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Title: Twinject discontinued: new Auvi-Q injector in production
Post by: twinturbo on September 27, 2012, 03:36:04 PM
When I tried to refill my Twinject today the pharmacist informed me that it's been discontinued. I confirmed it at Twinject's website. Shionogi sold to another company, the purchasing company decided to discontinue manufacture of that injector. I am hoping they at least license the design to a reputable manufacturer to continue that design's availability on the market! For me I have to carry so many for the kids it's not only a space saver but makes for a huge difference during a stressful moment to differentiate my injector from the kids' EpiPen, Jr.

What would make me furious is if this acquisition was a cutthroat move to monopolize market share for the remaining product. I am now forced to get an EpiPen brand or Greenstone generic, assuming that is still in production.
Title: Re: Twinject and Adrenaclick DISCONTINUED
Post by: Janelle205 on September 27, 2012, 04:12:37 PM
For me I have to carry so many for the kids it's not only a space saver but makes for a huge difference during a stressful moment to differentiate my injector from the kids' EpiPen, Jr.

This doesn't help the space issue any, but when I was at summer camp I differentiated the ones that I kept in the health center by wrapping the outside tube for mine in obnoxiously patterned duct tape - I wanted to make sure that I got mine in an emergency - I don't know how any of the kid's parents store their meds, and one of the allergic staff (who thankfully has never had a severe reaction) had an old-style epi, so you know that person hadn't refilled theirs in FOREVER.
Title: Re: Twinject and Adrenaclick DISCONTINUED
Post by: SilverLining on September 27, 2012, 05:56:00 PM
twinjects site doesn't say it's discontinued.  At the bottom it says "Amedra Pharmaceuticals".  When I checked that website, it lists adrenaclick as one of their products.  Couldn't find anything at all about twinject.

As for differentiating between YOUR epi and the jr epi....they are different colours.
Title: Re: Twinject and Adrenaclick DISCONTINUED
Post by: twinturbo on September 27, 2012, 06:05:52 PM
Front page green box to the right on Twinject's site.

Quote
Notice About Continued Availability Of This Website For Twinject Training And Instructional Purpose

This website and its various pages and downloads originally were created by the company that previously marketed Twinject (Shionogi Inc. of Florham Park, NJ). Shionogi transferred ownership of this website to CorePharma, LLC in April 2012. Concurrently, Shionogi announced that it was discontinuing Twinject effective March 30, 2012 and no new orders would be accepted.
In acquiring ownership of this website, CorePharma, LLC, did not acquire Twinject inventory or supplies, and CorePharma has no plans to reintroduce the product at this time. Any remaining inventory of Twinject (previously dispensed to patients, in pharmacies, or in the supply chain) are Shionogi product that Shionogi marketed and distributed prior to Shionogi's discontinuation of Twinject, and any follow-up about that product should be directed to Amedra.


Because CorePharma recognizes the important educational function of this website in training Twinject users and providing instructions on the proper use of Twinject, CorePharma intends to maintain this website to enable continued availability of the training and instructional materials that Shionogi originally provided through this website.

From Adrenaclick

Quote
Notice About Continued Availability Of This Website

For Adrenaclick Training And Instructional Purpose

This website and its various pages and downloads originally were created by the company that previously marketed Adrenaclick (Shionogi Inc. of Florham Park, NJ). Shionogi transferred ownership of this website to CorePharma, LLC in April 2012. Concurrently, Shionogi announced that it was discontinuing Adrenaclick effective March 30, 2012 and no new orders would be accepted.

In acquiring ownership of this website, CorePharma, LLC, did not acquire Adrenaclick inventory or supplies, and CorePharma has not yet reintroduced the product. Any remaining inventory of Adrenaclick (previously dispensed to patients, in pharmacies, or in the supply chain) are Shionogi product that Shionogi marketed and distributed prior to Shionogi's discontinuation of Adrenaclick, and any follow-up about that product should be directed to Amedra Pharmaceuticals, whose contact information is provided on this website.

Because CorePharma recognizes the important educational function of this website in training Adrenaclick users and providing instructions on the proper use of Adrenaclick, CorePharma intends to maintain this website to enable continued availability of the training and instructional materials that Shionogi originally provided through this website.

I called 3 unrelated pharmacies to get my Twinject filled. They have none. CVS told me flat out it was discontinued. A good question at this point is Canada affected differently from USA? And if so, who is manufacturing it?

ETA: I've emailed Twinject Canada to see if the corporate announcement on the US website affects their supply as well. And if anyone can find any at their pharmacies please let me know!! My local privately owned pharmacy is willing to help me get one elsewhere.
Title: Re: Twinject and Adrenaclick DISCONTINUED
Post by: SilverLining on September 27, 2012, 06:44:16 PM
When I tried to click on links within the twinject site I get errors.  I assumed it's blocked to Canada.  (Many US sites do that.)

twinject.ca still looks the same as it used to be.  I don't see any information about who manufactures it.  But, I'm sure it was being manufactured in the US.

Title: Re: Twinject and Adrenaclick DISCONTINUED
Post by: GoingNuts on September 28, 2012, 07:15:24 AM
I am not at all surprised.

Many people, myself included, are willing to pay extra for the Epipen, because it is what people are most familiar with.  In an emergency away from home, I don't want to worry about school or emergency personnel not being familiar with an epi delivery system; I want the one that everyone knows how to use.

Now the new sound activated one?  That might be worth switching to from my perspective.  As my DS is rarely with me anymore, I want to be sure that if he needs his epi it is in the most foolproof apparatus possible!
Title: Re: Twinject and Adrenaclick DISCONTINUED
Post by: Mfamom on September 28, 2012, 10:02:55 AM
I switched to the TwinJect a few years ago when epi pen redesigned
I did it mostly because the new epi pen was so bulky and didn't fit in the epi belt that I spent well over $100 on. 
I was pretty peeved that dey just rolled out this new device with no warning, no input from allergy community and with no care on how to improve their product besides making it flat so it can't roll away.
I am definitely going to give the auvi one a try when its released.
I don't see why so many people find the twin ject confusing. 
Title: Re: Twinject and Adrenaclick DISCONTINUED
Post by: CMdeux on September 28, 2012, 11:25:42 AM
Me, either, Mfamom.  Personally, I also LOVE the second dose, because we try to carry so many doses with us for particular situations.  (Air travel, remote areas during car travel-- basically anywhere that is going to put us an hour or more from emergency medical care, we carry multiple doses.)

I was really hoping that DD and I would be able to carry 8-12 doses with us to Europe this spring.  I guess not.   Er-- well, I guess that part we really don't have a LOT of choice about, actually... but it will certainly limit what ELSE we can carry on an airplane... including food.

   :-[
Title: Auvi-Q in production now!
Post by: twinturbo on September 28, 2012, 12:00:24 PM
No word from Twinject Canada yet. I'm going to ask at the national chain pharmacies to scour for any Twinjects left on the market. Will definitely post here if I find a small storage, heck, if they're still some supply in Canada I'll put it here.

In the meantime Auvi-Q looks as if it's about to hit the market. I know the agreement Sanofi signed off on with Pfizer and Mylan was no release until November 15, 2012 but that date is coming up soon. Auvi-Q has a nice professional looking website put up with pictures, prescribing information, demo video and a sign-up for release available. I signed up it's so dang hard to carry six EpiPens plus liquid antihistamine plus syringes and keep it all temperature steady throughout the Northeast winter. Unless I start wearing a bandolier the best I can do is 4 mixed lot EpiPens for the kids and one for myself since I'm the lowest risk. And no, I can't do fast melts for the kids it has to be liquid and the spoons underdose DS2. DS2 also can't self carry all the time reliably.

Auvi-Q

(https://www.auvi-q.com/images/auviQ-eai-device.png)

From Sanofi's press release on Auvi-Q the important stuff

Quote
Clinical Study Background

A bioequivalence clinical study was conducted using Auvi-Q (epinephrine injection, USP) and EpiPenŽ. Both auto-injectors delivered 0.3mg of epinephrine. Injections with epinephrine using Auvi-Q were well-tolerated and resulted in epinephrine plasma concentration levels that were found to be bioequivalent to EpiPenŽ.


adding link to Sanofi page with video on production you can actually see the injectors being made (it's the second video)

http://www.multivu.com/mnr/57459-sanofi-receives-fda-approval-for-auvi-q-epinephrine-auto-injector
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: GoingNuts on September 28, 2012, 04:06:27 PM
It's not that I find Twinject itself confusing, it's just that I don't want a school nurse to have to think too much.  They Re very familiar with the epipen design already, so that's what I want them to have available.  I want it to be as close to automatic as possible.

Just curious, are all defibrillators the same, or do they have different designs? 
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: candyguru on September 28, 2012, 07:39:47 PM

In Canada, twinject is manufactured by Paladin Labs
http://www.paladin-labs.com/our_products/ourproducts.html

In the USA, it appears twinject was manufactured by Shioogi Pharma
http://www.twinject.com/allergy-treatment-resources/notice-about-continued-availability.html


So perhaps the twinject is still available in Canada since it is manufactured by a different company than in the USA?
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: Macabre on September 28, 2012, 09:13:08 PM
It's not that I find Twinject itself confusing, it's just that I don't want a school nurse to have to think too much.  They Re very familiar with the epipen design already, so that's what I want them to have available.  I want it to be as close to automatic as possible.

Just curious, are all defibrillators the same, or do they have different designs? 

Exactly GN. We haven't used the twinject, but if we did, I'd still have regular epis for school and anyone but our family.  Just like when we move the Auvi, we'll have one (or two?) for DS--maybe one for DH.  But I'll still carry regular epis in my purse, and we'll keep regular epis everywhere else. 

I am assuming this will make the most sense expense-wise, but also everyone is already trained with teh regular epi. 

I had a school nurse mess up during an anaphylactic reaction with a regular epipen--the new one, which has a bit of resistance to it.  No way would I give the twinject to her (this was in middle school). 

BUT--I am upset that twinject is being discontinued, because many families really count on this option. :/
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: Mfamom on September 29, 2012, 07:26:08 AM
The twinject works same except there is a cap on both ends.  They are numbered 1 and 2.
For dose 2, you unscrew the pen sort of like taking a retractable ball point pen apart and you manually plunge.   
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: YouKnowWho on September 29, 2012, 07:34:28 AM
The horrible thought rolling through my head?  What if Epi's are recalled (and we have heard of several cases here of misfiring, one even causing death)?  What do we do then if we have no back up?  What if the Auvi Q is not all that and a bag of chips?

I hate the cost of the meds but pay because we need it.  What happens if it's not available?
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: Mfamom on September 29, 2012, 08:04:54 AM
What do you mean causing death.  Death due to misfire?
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: YouKnowWho on September 29, 2012, 09:45:43 AM
Kennesaw State University - will find the article but the student only had one epi pen on hand, attempted to use it but it misfired and died as a result.  It's getting more coverage locally because it happened just a few miles from here so what I am reading in the media vs what I am seeing on the local board might be different.
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: YouKnowWho on September 29, 2012, 09:53:15 AM
http://allergy.hyperboards.com/action/view_topic/topic_id/20072

This is from the old board - his needle bent and he couldn't use it.

Had he had the slimmer Twin Ject he would have had two doses.  The new design of the Epi is for the birds and not feasible for guys frankly.  Especially since most packs are designed not to hold the double pack.  Others have noted that he was not afraid to use his epi pen.

I am not trying to put the fear in anyone's hearts but yes, it's stories like this that make me worry about when my boys get older.  We are putting all of our eggs in one basket with the Auvi Q...
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: twinturbo on September 29, 2012, 10:27:30 AM
Yeah, current EpiPens are not "dude" friendly even with all my guys embracing their manpurse sides. The Auvi-Q demo specifically features a young teen male straightforwardly following the voice directions as he uses a trainer on himself. As for Twinject I'm not giving up until Twinject Canada gets back to me. If they're still in production I bet my local pharmacist will figure out a way one might obtain it. My preferred everyday carry would be: 2 EpiPen, Jr. mixed lot + 1 ped. Twinject
+ 1 ped Auvi-Q + mom's Twinject.
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: SilverLining on September 30, 2012, 07:41:14 AM
[url]http://allergy.hyperboards.com/action/view_topic/topic_id/20072[/url]

This is from the old board - his needle bent and he couldn't use it.

Had he had the slimmer Twin Ject he would have had two doses.  The new design of the Epi is for the birds and not feasible for guys frankly.  Especially since most packs are designed not to hold the double pack.  Others have noted that he was not afraid to use his epi pen.

I am not trying to put the fear in anyone's hearts but yes, it's stories like this that make me worry about when my boys get older.  We are putting all of our eggs in one basket with the Auvi Q...


Both shots of the twinject use the same needle, so if it was bent, neither dose could have been used.

When we switched (temporarily) to twinject, I still purchased just as many as when I buy epi-pens.
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: SweetandSour on September 30, 2012, 08:44:23 AM
I love twinject,and was upset when my pharmacy couldn't get the refill about a month ago. I had to get epi pen. I hate it.Too bulky.
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: Jessica on September 30, 2012, 12:06:53 PM
If the Auvi-Q can be carried easily by men in a pocket, won't it get too warm from body heat? I had that concern with the epis in a waist belt during the warmer weather. But since my PA/TNA is a girl and can carry a purse, it hasn't been a big issue.
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: SilverLining on September 30, 2012, 01:39:39 PM
Jessica, I live in Canada.  I carry my epi-pen in my purse.  In winter, it gets cold in there.

I do what I can....but some extreme temperatures are going to happen.  I make sure in the car my purse does not have the heat blowing on it, but other than that....it gets hot and it gets cold.

(I do think you raised a valid concern.  I just think for me it goes beyond what I can do anything about.)
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: GoingNuts on September 30, 2012, 02:12:16 PM
DS keeps his epipen in his pocket.  I thought that would be too warm, but the Mt. Sinai gurus said it's OK.  Honestly, as boys get older, it's the only way they're going to carry them. ~)
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: Mfamom on September 30, 2012, 06:46:08 PM
yeah, was going to say same about the bent needle and I've also wondered about if the auvi will get too warm in a pocket.

Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: Macabre on September 30, 2012, 07:54:53 PM
DS keeps his epipen in his pocket.  I thought that would be too warm, but the Mt. Sinai gurus said it's OK.  Honestly, as boys get older, it's the only way they're going to carry them. ~)

Quoting for truth. That's where we got to be in the last year. It just is. I used to worry about this with the Auvi. I wrote the folks developing it about that.  But in the last year, it's stopped being a concern.

And if I remember right, the issue with heat above 82 is the mechanism, not the medicine. I could be wrong about this. 

DS will still carry Epis in his backpack.  We will still buy the stupid, bulky epis.

Last night for homecoming, he carried an epi in one dress pants pocket and one in his suit coat pocket. Two auvis would have had a lower profile.
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: CMdeux on October 01, 2012, 09:18:29 AM
HI temps ==> medication integrity (It's both heat and LIGHT labile)

LOW temps (and other environmental insults like salt water, repeated x-rays, etc) ==> mechanism.  But also the seals can fail (extremely high temperatures also come with this concern), which can also lead to degradation of epinephrine via oxidation.

Just for clarification, either thing is obviously not good.  But my impression is that as long as the device and mechanism have good integrity, fairly frequent excursions into higher-than-ideal temps (meaning 80-100F) aren't that big a deal.  VERY high temps obviously are.  EVERY low-temp excursion (meaning down to something near freezing or below) is a risk because of cracking in seals.
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: twinturbo on October 01, 2012, 10:47:05 AM
Think about it this way: the epinephrine you keep in your possession is probably the most safeguarded epinephrine there is. You know where it's been, how it's been treated, how far from expiration it is. Most life-dependent products are engineered with at least some degree of tolerance so we who are carrying as close to ideal probably have the best injectable epinephrine around. My personal line of concern would be an injector and content origin that's a total ???, or if mine has knowingly been exposed to sustained variance beyond tolerance. In any case better to have a well tended epinephrine injector on hand that has experienced some stresses tha none at all.
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: Ciel on October 03, 2012, 09:43:33 AM

Both shots of the twinject use the same needle, so if it was bent, neither dose could have been used.

When we switched (temporarily) to twinject, I still purchased just as many as when I buy epi-pens.

I learned this lesson after I used my twinject to treat a reaction. Afterward I bent the needle kind of out of habit. I had only used one dose and a few days later when I was feeling better I got the idea to practice with the second dose and an orange, since I had never practiced with the real deal second dose. I couldn't though, because I had bent the needle.
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: Ciel on October 03, 2012, 09:51:49 AM
I was actually coming here to post a similar topic, but I see it already exists.... which sort of crushes my hopes that the pharmacist I spoke to yesterday was wrong.

I switched to Twinject after the EpiPen redesign but was forced to switch back to EpiPen about a year ago because Twinject was on backorder. At the time I asked if they had an idea how long and was told "indefinitely". A year later they still haven't come in and I've had it on my to-do list for a while to follow up at the Pharmacy. I asked yesterday when I was there picking up some other prescriptions and was told by the pharmacist that it had been discontinued in Canada (and also elsewhere I now see). I haven't checked with the company directly yet, was just about to do that actually but came here first to see if it was being discussed..... I am terribly upset that it IS. I was very much hoping my pharmacist was mistaken.

I am not pleased with this news. I have been tolerating the new EpiPens because in my mind I have been telling myself that it is only temporary until I can get Twinjects again. Sigh. I hope the new device materializes soon. And I hope I like it, because I still really hate the new EpiPens.

I haven't really read much about it yet -- heading off to look at the link now. Thanks for posting!
Title: Re: Twinject discontinued: new Auvi-Q injector in production
Post by: base700 on September 12, 2013, 10:25:08 PM
Twinject is a great product, it has a huge hill to climb vs. epipen.  Epipen is a great product, it's the standard.  Twinject is the same medicine but there is a backup second dose built right in.  It is a product that works!