posted Aug. 1, 2018
On July 30, 2018, Pfizer and Health Canada issued statements warning pharmacies of a more severe shortage of EpiPen® 0.3mg/0.3 mL product throughout the month of August. EpiPens have been in short supply for some time now and many pharmacies were already dispensing cautiously. Limits in PharmaNet have restricted the number of EpiPens per dispense (covered by PharmaCare) to 2 per fill, since April 2018.
With the increasing severity of the shortage, pharmacists may choose to provide pre-drawn syringes of epinephrine at the appropriate dose for adult patients. Pre-drawn syringes of epinephrine are stable for up to 3 months when kept at room temperature and when protected from light.
As the EpiPen shortage is widespread and severe, it is unlikely that pharmacists will be able to consistently communicate this alternate epinephrine product selection to prescribers. Prescribers should therefore be aware of the possibility that adult patients may be dispensed a pre-drawn syringe, and discuss this possibility with their patients when writing a prescription for epinephrine. Pharmacies will be directed to generally reserve the EpiPen Jr. product for pediatric patients.
If, in a prescriber’s clinical judgement, a patient does not have the capacity to safely administer a pre-drawn syringe, then it may be in the prescriber and patient’s best interest for the prescriber to connect with a pharmacy to determine availability of an EpiPen device.