What Everyone Ought To Know About the EpiPen Shortage

Adrenaline

On May 9th, 2018 the FDA declared a national shortage of epinephrine auto-injectors which are more commonly known to the general public as EpiPens. In this article, we will explore the factors involved in the EpiPen shortage, how epinephrine auto-injectors save lives, and some medical alternatives to the EpiPen.

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National EpiPen Shortage Announced by FDA in 2018

The FDA and American Society of Health System Pharmacists announced a national shortage of epinephrine auto-injectors on May 9th, 2018. According to Mylan Pharmaceuticals, these EpiPen shortages were caused by intermittent supply constraints due to manufacturing delays from their manufacturing partner, Meridian Medical Technologies, a Pfizer company.

The epinephrine auto-injectors affected by the shortage are: the EpiPen, Authorized Generic EpiPen, EpiPen Jr., and Authorized Generic EpiPen Jr. The brand of epinephrine auto-injectors available from Impax Laboratories, Generic Adrenaclick Adult and Generic Adrenaclick Child, are also affected by a shortage due to manufacturing practices.

What is Anaphylaxis?

Anaphylaxis is a potentially life-threatening medical condition triggered by a severe allergic reaction. Epinephrine is the first-line treatment for anaphylaxis. The symptoms include skin reactions, low blood pressure, swelling, nausea, vomiting, and dizziness. Conditions such as allergies and asthma increase a patient’s risk of anaphylaxis. With every reoccurrence of anaphylaxis, the patient flirts with death on an increasingly dangerous scale.

How the EpiPen Saves Lives

The EpiPen’s active ingredient is a synthetic hormone called epinephrine, also known as adrenaline. The EpiPen’s effectiveness lies in its ability to swiftly flood the body with the synthetic hormone which acts by narrowing blood vessels and expanding the airways to combat the symptoms of anaphylactic shock.

Interview with Click Pharmacy’s Head Pharmacist

I had the honor of conducting an interview with the head pharmacist at Click Pharmacy, Aqib Sheikh, concerning the benefits of their online pharmacy and how the EpiPen shortage has affected them in the UK.

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Kaitlin: What are the benefits of Click Pharmacy's free online medical consultation service and online pharmacy? 
 
Aqib Sheikh: You are able to obtain a prescription from a doctor for your medication at no extra cost which is used by the pharmacy to dispense and dispatch your medication. Under normal circumstances, you would not be able to buy certain medication from pharmacies without a doctor's prescription. However, when you fill out a medical questionnaire with our online pharmacy, the answers are reviewed by a professional who is qualified and authorized to issue a prescription. That prescription is used by the pharmacy to fulfill your order.
 
Kaitlin: In the future, would Click Pharmacy consider shipping outside the UK, for example to the U.S. and Canada?

Aqib Sheikh: We will consider shipping within Europe; we have not started yet as we are not sure at this stage how our regulators will regulate post brexit, regarding serving patients in Europe. Unfortunately, we do not have plans to ship to the U.S. or Canada as we are not regulated to do so.
 
Kaitlin: What do the regulations of the General Pharmaceutical Council consist of for Click Pharmacy? 
 
Aqib Sheikh: We have a distance selling license from the MHRA and GPHC to sell prescription only medicine. Further information can be found here and here.
 
Kaitlin: Why do you not currently accept existing prescriptions? 
 
Aqib Sheikh: We do accept current prescriptions, provided we have the authority to verify the validity of the prescription.
 
Kaitlin: How is the EpiPen shortage affecting Click Pharmacy? What are the alternatives? 
 
Aqib Sheikh: The shortage has affected us. Being a leading seller on the internet for EpiPen, we have been unable to fulfill all orders as at times our suppliers have been out of stock. Thus we have been unable to meed demand. As an alternative to EpiPen, Jext is a good alternative. Though patients prefer epipen due its brand identity, Jext fulfills the same purpose as the EpiPen.  
 
Kaitlin: Could you please give an illustration of the process a patient would go through during the free online medical consultation service that Click Pharmacy provides?
 
Aqib Sheikh: It can be found on our website here.

Common Allergies That Promote the Utilization of EpiPens

Common allergic reactions that promote the utilization of EpiPens in life-threatening emergencies include insect stings, drugs, and food allergies. These 8 foods trigger the majority of food-related allergic reactions according to Food Allergy Research and Education (FARE):

  • Milk
  • Eggs
  • Peanuts
  • Tree Nuts
  • Soy
  • Wheat
  • Shellfish
  • Sesame

Medical professionals recommend that patients wear medical alert bracelets to indicate their allergy to specific drugs and other allergens. Sometimes a food allergen comes disguised in an unexpected form. This was the case for Maximillian Alexander McGlinchey, a Penn State student who died on June 23rd, 2018 from cardiac arrest triggered by exposure to peanuts in Chinese food. A restaurant order of Beef Lo Mein, an eggroll, and diet coke resulted in the senseless death of a 19-year-old college student who “lit up a room” according to his sister, Chloe McGlinchey. Two EpiPen injections failed to save him, and perhaps the tragic circumstances of his death were escalated by his existing asthma condition and prior episodes of anaphylaxis as a child.

Alternatives to the EpiPen

Fortunately, in the face of this EpiPen shortage, there are alternatives available. Jext is one such alternative mentioned by Click Pharmacy’s head pharmacist, Aqib Sheikh, which is another adrenaline auto-injector for treating an emergency case of anaphylaxis. The epinephrine auto-injectors that are currently not affected by the national shortage in the U.S. include: Auvi-Q Adult (0.3 mg), Auvi-Q Child (0.15 mg), and Auvi-Q Infant (0.1 mg).

Can People Be Allergic to EpiPens?

The EpiPen is a life-saving device, but the public may not be aware that some people can in fact be allergic to the EpiPen itself. If anyone has a sulfite allergy, they should avoid EpiPens until they can get medical advice from their doctors. There are alternative treatments available.

Conclusion

In conclusion, the EpiPen shortage has affected many pharmacies across the United States, and there has been an international impact as a result. Fortunately, there are other medical alternatives available, and a variety of sources including online pharmacies like Click Pharmacy. If you have severe allergies that could result in anaphylaxis, talk to your doctor about finding the best medication. Don’t forget to have an emergency plan just in case!

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