Patients who depend on adrenaline auto-injectors for use in the event of an anaphylactic reaction are having a tough time as the devices continue to be in short supply around the world - and now there are reports that one of the three types of device available in the UK may not work as expected.
Following reports of problems with needle blockages with Emerade 150, 300 and 500 mcg pens earlier this year, now it has emerged that some Emerade devices have failed to activate, meaning that the injection of adrenaline is not administered.
Healthcare professionals have been urged to contact patients with Emerade auto-injectors to advise them that when the Emerade pen is used, it must be pressed very firmly against the thigh, and if it does not activate, to immediately use a second pen. If there is no improvement in the patient's condition, and an additional dose of adrenaline is needed, further attempts should be made to activate the failed device while waiting for emergency services to arrive. Any devices suspected of being defective should be kept for investigation.
Meanwhile, in an attempt to cope with shortages of EpiPen and Jext auto-injectors, the MHRA has authorised a 4 month extension beyond the labelled expiry date for devices with expiry dates between August and December 2019 for Jext 150 mcg and 300mcg, and September 2019 and December 2020 for EpiPen 0.3mg. (See https://www.gov.uk/drug-safety-update/adrenaline-auto-injectors-recent-action-taken-to-support-safety for further details).
Patients should continue to carry two in date auto-injector pens at all times. They can continue to use products with an extended use-by date until the end of the extension period, but need to order new devices when that period comes to an end. They should also check the viewing window of their device from time to time to ensure the liquid inside is clear and colourless - it should not be used if it is discoloured.
Before a patient is issued with an alternative device, the MHRA reminds clinicians that different brands of auto-injector are not used in the exact same way, and patients and carers should be provided with training and advice specific to the brand prescribed.
