What to Do with an Expired Epipen

The school nurse has been calling me for weeks and sending home notes because my daughter’s Epipen has expired. I finally took a new one in this morning and then comes the question of what to do with the old expired one. After all, it is a needle so you don’t want to throw it in the trash and have it stick some unsuspecting person.

The nurse said she could dispose of it for me the right way. But before she did, she asked if I had administered one to my daughter. I said no, though I had used the Epipen trainer. I think I once used an expired one on an orange, but wasn’t really sure. So she had the good idea of letting me try it, but, of course, she smiled and said not on her or myself. She guided me through the steps and had me punch it in the side of her trash can. Easy enough, but I still pray I never have to actually use one on a real person.

What was better about doing this with the school nurse was that she gave me a guided lesson. It was a little better than sticking it in the orange because she showed me the red plunger in the middle that showed that the medicine had been injected and pointed out the sound it made, too.

Even if you dispose of your own expired Epipens yourself, it is best to release them before putting them in the trash. You can do stick an orange for practice, or even into the ground outside. You should never dispose of them in the trash unless they have been released. Some may think it is a shame to throw them out when they haven’t been used, but you don’t want to hold onto an expired one in case of emergency as they may be less effective. As my doctor once said, it’s a great $15 investment, even if it’s never used.

I do wonder though if the medicine inside really expires. I’d hate for someone to have to find out by using an expired one and it not working, but does the medicine really go bad in that short of time? I think mine had expired in November and it sat for two months without being replaced. Was I a bad mom because I took so long to replace it? What would have happened if my daughter had had an allergic reaction and had to use and old Epipen? I guess I should have asked about the date on her Benadryl while I was there today!

Anyway, at least practice with your old ones before throwing them in the proper way. And after you have become proficient at it, teach someone else – your child’s grandparents or your child’s teachers. Let the nurse at school keep it and show someone else, she can use it in her staff training.

Epipens at School

When my daughter was first diagnosed with an allergy and needed an Epipen, I looked for all the information I could get, I wrote letters, and I talked to the doctors and school personnel. I learned that some schools (ours being one) greatly prefer that the Epipen stay in the nurse’s office. At first I was taken aback at this and did obtain a letter from the allergist stating she needed her medication close by at all times. In the long run, however, I realized I actually prefer her medication to remain in one place at all times, instead of following her around the school.

I’m not sure of the severity of my daughter’s allergy (but that alone is another story) and with her being in elementary school with the nurse’s office in a central location, I feel confident that if something were to happen, she could get there very quickly. Elementary school students really don’t carry backpacks with them throughout the day, though they do switch classes often (going to art, music, PE, lunch, recess). I didn’t want to put the responsibility of carrying an Epipen on her. I also feel it’s better to keep it one place rather than have the teachers pass it around between them. What if there is a substitute teacher who forgets, what if a regular teacher forgets and a reaction occurs. Do we really want to play “Where is the Epipen?”

It’s also important that the Epipen is in the hands of someone who is capable of administering it. I know the school nurse is, but do I know that the substitute art teacher is? Would someone else be too quick to give it, or worse, too slow? I am confident that the nurse can make the right judgment call; she also has all of my emergency numbers and our emergency medical plan on record.

It is important that teachers take medication (Epipens, antihistamines, whatever your child needs) with them on field trips and I always send in a reminder note to them to do this. Other than that, I like it to stay put until my daughter can carry it with her. That’s my comfort level, it’s up to you to find your own and assert your rights and yourself to make sure the school does what is best for your child, not their policies.

Should Epipens Be Used Without a Prescription?

Since my daughter was prescribed an Epipen auto injector pen 6 years ago, I’ve often wondered what happens if you need an Epipen but don’t have a prescription. Would someone offer theirs to you? Would an establishment or school have one on hand to save a life even without a prescription? What if a first reaction is life threatening and the person wasn’t aware of his allergy, so he didn’t have one?

Few days ago I saw in the news that in Chicago, a bill that could allow this is making its way to the governor’s desk to hopefully become a law. The senate just passed a bill that “would allow school nurses to inject students with epinephrine even if the student isn’t prescribed it.” The House already unanimously approved this bill in April.

If this passes, a nurse could use an Epipen on someone who is having an allergic reaction even if the student does not have his own prescription for an Epipen or have it in his medical plan. I even thought about this earlier this week as I was picking up my daughter’s Epipen from the school nurse for the summer. The nurse had to first find my daughter’s name in her file, then her Epipen in a closet FULL of Epipens. Wouldn’t it be a lot faster just to grab an Epipen, regardless of whose it is, if there is a life threatening situation? I certainly would not mind if her Epipen was used to help someone out, possibly save someone’s life.

I’ve also often thought that restaurants should all have an Epipen or two on hand, just in case. You really never know when an allergy could manifest. So many times people have a first reaction later in life, or simply don’t have their medicine on them. Wouldn’t it be worth it to have an Epipen or two around, just like a fire extinguisher or first aid kit? They are such a simple means of halting a reaction and possibly saving a life.

We know we live in a very litigious society, and everyone is afraid of a lawsuit. Who wants to be the person that stabs someone else with an auto injector full of epinephrine? But someone may just need it and not have a prescription – wouldn’t it be worth it?

With this new bill hopefully passing into a law in Chicago, maybe it will spread to other areas beyond schools. However, what a great place to start. Unfortunately, the reason behind this bill is a tragic one. Last year in December, a thirteen year old girl died in Chicago of anaphylaxis after eating food cooked in peanut oil. She was not given the injection.

Now this bill will only pertain to schools and school nurses, and a school  nurse will be needed to administer the shot. A few other states already have this ruling, including Massachusetts and Kansas. Maybe in the near future we will see this country wide and along with the need for donations of band aids, rubber gloves and extra clothes in school clinics, there will also be a call for Epipens. I, for one, would be more than happy to supply an extra Epipen if it could save someone’s life.

8 comments

  1. My husband was told years ago after being stung by a yellow jacket that even though he had a reaction that his blood work determined that he was NOT allergic. He was prescribed two epipens about 13 years ago. Until yesterday they had been stored as they should but never used because he never had another reaction from a sting even though he had been stung a few times over the years.
    Yesterday that all changed. He had been out in the yard and walked up to the house not aware that yellow jackets had built a nest in his path. He and my 16 y/o son walked up and were immediately swarmed. My son ran only receiving three stings and was fine but my husband was stung about six to eight times. Within minutes I had him taking two Benadryl but his condition worsened quickly. In a matter of five minutes he was collapsing and passing out. He loss all color in his face and his eyes dilated. As I am trying to not panic, my son grabs the old epipen and as I look back my husband had stopped breathing. I injected the epipen in his thigh and as my son spoke with 911 my husband opened his eyes and began to breathe again! It may not be ‘proper’ to hold an expired epipen but it saved my husbands life yesterday! The entire episode was over a five to eight minute period and was so fast that the paramedics had not reach my home when my husband stopped breathing. I thank God for that ‘old’ epipen!

    Cheryl B.

  2. Thank you for sharing Cheryl! My son had a reaction to peas at 6 months old. His first set of epi pens just expired and I was looking up if I should save them as extras “just in case.” Your story made up my mind. I’m glad your husband and son are safe!

  3. The epinephrine (adrenaline) is the active ingredient. It is highly unstable, which is why natural “adrenaline rushes” pass so quickly. It is also why EpiPens contain sodium metabisulfite as a preservative.

    How much is your loved one’s life worth, that you would skimp out on getting a fresh one every year? It should last a year, and if the expiration date is sooner than that, ask the pharmacy for a fresher stock.

  4. $15 investment?! Ours cost us $200
    The one time we did have to use ours, the one we had was a few months expired. It still did the job. Of course I think you should try to keep them current, but when you are paying $200 for them, I’m okay with letting a couple of months go by, if they have been kept in temp. controlled environments.

  5. I was swarmed by bees in 2009 and dies 3 days later several times while in ICU. I’m yet to discard old epi’s for this very reason. If they still are clear and I take care of them, I never toss them. Any epi is better than none if you could die any moment. I check them all regularly for clarity. I have the first two we purchased. The latest price hike by the company was a crime punishable by death from anaphalaxis as far as I am concerned. Don’t trash ’em, stash ’em. Just be vigilant and keep some up to date when at all possible.

  6. I used old epipen which was expired 7 months earlier.it worked,it did the JOB,saved my son’s life.what happened was my son was invited to Halloween party last October 2016.There were around 50-60 kids at the party with their parents.Kids were running,jumping on bouncing castles etc… with his friends.There was buffet table with 3-4 different hot foods and desserts as well.I was sitting at the dinner table chatting with my friend,suddenly my son came back to me coughing,his face was swollen,eyes were getting watery,I asked him immediately that what have you eaten? He told me that he ate chicken.I grabbed my son from his hand rushed to buffet table,asking him which one did you take? My son pointed to this one,pointing chicken on the wooden stick.I immediately checked the menu,which is written that CHICKEN SATAY.My son has just eaten chicken satay which contains peanuts sauce.I watched my son couple of minutes then decided to use his epipen.After I used the epipen 2-3 minutes later I started seen the different on his face,swollen almost gone,his breathing became normal.I always get 3 epipen for my son from his doctor.One for home,one for his school,one for my son’s after school care.I always keep them in dates,but I kept expired one epipen in my car for just in case.If we eat outside or go to somewhere we always bring epipen which is at home.But last year when we went to Halloween party we forgot the Epipen at home,when I was parking my car outside of the venue I realised that we forgot the pen.I knew there was a expired one in my car’s compartment,I took it out,put it my hand bag,hoping that everything should be ok.Headed to party.My son diagnosed with peanut allergy when he was 4 y/o,for 4 years we didn’t have any accident,but we had an accident 3 weeks before his 8th birthday.I used the epipen first time that time,I really tried stay calm as possible as I can.what I leant from this is keep the expired pen in your car in case you forget indate epipen at home or somewhere.expired epipen is better than Nothing.

  7. I have long expired epipens and brand new ones. It says on the old ones “Discard if discolored”. What the heck is discolored?
    They all look exactly the same when I look through the site glass on them. 2 are from 2012, 2 are from 2016 and the new ones expire in 11 months but they all have the same clarity. In a pinch I would use any one or two of them.

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