Allergy sufferers across the county have been left without vital medication – so what should you do if you're caught short?
Mylan, the US manufacturer of the life-saving adrenalin jab, has warned of months of global supply issues affecting UK pharmacies.
Supplies vary from pharmacy to pharmacy and prescriptions are being limited in a bid to curb shortages, it said.
Pfizer, the company that supplies the EpiPens, expects the supply issues to stabilise by December.
To manage the problem until supply is back to normal the Medicines and Healthcare products Regulatory Agency has granted Mylan UK permission to extend expiry dates on EpiPen 0.3mg auto-injectors.
That means you may be able to use your EpiPen for longer than it suggests on the product.
The shortage is a potentially life-threatening problem for the thousands of Brits who suffer allergies, Dr Sarah Jarvis, GP and clinical director of Patient.info, told The Sun.
Anaphylaxis is a deadly allergic reaction which causes the immune system to overact to an allergen.
It can cause the tongue and throat to swell up, blocking the airways.
The best-known and fastest way to relieve these symptoms is a jab of the hormone adrenaline from an EpiPen.
"It is potentially life-threatening," Dr Jarvis told The Sun.
"It is potentially very significant because EpiPens are only used for potentially life-threatening anaphylactic reactions.
"The problem we've got is that we use them for very good reason."
WHAT YOU SHOULD DO IF YOU DON'T HAVE AN EPIPEN
1. You can now use your EpiPen 0.3mg auto-injector up to four months after the expiry date. But you should still allow plenty of time to replace it. "The NHS has issued guidance that you can use your EpiPen up to four months out of date," Sarah said.
2. Be aware of your allergens and avoid any potential triggers. "It’s really important that people are aware of what their potential allergens are. If you’re worried about your EpiPen, speak to your pharmacist. If you’re worried about your allergies then speak to a GP or allergy clinic," she added.
3. Don't stockpile if you don't need to. If your EpiPen doesn't need replacing for months buying one from a pharmacy that has them in stock could be depriving someone else of it when they need it sooner.
4. There are other brands. Vext and Emerade are both alternatives to EpiPens – they use the same medication, it's just given differently. Speak to your GP about using them in place of EpiPens.
5. Ask your child's school to go nut-free. One of the biggest allergies in the UK is nuts, so asking your kids school, or your workplace, to go nut free can prevent allergic reactions.
6. Schools may have an EpiPen because they can buy them without prescription – if you are really stuck ask the school if there is one on site to protect your child.
7. Always carry antihistamines. Most allergic reactions can be treated, or lessened, with antihistamines. That's not the case for anaphylaxis though, that's a far more serious and life-threatening condition.
8. Never try to make your own EpiPen using adrenalin. Speak to your doctor about other ways to administer adrenaline – most of which will need to be done by a GP.
Mylan first warned pharmacists and patients in Britain of the problem in April.
Now, months on supply difficulties are still causing a shortage of EpiPens in some pharmacies.
The company said the problems had been caused by manufacturing delays at its supplier, Pfizer.
"Throughout 2018, there has been intermittent supply at wholesalers, distributors and pharmacies in the UK," a spokesman for Mylan said.
"We are actively exploring several options with Pfizer that would help stabilise supply and will continue to provide updates, including timing for resolution, as we receive them from Pfizer.
"We appreciate how important it is for individuals with life-threatening allergies to have access to epinephrine auto-injectors and understand the challenges this situation continues to pose for patients."
IS YOUR EPIPEN AFFECTED?
So far only two type of EpiPen are affected by the global supply shortage.
- EpiPen 0.3mg
- EpiPen Jr 0.15mg
If you use these EpiPens make sure they don't go out of date before you try to replace them, or you could get caught short.
Mylan said it was experiencing "persistent manufacturing delays" in the production of its EpiPen 0.3mg and its EpiPen Jr 0.15mg.
Pharmacies which prescribe the medication are limited to how many they hand out, to a maximum of two EpiPen 0.3mg or two EpiPen Jr 0.15mg per prescription.
But Mylan warned the EpiPens may not always be available for pharmacies to order.
Pfizer, the company that supplies the EpiPens, said it "cannot guarantee" the supply of the drug.
"We understand how important this potentially life-saving product is to patients, and are working tirelessly to increase production and expedite shipments as rapidly as possible," a spokeswoman said.
"Currently, supplies will vary from pharmacy to pharmacy, and we cannot guarantee that product will be available at all pharmacies.
"We are working closely with Mylan to meet their global supply needs during this tight supply situation."
What should you do if you have an EpiPen that needs replacing?
The most important thing is to be prepared.
Check the date on your EpiPen and if it's due to go out of date soon call your pharmacy to replace it now.
That way, even if your pharmacy is experiencing supply issues, you have plenty of time for one to be ordered in before yours goes out of date.
It's vital you don't get caught short as there is no guarantee an out of date EpiPen will provide the life-saving dose you need if you suffer an anaphylactic shock.
"People need to be aware that if they've got one they should check the date and be aware that we are experiencing supply issues," Dr Jarvis said.
"Call your pharmacy and check if they've got them in stock.
"They are probably OK after the expiry date but you cannot trust that, you should never use a drug that's out of date."
Amena Warner, head of clinical services at Allergy UK, added: "We are aware of the worry that this may cause to those whose allergies require having an adrenaline auto-injector as part of their allergy management plan.
"This is especially important at holiday time, for those travelling away from home who need prescriptions filled and we continue to ask the manufacturers for regular updates on the situation.
"Remember to check the expiry date on all of your AAI devices, and allow plenty of time for these to be replaced.
"The expiry date is the last day of the month in which the device expires. Contact your GP if you are unable to get your usual brand of prescribed adrenaline auto-injector supplied.
"If an alternative brand of AAI is prescribed, ensure that you know how to use it, as all devices have different instructions for use."
If your EpiPen is out of date and you can't get a new one, speak to your GP about other options.
You should never take the risk of waiting for a new EpiPen in case you suffer a reaction.
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