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Charity concerned pharmacists not ‘au fait’ with anaphylaxis issues

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Bausch & Lomb expects more Emerade pens to be with wholesalers from August
Bausch & Lomb expects more Emerade pens to be with wholesalers from August

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.

5 Comments
Question: 
Have you had questions from patients about availability of adrenaline auto-injectors?

Joan Richardson, Locum pharmacist

The Gp's need to be fully kept in the loop regarding supply issues.  I have spent several hours over the past few weeks trying to convince incredulous GP's that I can only obtain and thus supply 2 Adult Epipens per prescription form no matter how many they put on the form.  Being accused of trying to increase revenue by obtaining extra dispensing fees really does wonders for my morale.

Reeyah H, Community pharmacist

They can’t expect us to be as efficient as we used to be. Once there’s an issue with BN etc, the manufacturer can deal with the Drs. The Drs can contact patients. Oh hang on- Drs won’t lift a finger without extra pay! 

V K P, Community pharmacist

I am surprised by Reeyah H's affrimative comment today. good to read.

the manufacturer has caused the issue and they do not want to rollout a recall but want the pharmacies to call the patients up?? why?? calling around takes time and that is an unpaid task which will not be carried out. 

Even when a call is made, the parent is flustered and questions what the issue is, is their pen affected and can we replace it for them to a good one?

where are the answers to all of those from the manufacturers??? tell the doctors who have free staff to make the calls, they can run a search as to who was prescribed Emerade and ring them up regardless of the pen being faulty or not. 

this blanket calling only causes anxiety for the user and nothing else.

pathetic advise by MHRA and the charity person seems to know more so what is stopping them from making all the phone calls. also can they speak to alliance and get our epipen quotas increased since she knows alot about stock availabilty.

 

ABC DEF, Primary care pharmacist

Yet again the blame is passed onto pharmacists who have no control over supply and stock levels. No surprise here. "Whenever something goes wrong, no matter whose fault it is, blame the pharmacist" seems to be the ethos in current years.

In reality pharmacists can no longer promise anything nowadays as stock level and supply are changing every single day. One can have hundreds of stock today and the next day it goes oos until the end of the year. And now with people wanting replacement for their potentially faulty Emerades I can only expect Epiepn and Jext going oos even quicker, if not already happened.  

 

Dodo pharmacist, Community pharmacist

Which “chemists” are these ? Analytical or research chemists maybe?

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