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Charity concerned pharmacists not ‘au fait’ with anaphylaxis issues

A charity has told C+D it is “quite concerned” that many pharmacists are not “au fait” with adrenaline auto-injector use for anaphylaxis and are potentially misinforming patients.

Anaphylaxis Campaign – a UK charity supporting people with severe allergic reactions – has received calls to its helpline from patients “who have gone to their chemist and they haven’t been as informed as they should be”, the organisation’s CEO Lynne Regent told C+D on Monday (July 15).

“I do appreciate that pharmacists have a lot of things to deal with…but we do find that a lot of chemists aren’t quite au fait as perhaps they should be with issues around anaphylaxis and adrenaline [administration] – bearing in mind it is a life-saving drug,” she said.

This includes pharmacists not following correct protocol when there are supply issues with auto-injectors, and not giving patients “entirely the correct messaging” around their availability and use, Ms Regent added.

Emerade issue

The charity has been “very busy” since the Medicines and Healthcare products Regulatory Agency (MHRA) issued an alert last week (July 11), warning that all three strengths of Emerade auto-injectors have a 0.23% risk of “failing to deliver a dose of adrenaline from the syringe due to blockage of the needle”.

“We get a lot of calls because people are worried,” Ms Regent added.

Following the alert, the MHRA advised healthcare professionals to “contact all patients, and their carers, who have been supplied with an Emerade device to inform them of the potential defect and reinforce the advice to always carry two in-date adrenaline auto-injectors with them at all times”.

The MHRA is not recalling any Emerade auto-injectors and manufacturer Bausch & Lomb told C+D yesterday (July 17) it expects more pens to be with wholesalers “by the beginning of August”.

Ms Regent said: “There is no cause for panic.”

There are two alternative auto-injectors available – Jext and EpiPen – which patients can be prescribed, along with support and training on how to use them, she explained.

“Some chemists have been telling people that EpiPens aren’t available, when in fact they are,” Ms Regent claimed. “The correct process should be known to all pharmacists.”

New EpiPen process

EpiPen manufacturer Mylan told C+D that due to “recent manufacturing challenges, which interrupted the production of EpiPen 0.3mg and EpiPen Jr 0.15mg adrenaline auto-injectors”, it has introduced a new dispensing process to manage the supply of EpiPen 0.3mg.

Pharmacies that are presented with a prescription for EpiPen 0.3mg auto-injectors can place an order for up to a maximum of two devices per prescription, rather than bulk ordering the devices. This new process does not apply to the EpiPen Jr 0.15mg, Mylan stressed.

Manufacturer ALK said it has a “good supply of both strengths of Jext, which is available through Alliance”.

Do you know what to do if a patient presents at your pharmacy with signs of anaphylactic reaction? Read C+D’s free CPD case study to find out.

Have you had questions from patients about availability of adrenaline auto-injectors?

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