Winter is coming and for many of us that includes much colder temps. But for Individuals with a life-threatening stinging insect allergies, having a fully functional epinephrine auto injector (EAI) available at all times is critical. So what happens when you accidentally leave your EAI in your car when it’s cold outside? How does freezing an EAI effect its functionality?

A recent study exposed EpiPen 0.3 mg auto injectors to both cyclical and constant extreme cold (-25⁰ C/-13⁰ F) and reported no statistically significant epinephrine degradation, even after exposure to extreme freezing temperatures for prolonged periods.[1] While the primary focus was to study degradation, researchers found that all 20 devices that were tested fired correctly after being thawed.[1] While this is encouraging news, more research still needs to be done.

There were some limitations to the study. Only EpiPen 0.3 mg auto injectors were tested meaning other brands and types of EAI’s may not have the same results. Temperature exposure was also completed in a lab setting which does not reflect typical real-world circumstances. Also, frozen EAI’s are at risk for potential cracks in the device’s glass syringe which are invisible to the user.[1]

So what’s the take away?

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    Always try to keep your EAI within the recommended storage temperature range of 68-77⁰F (20⁰-25⁰C).[1]
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    You most likely do not need to replace your EAI after a brief excursion below 59⁰ F (15⁰ C) as long as it doesn’t freeze.[1]
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    EAI’s that have a longer exposure period or that you know have frozen should be properly discarded

As always, your Allergist or Pharmacist is your best resource. Contact them if you have questions or concerns regarding your EAI.

1. Rachid, O., Simons, F.E., Rawas-Qalaji, M., Lewis, S., & Simons, K.J. (2015). Epinephrine autoinjectors: Does freezing or refrigeration affect epinephrine dose delivery and enantiomeric purity? Retrieved 2019: https://www.annallergy.org/article/S1081-1206(16)30130-2/fulltext.