Drug Shortage Detail: Epinephrine Injection

Drugs held by consumers may have been stored under varied conditions after entering the market. As a result, it would be difficult to conduct testing to determine expiration dates that would be meaningful and generally applicable after prolonged periods of storage under different conditions. The appropriate conditions will depend on the drug, but may include considerations regarding temperature, humidity, and exposure to light. One way is through issuing an Emergency Use Authorization under section 564 of the FD&C Act since use of a product beyond its labeled expiry date is considered unapproved.

Patients with other conditions not listed may also have moderate to severe immune compromise and therefore be eligible for Evusheld therapy, assuming the remaining terms and conditions of the authorization are met. Prescribers should monitor CDC regional variant frequency data and refer to the table of variants detailed in the Fact Sheet for Health Care Providers for the latest data on the neutralization activity of Evusheld against SARS-CoV-2 variants in your area. Prescribers should discuss the risk of developing COVID-19 infection with patients receiving Evusheld. Today’s action to limit the use of Evusheld prevents exposing patients to possible side effects of Evusheld such as allergic reactions, which can be potentially serious, at a time when fewer than 10% of circulating variants in the U.S. causing infection are susceptible to the product. 5.Zilker M, Sörgel F, Holzgrabe U. A long-time stability study of 50 drug substances representing common drug classes of pharmaceutical use. Regularly engage in dispensing prescription drugs upon a valid prescription by practitioners licensed by law to administer these drugs to patients under their professional care.

Drug Shortage Prompts Expiration Date Extension for Some Epinephrine Products

Patients who have already received the previously authorized dose should receive an additional dose of 150 mg of tixagevimab and 150 mg of cilgavimab as soon as possible to raise their monoclonal antibody levels to those expected for patients receiving the higher dose. In preparation for national health emergencies, the United States government has created medical countermeasures . MCMs include FDA-regulated products that consist of biologics, drugs, and devices stockpiled by the government and some private sector partners. Some types of drugs that may be included in MCM stockpiles are antimicrobials and antiviral drugs. Sterility Testing Products manufactured as sterile must maintain that quality throughout the labeled expiration dating period as long as the product is unopened and stored according to labeled instructions.

“A review of CCTV is also underway while members of the public can expect to see officers canvassing the area, including local businesses, to identify any witnesses. We believe this incident to be an isolated one but should anyone have any specific concerns then I’d encourage them to talk to an officer.” Investigators https://datingmentor.net/hyesingles-review/ found the bacteria were not susceptible to any antibiotics routinely tested at public health laboratories. The technology then builds a digital computational simulator of the human body that can be used to predict responses to drugs, thus providing insights which ones could be best matched for patients.

Healthcare providers should assess whether treatments are right for their patients. It is also current policy to allow firms to repackage solid dosage units from plastic containers into glass containers because glass has been shown to be a superior moisture and gas barrier. This policy does not apply to liquid drugs because of pH problems resulting from the alkaline nature of glass. Policies relating to the expiration dating of unit dose repackaged drugs may be found in Compliance Policy Guide 7132b.11. Although stability studies were performed on the dosage unit in the original manufacturer’s container, the event of placing the dosage unit into a different storage unit may and often does affect the product’s shelf life.

Estimated Resupply Dates

The FDA said that it has extended expiration dates on some EpiPen and generic versions, all manufactured by Pfizer, by 4 months. As part of the EUA, FDA requires health care providers who prescribe Evusheld to report all medication errors and serious adverse events considered to be potentially related to Evusheld through FDA’sMedWatch Adverse Event Reporting program. Providers can complete and submit the reportonline; or download and complete the form, then submit it via fax at FDA-0178. Patients who previously received an initial lower dose of Evusheld should contact their health care provider and return for an additional 150 mg of tixagevimab and 150 mg of cilgavimab dose as soon as possible.

They warn there are potential side effects including nausea, diarrhea and hypoglycaemia. Do NOT use bacteriostatic water for injection in place of sterile water for injection , especially for intrathecal or epidural injections or for neonates. Frozen vials may be stored in an ultra-low temperature freezer at -90ºC to -60ºC (-130ºF to -76ºF).

On August 22, 2021 FDA issued a concurrence letter , and on August 23, 2021, FDA revised the Fact Sheet for Healthcare Providers Administering Vaccine (1.3 MB) to provide updates on expiration dating of the authorized Pfizer-BioNTech COVID-19 Vaccine. Please see the fact sheet for additional important information about storage and handling. Results from pfizer to industry april 6 months on certain future compliance with emergency.

To see complete information on smaller screens, select the blue plus (+) button beside the test name. Please contact Brad Leissa at or Brooke Courtney at with questions regarding this update. Department of Defense components should continue to direct any auto-injector expiration dating and disposal questions to the DoD Shelf-Life Extension Program Manager. FDA is not requiring or recommending that the identified lot numbers in the following table be relabeled with their new use dates. However, if replacement product becomes available during the extension period, then the agency expects the lots in these tables will be replaced and properly disposed of as soon as possible.

Retained product must be appropriately held in accordance with storage conditions detailed in the authorized Fact Sheet for Health Care Providers and the Letter of Authorization for Emergency Use Authorization 091. To help alleviate drug shortages, FDA has also approved extensions of expiration dates when data supporting the extension are available. Another way FDA can approach expiration dating challenges is through FDA’s expiration dating extension authority under section 564A of the FD&C Act, which was established by PAHPRA in 2013. Before PAHPRA, the distribution, dispensing, or use of products with extended expiry, and any related labeling adjustments, were possible through an EUA or FDA enforcement discretion. PAHPRA provides FDA with the explicit authority to extend the expiration dating of eligible FDA-approved MCMs stockpiled for use in CBRN emergencies.

FDA regulations require drug applicants to provide stability testing data with a proposed expiration date and storage conditions when they submit an application for FDA approval of their drug. This testing is designed to provide confidence that the product will meet the applicable standards of strength, quality, and purity throughout its shelf-life. The FDA verifies that an applicant’s proposed expiration date is supported by appropriate studies that the applicant has conducted.

Table 1: Extended Expiry Dating for Bamlanivimab Authorized under EUA 94 (Bamlanivimab and Etesevimab Administered together)

Users of this information are advised that decisions regarding the use of drugs and drug therapies are complex medical decisions and that in using this information, each user must exercise his or her own independent professional judgment. Neither ASHP nor the University of Utah assumes any liability for persons administering or receiving drugs or other medical care in reliance upon this information, or otherwise in connection with this Bulletin. Neither ASHP nor the University of Utah endorses or recommends the use of any particular drug. Any application of this information for any purpose shall be limited to personal, non-commercial use.

FDA has worked with companies to support expiration date extensions for “critical” drugs on the FDA’s drug shortage list. The current list contains 343 entries Most products have had their expiration dates extended by one year from the labeled expiration date. Drug expiration dates reflect the time period during which the product is known to remain stable, which means it retains its strength, quality, and purity when it is stored according to its labeled storage conditions. In addition, FDA has received stakeholder inquiries about expiration dating extensions for certain lots of DuoDote product that they have received from MMT since 2015 (i.e., with a labeled expiration date of February 2019 or later) and are not included in the table below. The DuoDote expiration dating extensions FDA previously issued were in response to supply disruptions. Because DuoDote manufacturing has resumed, expiration dating extensions of lots with a labeled expiration date of February 2019 or later are not warranted at this time.

At the time the boy was arrested, Hankin was already behind bars, hundreds of miles away in HMP Portland, Dorset, after being convicted of drug supply offences and wounding. His phone was seized and analysed, and the results painted a harrowing picture of how the teenager had been trafficked across the country to line the pockets of grown men. At the top of the gang was 29-year-old Wesley Hankin, a career criminal from Wavertree with a raft of previous conviction for guns and drugs offences.