Category: Managing Medications Properly

Manage the expiration dates of epinephrine auto injectors, Benadryl, asthma meds, etc.

Update to my “Generic Epi-Pen Post”

A few weeks ago I posted a full article that compared the generic “Adrenaclick Auto Injector” to the Mylan Epi-Pen.  I mentioned that our insurance company automatically filled this generic auto injector in lieu of the mainstream Epi-Pen as of January 1st, 2017 when all of the insurance companies changed their RX coverage plans for the new year.  I discussed in quite length the pros and cons, and noted that I did not have any confidence in this product because I have not had to use it.

As a follow up here is what I have found:

  • It took 6 weeks for me to receive the several “Trainer” pens I ordered online from the website I discussed.  To my dismay, the trainer pen when pushed into the thigh, does not make a “click” sound and the spring in the device does not budge at all.  It didn’t make me feel like this was the reality of how this pen would actually work if I was using this in an emergency situation.
  • I realized the actual auto injectors when dispensed, will not retract the needle once you remove the injector from the thigh after the medicine is administered.  I think this is dangerous and how does one dispose of this?
  • Although I’m not pleased with either of the two points I mentioned above, this pen was still a $0 co-pay and although not easy to use, I’m sure it would work well if need be.

Again, these thoughts are 100% my opinion.  After all of my research and actually trying to practice using this generic Adrenaclick trainer product, we have decided not to let our boys carry these pens.  Additionally, we have not taken them to our son’s school either.  I just don’t feel confident with this product.    This is because it’s so vastly different from Mylan’s Epi-Pen and Auvi-Q, and my concern is that a caregiver of school employee may not know how to properly use this product in an emergency situation, when time is of the essence.

Last week was my boy’s annual food allergy appointment at the University of Michigan where they have been receiving amazing food allergy treatment for the last 6 years!  Our doctor wrote new scripts for each boy and stated on the script “Generic for Mylan 0.3mg Epi-Pen.”  I then filled these scripts at the pharmacy and the cost was only $35.00 for 2 two packs!  The generic Mylan Epi-Pen is actually the same auto injector but significantly less in price.  In addition, I have used Auvi-Q’s Patient Affordability Program to order the new injectors for each of my boys!  This is paid for 100% by Auvi-Q and is a home delivery prescription service.  I can’t say enough wonderful things about this program!  We have always be a HUGE fan of Auvi-Q and we’re thrilled they are back on the market!  As a mother of 2 boys, the Auvi-Q’s are small enough to fit in their pant or jacket pockets.

At the end of the day, every family needs to do what is best for them specifically.  Personally, I don’t feel comfortable carrying a life-saving device that I’m not 120% confident with which is to be used as the first line of defense during an allergic reaction.  I encourage everyone to do their own research and make an educated decision.  The bottom line is that it’s wonderful that we, as food allergy families, now have more choices when it comes to epinephrine.

Have a great weekend!

~Erika

 

Mylan Expands Voluntary Recall of More Epi-Pens & Epi-Pen Jr. in United States

Mylan Pharmaceuticals expanded its’ Epi-Pen Recall over the weekend to include the Epi-Pen Jr. and several more lot numbers below.  Many of us experienced a similar recall with the Auvi-Q Auto Injectors just over one year ago…this is all too familiar and extremely frustrating!  Please click here for the full article on Mylan’s website regarding the recall.

 

Generic vs. Milan’s Epi-Pen

A few days ago I picked up a refilled prescription for my oldest son of what I thought was going to be Mylan’s  Epi-Pen 0.3 mg twin auto injectors.  This is what we’ve been accustomed to using since the big recall happened with the Auvi-Q auto injectors fall of 2015.  Despite all of the controversy with Mylan, and the increase in pricing for the Epi-Pens, we have unfortunately had to stick to this prescription, as our insurance RX program never filled a generic option in the past.

To my surprise, when I arrived home and opened up the bag from the pharmacy, I receive 2 twin packs of the Authorized Generic form of the Adrenaclick, 4 auto injectors 0.3mg manufactured by Lineage Therapeutics.  This generic version was apparently introduced to the market back in June of 2013.  It boggles my mind why it was not available to me as an option until now???

At first, I was really UPSET because the pharmacy didn’t notify me that my prescription for Mylan’s Epi-Pen had been replaced by the Adrenaclick generic.  After a few minutes and once I cooled down, I realized it was exciting to finally see a “generic form of the life saving auto-injectors!”

My excitement quickly turned to ANGER again when I realized that the devices did not come with any type of training device!  What???  The box that contains the twin injectors has a spot for a trainer, but NO trainer was included in the box!  I was LIVED to say the least!

I quickly went to my laptop and typed in the manufacturer’s website which is http://www.epinephrineautoinject.com/contact_lineage.php.  The site contains a link which allows you to order ONLY 1 training pen at a time!  There is a 1-800 number you can call to order more than one training pen at a time.  Of course, I called it right away thinking about all of the people in our lives that we would need to train how to use these generic auto injectors- school staff, coaches, kid sitters, our boys of course, myself and my husband, friends, grandparents, aunts and uncles, etc…the list goes on and on.

After being on hold for approximately 5 minutes, a nice customer service lady answered my call, and when I told her that I would need to order at least 4-5 trainers, she mentioned they were backordered by 4-6 weeks!  She suggested I go to the website and individually order 1 trainer at a time.  This is what I did…I ordered 2 in my parents names, 1 in my name and 1 in my husband’s name, 1 in my sister’s name, and 1 in my brother-in-law’s name…WHAT A PAIN IN THE BUTT!  Needless to say, we’ll see when these trainers actually arrive!

So, all in all, it’s absolutely wonderful that my insurance RX program finally gave me a generic option!  It appears that consumers dealing with anaphylaxis do have more prescription options available now. Here are the PROS & CONS broken down for you:

PROS:

  • Price- my out of pocket expense for 1 pack of twin injectors was approximately $15.00 compared to hundreds for Mylan’s Epi-Pens
  • Size- generic packaging of auto-injector is approximately a 60% reduction in size compared to Mylan’s Epi-Pen.  Since we have 2 boys and they do not carry a purse, it will be easier for them to carry these in their pockets

CONS:

  • Trainers do not come with auto-injector prescription
  • Trainers must be ordered separately on manufacturer’s website
  • Only 1 trainer can be ordered online at a time, for more you must call customer service hotline
  • If you want more than 1 trainer, these orders are on back order for 4-6 weeks!  Unacceptable!
  • It took the pharmacy over 5 business days to fill the script…I’m assuming because Meijer does not keep this generic version on their shelves.  This was frustrating and thank god I had extras and didn’t need it immediately!
  • Trust- I don’t trust the generic as I have not had to use it yet
  • Quality- I do not know the quality of the generic
  • Learning Curve – it is cumbersome to re-train everyone in our life with new auto-injectors- cannot train them until trainers arrive
  • I have 4 new generic auto-injectors that cannot be used since we do not have the trainers…our boys will need to practice on trainers 1st before we feel comfortable with them carrying these devices

While there are currently more CONS than PROS at this juncture, I’m confident once we have an opportunity to familiarize ourselves with this generic, the PROS will begin to outweigh the CONS.

If you have any experience using these Lineage Generic devices I would love to hear your feedback!  Please contact me or leave feedback in the “comments” section of my post.

Once the trainers arrive in the mail I will update this post with feedback regarding re-training everyone/ease of use.

~Erika

 

Epi-Pen Scripts All Finally Refilled After Recall Debacle

As I have posted a few times within the last week since the Auvi-Q recall, it has been a week of STRESS trying to fulfill refills to replace the total of 9 Auvi-Q two packs for my boys that were recalled.  After countless hours on the phone with doctors, pharmacies, insurance companies, pharmaceutical manufacturers and multiple visits to many different pharmacies, I’m happy to report I just picked up the last script of Epi-Pen Juniors at Meijer pharmacy for my boys. 

That said, I have to mention a HUGE shout out to the AMAZING customer service I received from the pharmacy staff at the Petoskey Meijer! They were compassionate, understanding and determined to get our insurance company to fill the multiple refills this week! I sincerely thank you all!  Oh and thank you to the wonderful customer service at Mylan Pharmaceuticals who manufacturers the Epi-Pen Junior.

We are now safely armed at school, home and on my person  with the appropriate number of Epi-Pens my husband and I feel is necessary to be safe at all times with our food allergic boys. This includes 4 auto injectors at home, 4 on my person at all times, 2 per son’s school classroom, 2 per child in the school office medical cabinet and 2 posted in the school cafeteria….Phew!  Now I’m completely relieved!

Just thought I would share this update as many have been following and praying for us during this difficult journey over the last 7 days. Thank you for your kind thoughts and prayers. It is a good feeling to know we now have safe medicine in case we face an accidental food exposure.  Time to relax a bit!

~Erika

Auvi- Q Epinephrine Auto-Injector Recall

auvi a

This recall couldn’t have come at a worse time with Halloween less than 2 days away!  We switched over to the Auvi-Q Epinephrine 0.15 mg auto injectors over two years ago for my boys because of their ease of use.  They are also smaller and easier for my sons to fit in their coat or jacket pockets.  Plus, they even talk to you so it makes it easier for teachers and caregivers to know how to properly use the device in an emergency situation. We love our Auvi-Q’s!

Thankfully, one of my friends who also has children with food allergies, sent me a text this morning notifying me of the massive recall.  Sanofi states on their website below that the recall includes lot number 2299596 through 3037230, which expire March 2016 through December 2016. 

I just left my boy’s school and sure enough I had to pull a total of 2 two packs that had been expired.  In addition to that I had 3 more recalled 2 packs in our kitchen and my purse where I always carry 4 auto-injectors.  Thankfully, I had enough Auvi-Q’s that were not recalled to replace at school.  As I was walking out of my children’s school building holding the ziplock bag that contained the 6 two packs that I pulled from the school I ran into one of my best friends.  She asked what was going on and I quickly explained what had happened, then started to burst into tears!  My anxiety level is about at an all time high today trying to figure out how to replace all of these injectors in a hurry so I have some on hand when I pick my boys up from school.  Ugh…the stresses people with food allergies face daily.

Since I do not have any on my person right now and I’m anxiously awaiting my son’s pediatrician to call in new scripts for the Epi-Pen Junior 2 packs.  This is my recommendation to everyone who may be in the same boat as myelf right now.  In the interim, until Sanofi figures out how they are going to replace/reimburse us for the thousands of dollars of recalled Auvi-Q’s, we can have our child’s doctor call in new scripts for the Epi-Pen Junior packs.

Also this is what the Auvi-Q site states, “Due to high volume of calls being received on the Auvi‑Q customer service phone line, callers may periodically receive a message that the line is down. We appreciate your patience and please call back.”  I recommend not calling them like I did and being placed on hold for a decade.

Please click on the link below for more detailed information from Sanofi…hopefully my day will get better once I’m armed with new Epi-pens.

https://www.auvi-q.com/

Epi-Pen Injection Given to Our Son on Vacation and Thankfully It Turned Out Positively!

I apologize for not posting over the last several weeks.  My computer crashed and my new laptop is finally up and running.  My husband, two boys and myself were on vacation in Florida with family two weeks ago for spring break.  Two days before our last day of vacation the boys and I were in the grocery store reviewing the boxes of the many different flavors of Pop Tarts.  There are a few flavors of Pop Tarts that have been safe in the past for my boys multiple food allergies which are: Brown Sugar Cinnamon, Strawberry, Cherry, and I believe Blueberry.  My boys were excited to try a new flavor and since we were on vacation I was a bit more laid back with them eating a healthy breakfast in the morning.  My youngest handed me a box of Pop Tarts and I read the ingredients and noticed that they contained “milk, eggs, and wheat.”  I then told him the allergens that were in the box and to look for a different “New” flavor.  My oldest then handed me the Cinnamon Swirl box and after reading through the ingredients about 3 times slowly I told him we were safe and they only contained “Wheat” which is not an allergen for my boys.  After that my youngest son chose his box of Pop Tarts, and looking back in hindsight, I believed it was a flavor we had purchased before and I failed to “re-read” the box which was unusual for me but the boys were getting hyper and we needed to get to the check out aisle and complete our shopping trip.

Moving forward, very early the next morning my husband and I were still in bed and both of our boys were on their Ipads just outside of our bedroom on the sofa lounger.  They each knew where the kitchen cupboard was that contained all of their “safe” foods and namely their new and exciting Pop Tart flavors.  We told them they could each grab a Pop Tart.  A few minutes later our youngest son told us his tummy hurt after only eating one third of the Pop Tart.  It was at that moment my husband ran into the kitchen, grabbed the S’Mores Pop Tart box and re-read the label to then shockingly discover they contained not only one but two MAJOR allergens of our boys- “Milk and Eggs!”  I was completely dismayed and shocked this box made it into the grocery cart without me even noticing it!  I had known from past label reading that the S’Mores Pop Tarts contained the lethal allergens for my boys.  Then, our youngest son yelled “Mom! Dad!”  We both rushed upstairs and he had vomited all over the couch and was feeling very lethargic.  At that point we knew something serious was about to ensue and we both kept our calm and comforted our son.  We gave him 2 Benadryl children’s chewable tablets and I grabbed our Emergency Action Plan to review.  I had read it a thousand times before but this time I read it very slowly as if in slow motion paying attention to every single detail.

A few minutes later our little guy ran to the bathroom and had violent diarrhea.  At that point we knew we were headed to the ER because our little guy was not only anaphylactic but an asthmatic which adds another element of fear to this whole process.  About a year earlier he accidentally ingested a Tara chip with milk in it and he described words that made us think his throat was starting to close up.  That said, we knew the Auvi-Q injection was going to be needed.

We loaded into the car and I drove our youngest to the ER which was about 4 miles away in South Naples thankfully.  My husband stayed back with our oldest son.   On the way to the hospital I kept talking and reassuring my little 5 year old that everything was going to be okay.  In the heat of the moment I was surprised that I was able to keep my composure and do what was necessary- get us to the hospital safely.  I kept telling my son that he was such a brave big boy and I would have to give him the Epi-Pen injection when we parked the car.  I reassured him that he didn’t cry this year when he got his flu shot and he Epi-Pen would feel about the same.

I parked the car in the lot adjacent to the ER entrance doors and quickly got out of the driver’s side door.   I walked around to my son’s door, opened the door and told him it was time for the Epi-Pen (Auvi-Q).  I pulled the injector out of it’s housing sleeve like I had done a thousand times before with the trainer and then told my son to squeeze my hand really hard while I injected the Auvi-Q into his right quadricep.  Then we listened to to injector count down from 10 to 1 and then it said “Injection complete.”

I then whisked my brave son up into my arms as I ran into the Emergency Room.  My son then said, “Mom that didn’t even hurt.”   I held back the tears trying to wear my brave hat as well.  Thankfully the waiting room wasn’t very busy and we were admitted back into the initial screening room right away where they took my son’s blood pressure, listened to his breathing and took his weight.  I calmly reiterated to the nurse what had happened and that I was fearful that his breathing may continue to decline like it had during the previous allergic food reaction a year ago.

Long story short, when the ER doc finally came back to take our son’s vitals he reassured me that I did the right thing by giving him the Epi-Pen.  He said that “it was the right move given our son’s past food reaction, asthma and being on vacation in an unfamiliar town.”  The doctor said that he thankfully was NOT going into anaphylactic shock.  Due to new standards across the country for ER patients admitted after being injected with Epinephrine, they would have to monitor him for 6 hours post-shot.  This is because in the past patients have been released too prematurely and have had more serious allergic reactions landing them back in the Emergency Room.

Our son received a pretty large liquid dose of children’s prednisone to continue to help his body fight off the reaction and we began counting down the hours in the ER.

It was a LONG and stressful day in the ER but bottom line is that we took the necessary precautions to get our son to the ER to receive further treatment.

I beat myself up for days post-reaction thinking what I could have done differently to avoid such an allergic reaction?  I kept asking myself, “If I can make a mistake like this and I re-read all labels multiple times and I’m extremely precautious and diligent then it can happen to anyone.”  I finally came to terms with the fact that this was a freak accident and that accidents will happen with our children in the future with regards to allergen exposure.  I kept reassuring myself that both my husband and I acted quickly in the heat of the moment and followed our son’s emergency action plan which I believe ultimately kept the reaction from worsening which could have resulted in a lethal ending.

This was a very emotional situation for both of our sons, my husband and myself.  The lesson learned here is that we can move forth with positivity knowing that we have all trained ourselves how to act promptly during an emergency allergen exposure situation.  Please ALWAYS carry your Epi-Pen auto injectors.

Know the Difference: Epinephrine vs. Antihistamines

The Emergency Action Plan put in place for my boys by University of Michigan actually changed a bit 1 year ago to reflect this verbiage, “Any SEVERE SYMPTOMS after suspected or known injection”…”INJECT EPINEPHRINE IMMEDIATELY.” This was something new from past years in which we were always trained to administer a dosage of Benadryl 1st and if symptoms worsen THEN inject the Epi-Pen. This is very important to note to school staff and child care givers as well as all family members. I highlight it with a yellow marker on every Emergency Action Plan.. Food for Thought.