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September 6, 2013 Volume 10, Issue 36
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Loyd V. Allen, Jr., Ph.d., R.Ph  Letter from the Editor

Editorial: Three Default Beyond-use Dates in United States Pharmacopeia Chapters <795> and <797>

This week we will review the default beyond-use dates (BUDs) in United States Pharmacopeia (USP) Chapters <795> and <797>. It should be noted that these default dates are used in the absence of stability information that is applicable to a specific drug and preparation.

The three sets of default BUDs to be briefly discussed include those for:

  1. Nonsterile preparations
  2. Sterile preparations that are not sterility tested
  3. Sterile preparations in a facility with a program of sterility testing in place

Nonsterile Preparations

Chapter <795> presents "maximum BUDs recommended for (1) nonsterile compounded drug preparations that are packaged in tight, light-resistant containers and stored at controlled room temperature, unless otherwise indicated." The section proceeds to describe in tabular form the BUD by Type of Formulation.

  • For Nonaqueous Formulations- The BUD is not later than the time remaining until the earliest expiration date of any API or 6 months, whichever is earlier.
  • For Water-Containing Oral Formulations-The BUD is not later than 14 days when stored at controlled cold temperatures.
  • For Water-Containing Topical/Dermal and Mucosal Liquid and Semisolid Formulations-The BUD is not later than 30 days.

Sterile Preparations that Are Not Sterility Tested

Chapter <797> states the following:

Low-Risk Level CSPs

For a low-risk level preparation, in the absence of passing a sterility test, the storage periods cannot exceed the following time periods: before administration, the CSPs are properly stored and are exposed for not more than 48 hours at controlled room temperature, for not more than 14 days at a cold temperature, and for 45 days in solid frozen state between -25� and -10�.

Medium-Risk Level CSPs

For a medium-risk preparation, in the absence of passing a sterility test, the storage periods cannot exceed the following time periods: before administration, the CSPs are properly stored and are exposed for not more than 30 hours at controlled room temperature, for not more than 9 days at a cold temperature and for 45 days in solid frozen state between -25� and -10�.

High-Risk Level CSPs

For a sterilized high-risk level preparation, in the absence of passing a sterility test, the storage periods cannot exceed the following time periods: before administration, the CSPs are properly stored and are exposed for not more than 24 hours at controlled room temperature, for not more than 3 days at a cold temperature, and for 45 days in solid frozen state between -25� and -10�.

[NOTE: Sterility tests for autoclaved CSPs are not required unless they are prepared in batches of more than 25 units.]

Sterile Preparations that Are Sterility Tested

In Chapter <797>, STORAGE AND BEYOND-USE DATING, Determining Beyond-Use Dates, we read:

BUDs for CSPs that lack justification from either appropriate literature sources or by direct testing evidence shall be assigned as described in Stability Criteria and Beyond-Use Dating under Pharmaceutical Compounding-Nonsterile Preparations <795>.

In Chapter <795>, STABILITY CRITERIA AND BEYOND-USE DATING, General Guidelines for Assigning Beyond-Use Dates, we read:

In the absence of stability information that is applicable to a specific drug and preparation, the following table presents maximum BUDs recommended for (1) nonsterile compounded drug preparations that are packaged in tight, light-resistant containers and stored at controlled room temperature, unless otherwise indicated; and for (2) sterile preparations for which a program of sterility testing is in place.

Note that the second set of preparations are sterile and involve a "program of sterility testing." If a program of sterility testing is in place and documented, then the BUDs provided in the <795> table can be used. Of those, the first two categories involve either nonaqueous formulations or water-containing oral formulations.

There has been confusion regarding this table and the use of the word "oral" that differentiates this category from the water-containing topical/dermal and mucosal liquid and semisolid formulations category. Practically, CSPs will generally be either nonaqueous or water-containing and the conservative BUD seems more appropriate.


Loyd V. Allen, Jr., PhD, RPh
Editor-in-Chief
International Journal of Pharmaceutical Compounding
Remington: The Science and Practice of Pharmacy Twenty-second edition

 
News

New Cap for Tylenol to Help Curb Overdoses
Caps of U.S. bottles of Tylenol will soon bear red warnings alerting users to the potentially fatal risks of taking too much of the drug. This results from a growing number of lawsuits and pressure from the government that could have widespread effects for a drug used by millions of people every day.

J&J says the warning will appear on the cap of new bottles of Extra Strength Tylenol starting in October and on most other Tylenol bottles in coming months. Overdoses of the drug send 55,000 to 80,000 people to the emergency room each year and kill at least 500 according to CDC and the FDA.
http://www.businessweek.com/ap/2013-08-29/j-and-j-tries-new-cap-to-curb-fatal-tylenol-overdoses

Cubicin Recalled Due to Glass Particles
Four lots of intravenous daptomycin (Cubicin) have been recalled because of glass particles found in some vials. No injuries have been reported the FDA said. Affected lot numbers include 950453F, 090203F, 201703F, and 201653F, with expiration dates ranging from December 6, 2013, to September 1, 2015; the lots were shipped from May 2011 to March of this year. It appears that the contamination originated with a third-party supplier.
http://www.medpagetoday.com/HospitalBasedMedicine/GeneralHospitalPractice/41283

Police Reveal More Details About GSK China's Suspected Violations
GlaxoSmithKline (GSK) higher-ups are suspected in economic violations by GSK China. The British drug giant has been under investigation since early July for suspected bribery and tax-related violations, which have pushed up drug prices.

Each GSK "team" involved with large customers has almost 10 million yuan (1.634 million U.S. dollars) of "public relations funds." The parent company assigned annual growth goals as high as 25 percent in recent years, 7 to 8 percentage points more than the average growth rate of the industry, and employed a salary policy closely linked to sales volume. If a salesperson failed to reach their goal, they could lose several thousand yuan every month.

Company policy states that every employee should abide by the country's laws and prohibits any cash transfers to doctors or government officials; however, salespeople appear to have achieved targets by breaking those rules. The investigation found that GSK China went through the motions in internal auditing so as not to discover these violations. Also, the police revealed details of suspected bribe taking by some GSK China executives.
http://english.peopledaily.com.cn/90778/8387417.html

 
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...that all 17 years of the International Journal of Pharmaceutical Compounding are now on MEDLINE?

 
Tip of the Week

Go to http://www.ncbi.nlm.nih.gov/pubmed and check it out!

 
Book Review

Motivational Interviewing For Health Care Professionals
Berger BA, Villaume WA
APhA; 2013; Paperback; 240 pages; 6" � 9"; $35.00

The authors have put together a very interesting book on a new way of teaching motivational interviewing (MI). MI can improve adherence to treatment plans, outcomes, patient satisfaction, retention rates, and promote health behavior change. The eleven chapters systematically approach the topic with background information and practical examples of role playing between a healthcare provider and a patient. This book is enjoyable to read and is highly recommended.

Note: This title and dozens of other compounding related items are available from CompoundingToday.com's online compounding bookstore

 
Looking Back

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