Pharmacists

Update on the EpiPen® Shortage

Fri, Sep 28, 2018

Update from Pfizer Canada:  

Important Safety Information on EpiPen® and EpiPen Jr® auto-injectors: A very small number of EpiPen® and EpiPen Jr® auto-injectors may stick in their carrier tube, delaying or potentially preventing emergency treatment. Consumers need to check their device now to confirm that it can be removed from the carrier tube with ease. Click here for the full update

Recent updates from Health Canada and the Health Minister of Canada:

News Release – Health Minister announces access to a U.S.-approved epinephrine auto-injector

https://www.canada.ca/en/health-canada/news/2018/08/health-minister-announces-access-to-a-us-approved-epinephrine-auto-injector.html

Interim Order Respecting Epinephrine Auto-Injectors

https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/announcements/interim-order-epinephrine-auto-injectors.html

Explanatory Note: Epinephrine

https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/announcements/explanatory-note-epinephrine.html

Dear Healthcare Professional Letter

https://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2018/67658a-eng.php

Patient Information — Auvi-Q® (epinephrine injection) Auto-Injector For Allergic Emergencies (Anaphylaxis)

https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/announcements/auvi-q-patient-information.html

 

Pfizer Canada does not expect to be able to provide new supply until the end of August.

The company has also advised that, at this time, they continue to be able to supply EpiPen Jr (0.15 mg)®; however, the supply is limited and is being carefully managed at the national level.

Recommendations:

  • During the shortage, and given the likelihood that quantities are expected to deplete across all pharmacies, pharmacists are encouraged to only process one EpiPen® per patient (where possible), effective immediately, to preserve supply in order to provide care to as many patients as possible until the product becomes available.
  • EpiPen® products expire on the last day of the month indicated on the product packaging. For example, if the product is marked as expiring in August/2018, it remains valid (not expired) until August 31, 2018.
  • Health Canada recommends that in this shortage situation if an individual is experiencing an anaphylactic reaction and has only an expired auto-injector immediately available, they should use the expired product and immediately contact 911. Regardless of whether the product is expired, as usual, a patient should get to the nearest hospital as soon as possible following the administration of the product.
  • If pharmacies or patients do not have access to any form of EpiPen®, manual injection of epinephrine is an option. PAS worked together with medSask to create a supportive document on how to create an "epinephrine kit" and how to teach patients to administer a   manual injection of  epinephrine. Also, medSask created a video that can be used as a support for pharmacists and patients in the teaching process. PAS highly recommends that all pharmacists become familiar with kit contents and how to administer manual epinephrine.
  • Pharmacists can reference the "Anaphylaxis Protocol" document on the PAS website, under the Influenza Immunization Program (and other injectables) area for information on dosing and other anaphylaxis protocol.
  • There is a bulletin developed with input from Health Canada, Pfizer and pharmacy stakeholders which includes additional information and   FAQs on the shortage.

If you have any questions or require additional support in managing an Epipen® shortage, please contact myla.wollbaum@skpharmacists.ca.

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