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New EpiPen junior validation process mandated following ‘critical’ shortages in UK

Pharmacists must implement new validation processes from today (17 October) to prioritise the limited stocks of EpiPen junior 150 microgram (mcg), the Department of Health and Social Care (DHSC) and NHS England have said.

Following ‘critical’ shortages of the device, the DHSC and NHS England asked pharmacists to validate both private and NHS prescriptions before ordering and supplying the device to a patient.

The DHSC recommended that patients access at least two auto-injectors but said that it is sufficient if just one of the devices has a remaining shelf life of a month – assuming the patient carries an expired device that is not discoloured and does not contain precipitate.

In addition, all expired auto injectors that are discoloured or contain a precipitate should now be discarded through the pharmacy, the DHSC said.

When should I dispense the device?

The chart below has been designed to help pharmacists verify whether a patient should be prioritised to get supplies of EpiPen junior 150mcg, Jext 150mcg or Emerade 150mcg adrenaline auto-injectors.

Further information that pharmacists will need can also be found here.

‘Critical supply issue’

NHS England said: ‘We have now reached a critical supply issue and need to implement controls on the supply of 150mcg adrenaline auto-injectors.

‘Children weighing 25kg or less with the greatest short-term need must have access to these first, ensuring that every patient has at least one in date 150mg adrenaline auto injector. This can only be achieved by restricting issue of new devices until further notice.’

On Monday (15 October), NHS England issued a letter with the following recommendations:

  • Children should avoid known allergens.
  • If a severe allergic or anaphylactic reaction occur, adrenaline pen should be given straight away and 999 called.
  • An out-of-date pen can still be used, unless it contains a precipitate or is discoulored.
  • Alternative pens such as Jext or Emerald can be used.
  • Children weighing more than 25kg (four stone) should be prescribed a 300mcg adrenaline pen. However, it is acceptable to use a pen that is for children weighting over 30kg.

A version of this article first appeared on our sister publication The Pharmacist.

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