Study Looks At How Hot and Cold Temps Alter Epinephrine

What if, while attending a summertime family picnic, a food-allergic child shows signs of anaphylaxis. In a panicked instant, adults realize the child’s epinephrine auto-injectors were left inside a sun-baked car for a few hours, where the temperature far exceeds auto-injector storage recommendations. Will the epinephrine still be effective?

Some researchers, most working at Seattle Children’s Hospital, wondered about scenarios such as this one, and decided to look for answers.

Temperature Levels for Epinephrine Storage

Currently, U.S. recommendations for epinephrine storage call for room temperatures of 68 to 77 degrees fahrenheit. When taking auto-injectors on outings, keeping them at 59 to 86 degrees fahrenheit is advised, though this can be tricky for people to monitor or control.

The Seattle investigators combed through research literature looking for studies that exposed epinephrine to temperatures above, at, or below what is recommended. They found nine such studies involving epinephrine in sealed ampules, vials, or syringes, and at concentrations normally used for anaphylaxis or heart resuscitation. Just two of these studies involved auto-injectors.

Findings

Analyzing the results of these nine studies, the Seattle researchers found:

  • Epinephrine deteriorates when exposed to above recommended temperatures, but only with prolonged exposure.
  • Extreme cold did not weaken epinephrine in any of the studies.
  • None of studies looking at the effects of “real-world temperature fluctuations” found significant degradation.

Though the researchers believe more studies are required to assess the effects of temperature extremes on auto-injector devices, they concluded that:

  • Temperature fluctuations “in real-world conditions may be less detrimental [to epinephrine] than previously suggested.”
  • Freezing and limited heat exposure do not cause epinephrine degradation, and refrigerating epinephrine seems to reduce degradation.

Keeping It Cool

Keeping this Seattle research in mind, what if, while attending a summertime family picnic, a food-allergic child shows signs of anaphylaxis, and the child’s auto-injectors have been in a hot car for several hours. Will the epinephrine still be effective?

Though more research details are needed to answer that with any degree of certainty, the Seattle data suggest epinephrine holds its integrity well, deteriorating only when exposed to prolonged high temperatures.

So, in an emergency, if the only auto-injector available has been exposed to extreme heat, it may make the most sense to use it (unless your doctor or allergist advises otherwise)—and call 911.

Source: Annals of Allergy, Asthma & Immunology
Photo: Pixabay

Community

Latest Post by absfabs Tue, 11/19/2019 - 11:06am
Comments: 171
Latest Post by absfabs Tue, 11/19/2019 - 11:01am
Comments: 478
Latest Post by absfabs Tue, 11/19/2019 - 10:51am
Comments: 3
Latest Post by william robenstein Mon, 11/18/2019 - 10:35am
Comments: 1

More Articles

It’s the time of year when holiday parties, and family gatherings can make allergen avoidance more problematic. Whether you celebrate Christmas,...

When love is in the air we can get caught up in the moment and throw caution to the wind. However, if you have a...

Food allergies and sensitivities are on the rise. Almost everyone knows someone who has problems with at least one food. The most common food...

Peanuts and Nuts Can Trigger An Asthma Attack

According to the American Academy of Allergy, Asthma and Immunology (AAAI), more than 3...

The relationship between anxiety and food or other allergy is a complicated and puzzling one. Research has shown that stress can exacerbate...

More Articles

More Articles

According to the American College of Allergy, Asthma & Immunology, over 50 million people in the U.S. have allergies. Today's allergy tests...

The Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA) addresses the labeling of packaged food products regulated by the FDA....

For people who suffer from anaphylaxis, a severe allergic reaction that can result from an allergy to...

Anaphylactic shock (A-nuh-fih-LAK-tik shok): A severe and sometimes life-threatening immune system reaction to an antigen that a person has been...

In 1963 the American Medical Association designed a special symbol that would alert emergency medical personnel of special medical conditions when...

Finding allergy-free foods for an office potluck may seem impossible, but more options are available than you might think. Eating foods prepared...

One of the most difficult things for a parent to do is determine whether his or her toddler has a cold or a...

You no doubt have your own way of teaching people about your child’s food allergy, a way that suits your temperament, and style of communication....

Reliable peanut allergy statistics are not that easy to come by. There is a lot of available research on food allergies in general but not too...

Most people know that to enjoy whatever food safety accommodations an airline offers they need to inform the airline of their allergy prior to...

A 504 plan* documents food allergy accommodations agreed to by parents and their child’s school. Plans are typically created during a 504 meeting...

If there is a child at your children's school allergic to peanuts, the school probably discourages or may not allow peanut products to be brought...

If you are on a budget, but you need to wear some sort of notification that you have a peanut...

Unless we consciously carve out time for self-care, constant food allergy management can slowly erode our sense of well-being. Signs of allergy-...

Peanuts cause more severe food allergic reactions than other foods, followed by shellfish, fish, tree nuts and eggs. Although there is only a...