Education Specialist & Pharmacist for over 25 years
EpiPens® can be the difference between sharing a story about a close call and dealing with an unimaginable tragedy caused by anaphylaxis. However, the EpiPen's ability to ensure allergic reactions have a happy ending is very much dependent on your child's ability to keep the EpiPen safe.
Epinephrine the active ingredient in the EpiPen, and the components of the pen itself remain effective up until its expiration date, provided that it is carefully cared for. That means avoiding cold temperatures below 59 degrees Fahrenheit (15°C), keeping it away from hot conditions above 86 degrees (30°C), and avoiding extended contact with light.
EpiPens include a small window into the pen, which shows if the medication contained within has become discolored. If it is, the EpiPen should be discarded and replaced with one that will work. However, the medication within the window doesn't tell the full story.
In a study published in the Journal of Allergy and Clinical Immunology, researchers split 53 pairs of EpiPens. One of each pair was exposed to extreme heat for 8 hours, simulating the effect of leaving an EpiPen in the car on a hot, sunny day, while the second of the pair was kept at normal conditions.
After the heated up EpiPen cooled back down to normal conditions, researchers tried using the EpiPens. They found that 84% of the devices that had been heated were difficult to remove from their carrier tubes. The heated devices fired a smaller dose of epinephrine and were more prone to malfunction. While the test did not measure the effectiveness of the active ingredient, it clearly showed that an EpiPen exposed to extreme heat for extended time periods couldn’t be relied upon in an emergency.
It's easy to leave an EpiPen in the car. Unfortunately, it hosts a hostile environment nearly all year long for EpiPens. Cars parked outside in the sun🔆 on a 70° spring day reach 120 degrees inside after 90 minutes. On hot summer days, the temperature is significantly hotter and reaches those extreme temperatures quickly.
Winter days aren’t much better. It doesn’t take long for temperatures inside the car to drop below the safe temperature of 59 degrees. Cold climates can be particularly harsh, but even in a mild climate, if an EpiPen is in a backpack and accidentally left in the car, it can easily be ruined by morning.
If your child's EpiPen was left in the car, your best bet is to replace the EpiPen as quickly as possible to ensure it will be in working order if needed.
It’s remarkable how many times things that shouldn’t be laundered end up going through the wash. A study published in 2021 examined the effect washing machines have on EpiPens. They tested 68 pairs of pens, running one through the washing cycle and leaving one as a control.
Researchers expected that the laundered devices would eject less medication than the control devices, but found they actually ejected a larger mass. One theory is that the dosage included water from the laundry machine that entered into the mechanism, which could introduce contaminated water into the patient.
Researchers concluded that an EpiPen that goes through the laundry should not be considered safe and should be replaced.
It seems obvious, considering that EpiPens should not be exposed to temperatures below 59 degrees, but EpiPens should never be refrigerated. Exposure to cold temperatures for long periods of time can degrade the effectiveness of epinephrine and its operating mechanism. If your child's EpiPen is accidentally refrigerated, talk to your pediatrician to get a new prescription and replace it as quickly as possible.
Instructions on the EpiPen are fairly clear about its care. It warns against exposure to light, heat, and cold temperatures. It also includes a window to look in on the medication, which tends to change color when it is no longer effective.
Due to the cost of EpiPens and confusing information on the Internet, many people keep their EpiPens in use beyond the expiration date. While some anecdotal evidence has indicated it may still be effective, acting counter to the FDA-approved recommendation may put your child at risk. It is far safer to replace an expiring EpiPen than to hope it will remain effective.
Your best investment to protect the effectiveness of your child’s EpiPen is to purchase a case that protects against both cold and hot temperatures and shields the device from direct light. There are a number of different types of cases on the market, some of which require submersion in cold water or the use of ice packs.
The VIVI Epi is a patented EpiPen case using materials that were developed using space technology. It protects EpiPens from environmental dangers, maintaining a constant temperature without the need to submerge the case or charge it. Its ease of use and patented technology make it a great choice to ensure the effectiveness of your child's EpiPen.
The VIVI Epi is a carrying case designed to keep EpiPens at a safe temperature regardless of the external environment. Its patented technology was developed for space and clinically validated in scientific trials. It doesn’t need to be soaked in water to provide a consistent, safe temperature for the EpiPen.
The space age materials not only shield against cold weather, but the self-activating insulation actually absorbs heat and then safely releases it back into the environment. The VIVI Epi never needs to be charged and works 24/7/365.
The VIVI Epi offers peace of mind to parents who send their children off to kindergarten, school, or camp, knowing that if there is ever any need for a shot of epinephrine, the EpiPen® will function as designed.