Jump to content

Twinject

Add links
From Wikipedia, the free encyclopedia

This is an old revision of this page, as edited by 98.218.179.239 (talk) at 01:39, 5 September 2009 (→‎Usage: made a correction (vile->vial)). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

Twinject is the registered trademark of the first epinephrine autoinjector that contains two doses. It is used in medicine as an emergency treatment for severe allergic reaction (anaphylaxis).

History and development

Twinject was originally designed and manufactured by Verus Pharmaceuticals in the United States. The Twinject was developed after some studies showed that more than one dose of epinephrine may be required in up to 35 percent of anaphylaxis cases to properly address the allergic reaction.[1] It is currently available in two models, the Twinject 0.3 mg, and the Twinject 0.15 mg, in both the United States and Canada.

United States

Twinject was released in the United States on August 16, 2005. It was the first, and currently only, two dose epinephrine autoinjector approved for use in the United States by the FDA. In the U.S. autoinjectors are a regulated medical device and require a prescription from a medical doctor. [2] The device is available in two strengths. In April 2007 Verus announced that changes were being made to the device, but the actual proposed modifications have not yet been made public.

Canada

On July 27, 2005, Verus announced that it had entered into an exclusive agreement with Paladin Labs to commercialize Twinject in Canada. Paladin released Twinject in Canada on September 22, 2005, after approval of Health Canada.[3] In Canada, Twinject is available in pharmacies. While it is available without a prescription, most patients choose to have it prescribed as it is usually covered by private and public medical insurance. In Canada, Twinject usually has a retail price between 95 CAD and 115 CAD[4].

On July 14, 2008, Health Canada issued an advisory [5] regarding the possibility of malfunctions with the Twinject 0.3 milligram auto-injector and the Twinject 0.15 milligram auto-injector. However, Health Canada's report has not resulted in a recall. Twinject remains available throughout Canada and the United States, and is deemed safe for use.[6]

Europe

On August 21, 2006, Verus announced that UCB, a European pharmaceutical company, will begin marketing and producing the Twinject for distribution in Europe. While the Twinject has yet to be sold outside Canada or the U.S., UCB has the option of commercialize the entire Twinject product line in all other territories beyond Europe (excluding the U.S. and Canada). [7] Most markets in Europe require a prescription for epinephrine autoinjectors.

Dosage

The Twinject is available in two doses:

  • In an anaphylactic emergency Adults weighing 30 kilograms (66 lb) or more require a dosage of 0.3 mg of 1:1000 epinephrine. The Twinject 0.3 mg includes more than three adult doses but claims to have only two adult doses. It contains 1.1 ml. In cases of emergency, one can access these "secret" doses with a syringe given IM. As well, for chronic suffers, many prefer manual IM injections rather than having an "auto-injector" used on them.
  • For children weighing 15 to 30 kilograms (33 to 66 lb), the standard dose is of 0.15 mg of 1:1000 epinephrine. The Twinject 0.15 mg contains two doses of 0.15 mg.
  • For children weighing less than 15 kilograms (33 lb) a dosage of 0.01 mg/kg of 1:1000 epinephrine is recommended. As the smallest dose available with the Twinject is 0.15 mg, for children weighing less than 15 kilograms other forms of injectable epinephrine may need to be considered. [8]

Usage

The Twinject is used to temporarily reverse the effects of a severe allergic reaction. Advanced medical care is required immediately after administering the epinephrine.

The Twinject contains a spring-loaded needle that shoots through a membrane in the tip and into the recipient's body to deliver the medication. A patient uses the device by removing the green protective cap around the needle end of the device, then remove the locking cap from the end of the device, then forming a fist around the unit, and jabbing it firmly into a thigh until the click of the spring-loaded needle activating is heard. The patient holds the device in place for 10 seconds as the epinephrine is delivered. Using the device intravenously or subcutaneously is highly discouraged.

After administering the device, patients are advised to seek immediate medical attention as epinephrine will temporarily relieve the symptoms of anaphylaxis but advanced medical care is required to permanently reverse the reaction. The second dose can be used after 10 minutes if the symptoms have not receded or if they begin to return before medical help has been reached.

To administer the second dose, the red, rounded tip is screwed off and exposing the vial and needle of epinephrine. Then, being careful with the exposed needle, the full syringe needs to be removed. Then a yellow (in the 0.3 mg dose autoinjector) or orange safety stopper (in the 0.15 mg dose autoinjector) needs to be taken off the plunger. Then the needle can be inserted into the thigh and the plunger can be pushed completely down. It is advised that the second dose be prepared immediately following the first dose in order for it to be ready to administer when required.[8]

Contraindications

There are no known contraindications to the use of epinephrine in a life-threatening allergic reaction. [8]

Storage

The Twinject usually has a shelf life of about 12 months or until the epinephrine (usually a clear liquid) begins to contain a precipitate, discolor (pinkish color, or more than only a slight yellow color). Once either of these occurs the Twinject should be immediately replaced. However, in the event of a life-threatening allergic reaction, even if the epinephrine has expired, the Twinject should be used.

The Twinject should be stored between 20 to 25 °C (68 to 77 °F). During excursions, epinephrine may be kept at a temperature of 15 to 30 °C (59 to 86 °F). It should not be allowed to freeze and should not be refrigerated. [4]

See also

References

  1. ^ Twinject Canada
  2. ^ Verus Pharmaceuticals Announces U.S. Launch of Twinject for Anaphylaxis
  3. ^ Verus Pharmaceuticals Announces Canadian Launch of Twinject for Anaphylaxis
  4. ^ a b http://twinject.ca/en/faqs.php
  5. ^ http://www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_2008/2008_109-eng.php
  6. ^ http://www.twinject.ca/news.php?lang=en&news_id=82
  7. ^ Verus Pharmaceuticals Announces Agreement with UCB for Commercialization of Twinject in Europe
  8. ^ a b c Package insert of Twinject 0.3mg
Retrieved from "https://en.wikipedia.org/w/index.php?title=Twinject&oldid=311938887"