Study: Expired EpiPens Still Effective

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Study: Expired EpiPens Still Effective

EpiPen and EpiPen Jr.

An expiration date is defined as the last day that a medicine is warranted to be safe and effective when stored properly. I’ve written for years that this date is often arbitrarily determined, and that the idea all medicines somehow “spoil” very soon after their expiration dates is incorrect.

I’m not alone in this opinion: A new study now reports that an important medical product that prevents deaths from severe allergic reactions (also called”Anaphylaxis“) can still be used effectively years after the expiration date on the package.

The California Poison Control System in San Diego tested 40 unused, expired Epipens and found that all (yes, all) of them retained at least 80% active epinephrine, the main ingredient.  This was true even for Epipens that closed in on the four-year expired mark. The least potent device was found to be at 81 percent 30 months past its expiration date. Most were at 90% or above.

Epipens are expensive items that are sometimes in short supply. F. Lee Cantrell, lead researcher of the California study, concludes that those unable to replace the product should hold onto it for use past the expiration date.

“There’s still a dose that would be therapeutic in there…” Cantrell also said: “if an expired EpiPen is all that I have, I would use it.” He suggests that it might be appropriate for the FDA (Food and Drug Administration) and Mylan, the company that distributes Epipen, to consider adjusting the expiration dates. Currently, the drug”expires” 12-18 months from the date of manufacture.

Of course, in normal times, the recommendation is to replace expired EpiPens. This new information, however, if of use to those who cannot afford to replace Epipen often and, also, to those in the preparedness community who store medical items in case of disaster.

The recommendation given by the California Poison Control System is a rare departure from standard conventional medical wisdom, which states that drugs should be disposed of as soon as they become expired. However, even the Department of Defense has determined that many medicines are 100% effective and safe to use even if expired. This data can be found in the July 2006 issue of the Journal of Pharmaceutical Sciences.

many drugs remain potent after expiration

The “Shelf Life Extension Program” (SLEP), which initially evaluated 122 drugs commonly stored for use in peacetime disasters, determined that most drugs in pill or capsule form were therapeutically effective for 2 to 10 years beyond the written expiration date. This led to the government issuing “emergency use authorizations” for various expired medicines when a shortage occurred. One example is the antiviral drug Tamiflu: During the 2009 Swine Flu epidemic, existing supplies of Tamiflu were authorized for use up to five years after the expiration date.

Drugs in liquid form did not fare as well in SLEP studies, which makes the Epipen (which uses a liquid solution of epinephrine) data so interesting. Granted, 100% potency would have been better, but 80-90% would still have a beneficial effect on an allergic reaction.

Given the 2016 Mylan scandal where the company increased the price from about $100 per two-pack to $600, an extended shelf life would be welcome news. (Mylan recently released a “generic” version for $300 per two-pack).

It should be noted that potency of a drug is affected by storage conditions. Most medicines should be stored in dry, cool, dark conditions. Allowing Epipens to be exposed to high heat or freezing could adversely affect effectiveness.

Many physicians are greeting the study’s findings skeptically, but I consider it more evidence that expiration dates are sometimes artificially determined, and that those storing medications for use in disaster settings might get more longevity out of their supply than expected. Get fresh medicine if available, but think twice before throwing out your last Epipen. Sometimes, something is better than nothing.

Joe Alton, MD

Dr. Alton:

Find out more about expired drugs, anaphylactic shock, and 150 other medical topics in austere settings with the 700 page Third Edition of The Survival Medicine Handbook: The Essential Guide for When Medical Help is Not on the Way, available at Amazon. (Be aware that the Second Edition can still be found there; be sure to get the latest edition or just order from store.doomandbloom.net.

How to Avoid This Potentially Dangerous Preservative Found in Dried Fruit

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dried fruitIf you opened up a pantry belonging to any prepper, you’d most likely find a veritable cornucopia of dried foods within. It’s pretty much a staple for preppers. Unfortunately, dried foods of all kinds often come packaged with preservatives that aren’t so healthy. It can be a real challenge to find long-lasting foods that you would want to eat during an emergency, that aren’t also filled with toxic preservatives.

Among those preservatives, there’s one that most people aren’t aware of. It’s called sulfur dioxide, and it’s found in more foods than you probably realize. It can be found in wine, jam, fruit juices, shrimp, instant coffee, pickled foods, processed meats, and powdered potatoes.  And the one food that probably contains the most sulfur dioxide is dried fruit. It’s typically added to all of these foods, not only to prevent bacterial growth, but to preserve the color of the food.

So is sulfur dioxide something that you need to worry about? That really depends on who you ask. The FDA has deemed it safe for most people. I say “most people” because some folks are more sensitive to it than others. About 1 in 100 people have some degree of sensitivity to sulfur dioxide, and people who are asthmatic are 5-10 times more likely to have a sensitivity.

When these individuals consume this preservative, they may face nausea, diarrhea, difficulty breathing, and sometimes full-blown asthma attacks. Occasionally this leads to death. And just because you’ve never had any harmful symptoms from eating these foods, doesn’t necessarily mean that you’re out of the woods. You can develop a sensitivity to sulfur dioxide at any point in life. It’s also important to note that even if you never have this kind of reaction, sulfur dioxide might still hurt you. A study conducted in 2004 found that sulfur dioxide, when fed to mice, would damage their DNA and cause cancer.

With that said, it may be a good idea to avoid this preservative entirely. If you avoid processed foods, then you’re already on the right track. You can also avoid sulfur dioxide by buying organic products. At the very least you should be checking the labels on anything you buy. Any food item that contains this preservative in more than 10 parts per million is required to be labelled as such to protect people who are sensitive to it.

And if you really love dried fruit and want to make it a staple in your emergency food supply, you can also make it yourself in your oven. You can dry fruit in the sun. And if you’re a real fanatic for dried fruit, you can buy a food dehydrator.

Joshua Krause was born and raised in the Bay Area. He is a writer and researcher focused on principles of self-sufficiency and liberty at Ready Nutrition. You can follow Joshua’s work at our Facebook page or on his personal Twitter.

Joshua’s website is Strange Danger

This information has been made available by Ready Nutrition