pocket," demonstrated Cresson, "and unlike the EpiPen it talks to you."

Cresson removed the cap from the Auvi-Q, and a recorded message blared instructions for engaging the needle. 

With Epi-Pen prices, Cresson is glad she shopped around for an alternative, even before the shortage and shifting expiration dates added to her skepticism.   

"Creating those short deadlines to use EpiPens is part of the company's plan to get as much money out of patients as they can," she surmised. 

Cresson's last peanut allergy episode was as a toddler, and she has never had to inject herself, but always remains prepared.