Tag: Epinephren

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At first, I was really UPSET because the pharmacy didn’t notify me that my prescription for Mylan’s Epi-Pen had been replaced by the Adrenaclick generic.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

 

FIELD TRIPS WITH FOOD ALLERGIES

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My boys have now been back in school this fall for about 4 weeks and today is their first field trip to the high school football field for a Homecoming Pep Rally.  Looking back a few years when my oldest son was in kindergarten, I remember feeling quite a bit of anxiety leading up to his school field trips.  Its silly to think about the stress these school functions caused me but I’m sure most parents of kids with food allergies can relate in one way or another to my elevated anxiety levels on the subject. Even though I chaperoned almost all of the field trips,  I think most of my stress came from thoughts about my son riding on the bus and the potential of food that had been left on the bus prior to him riding it, and/or allergen oils on the bus seats.  Additionally, the is an added element of stress knowing that your child may not be as close to he hospital in case there is an allergic reaction.

In preparing my children for today’s school outing I referenced a very helpful checklist provided by FARE at www.foodallergy.org.  I have included this helpful checklist in the “Food Allergy Folder” I prepare for each of my children’s teachers at the beginning of each school year.  It’s a wonderful reference guide and I hope you will find it helpful to ease your mind while your children are safe and enjoying their school field trips.  ~Erika

Field Trip Tips

For Parents

  • Keep yourself up-to-date on upcoming special events in your child’s school. The more time you have to plan ahead, the better.
  • Remember that you and your child’s teacher need to work together as a team to keep your child safe.
  • Role-play with your child and practice what your child should do if a reaction is occurring.
  • Often times children are reluctant to mention that they’re having symptoms of an allergic reaction for fear of creating a scene. Teach your child to be persistent. In the event of a reaction, rapid treatment is essential.
  • After the event, briefly call or meet with your child’s teacher to discuss what went well and what, if anything, should be changed in the future. Be sure to give praise for a job well done; a thank-you note reinforces the idea of teamwork and builds a positive atmosphere.

For Educators

  • Update the food-allergic student’s Food Allergy Action Plan. Ask the parents to review the plan you have on file and note any updated information. Also ask parents to check the expiration dates on any medications.
  • Review the Food Allergy Action Plan with regard to the upcoming event. Find out where the nearest hospital is and discuss how a student would be transported there in case of an emergency.
  • Brief the staff and chaperones that will be supervising students during the event or trip. Identify the food-allergic student, discuss what foods must be avoided, explain the symptoms of an allergic reaction, and review the Food Allergy Action Plan. Designate a staff member to check the safety of any food served to that student.
  • The day of the event or trip, carry the food-allergic student’s medications wherever the student goes. In the case of a severe allergic reaction, known as “anaphylaxis,” speedy access to medications can be the difference between life and death. Keep all staff and chaperones informed about who will be carrying the student’s medications.
  • Carry a cell phone to place emergency calls, if necessary. Make certain all staff and chaperones know where the phone will be kept.
  • Take all complaints seriously. If a food-allergic student notifies the staff that he or she is not feeling well, compare the symptoms with those listed on that student’s Food Allergy Action Plan. If the student is having an allergic reaction, activate emergency procedures immediately. Remember, if epinephrine is administered, but not needed, the student may experience increased heart rate and nervousness. If epinephrine is needed, but not administered, the student may experience a severe or fatal allergic reaction.

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.