Is it safe to administer allergy immunotherapy (allergy shots) that is 1 month past its expiration date?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: June 14, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

No, it is not safe to administer allergy immunotherapy that is 1 month past its expiration date. The potency and stability of allergy immunotherapy extracts are influenced by several factors, including storage temperature, presence of stabilizers and bactericidal agents, concentration, presence of proteolytic enzymes, and volume of the storage vial 1. According to the study, the expiration date for more dilute concentrations of allergy immunotherapy extracts should reflect their shorter shelf life, and the potency of concentrated allergen immunotherapy extracts is relatively constant when kept at 4°C, but less concentrated extracts are more sensitive to the effects of temperature and might not maintain their potency until the listed expiration date 1.

The study also notes that the expiration date of any dilution should not exceed the expiration date of the earliest expiring constituent that is added to the mixture 1. This suggests that even if the extract itself is still potent, the presence of other components with shorter expiration dates could compromise the safety and efficacy of the treatment.

Key points to consider:

  • The potency and stability of allergy immunotherapy extracts decrease over time, especially for more dilute concentrations 1.
  • The expiration date on the label is established based on stability testing and is a critical safety measure, especially for injectable medications like allergy shots where precision dosing is essential for both effectiveness and safety.
  • Using expired allergy immunotherapy could result in treatment failure or increased risk of adverse reactions, including severe allergic reactions or anaphylaxis.
  • If you have expired allergy immunotherapy, contact your allergist or healthcare provider immediately to obtain a new, unexpired prescription. Never attempt to adjust dosing of expired medication thinking it might compensate for potential degradation.

From the Research

Safety of Expired Allergy Immunotherapy

  • The safety of administering allergy immunotherapy that is 1 month past its expiration date is not directly addressed in the provided studies 2, 3, 4, 5.
  • However, a study on the use of expired drugs suggests that some medications, if properly stored, remain safe to use after the expiry date, which could be extended by many years 6.
  • It is essential to note that the pharmaceutical manufacturers have an interest in producing products with short shelf life, and disposing of expired ones can generate sales and profit for the development of new products 6.
  • There is no specific guidance on the safety of expired allergy immunotherapy in the provided studies, and it is crucial to consider the potential risks and benefits before administering expired medication.
  • The decision to use expired allergy immunotherapy should be made on a case-by-case basis, taking into account the specific medication, storage conditions, and patient factors, and in consultation with a qualified healthcare professional.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Biologics and Allergy Immunotherapy in the Treatment of Allergic Diseases.

Immunology and allergy clinics of North America, 2020

Research

Use of biologics in allergen immunotherapy.

Allergologie select, 2021

Research

Risks and safety of biologics: A practical guide for allergists.

The World Allergy Organization journal, 2023

Research

International consensus on allergy immunotherapy.

The Journal of allergy and clinical immunology, 2015

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.