Ampoules of epinephrine an approved replacement for EpiPens
This spring and summer, Canadian pharmacists have been managing the ongoing shortage of EpiPen auto-injectors used by patients and caregivers to administer epinephrine during an anaphylactic shock.
In late July, after hearing about the impending shortage of adult EpiPens through the month of August, the BC Pharmacy Association reached out to the College of Pharmacists of BC about how community pharmacists could help manage the shortage of EpiPen adult auto-injectors.
“We knew our members were facing patients’ concerns, so we worked to find out how pharmacists could manage supply in B.C. and use their scope,” says Linda Gutenberg, BCPhA’s Deputy CEO and Director of Pharmacy Practice Support.
The College confirmed that pharmacists could change new and existing prescriptions of EpiPens to ampoules of epinephrine that could be injected through a needle. EpiPens are Schedule II drugs, which do not require a prescription, while epinephrine is a Schedule I medication, which does.
“Most patients have a prescription for EpiPens because a doctor has required it,” Gutenberg says. For individuals without prescriptions, they’ll need to see a physician to obtain a prescription.
Pharmacists changing a prescription from an EpiPen format to the ampoule formulation can do so under product selection. Therefore, this does not qualify to be billed as an adaptation. Currently, pharmacists can dispense the 1 ml ampoule with appropriate counselling of the patient or caregiver on how to draw up the correct dose of 0.3 ml of epinephrine.
Pharmacists changing prescriptions due to the EpiPen shortage will need to also provide patients with counselling on how to use the ampoule and draw the correct dosage. Pharmacists are encouraged to provide patients or caregivers with retractable or safety needles. As with all sharps, pharmacists should also provide a sharps disposal container.
Gutenberg was interviewed by The Vancouver Sun, CBC Radio and appeared on CBC’s The National to talk about ways that B.C. community pharmacists could help during the shortage.