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April 1, 2016  |  Volume 13  |  Issue 13
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Loyd V. Allen, Jr., Ph.d., R.Ph Letter from the Editor
Implementing United States Pharmacopeia <800>, Part 8: Hazardous Drugs-Handling in Healthcare Settings

(Learning about USP Chapter <800> in 10 minutes a week.)

5. Facilities and Engineering Controls (5.3 Compounding [Introductory paragraph]

5.3 Compounding


*Protection from cross-contamination and microbial contamination
*Engineering Controls
     -Primary
            C-PEC Containment-Primary Engineering Control
                                  DEVICE
     -Secondary
            C-SEC Containment-Secondary Engineering Control
                                  ROOM
     -Supplemental
            CSTDs etc.    Closed System Transfer Devices
                                  OTHER CONTROLS

1. Both sterile and nonsterile HDs must be compounded in a C-PEC located in a C-SEC.
 
2.The C-SEC (Room) must:
• Be externally vented through a HEPA filter.
• Be physically SEPARATED from other preparation areas.
• Have appropriate air exchanges (ACPH).
• Have a NEGATIVE PRESSURE between 0.01 and 0.03 inches of water column relative to all adjacent areas.
 
3.The C-PEC must run continuously if it is used to supply negative pressure for the room or is used for sterile compounding.
 
4.A sink must be available.
 
5.An eyewash station and/or other emergency or safety precautions must be available.
 
6.Water sources and drains:
-must not interfere with required ISO classifications.
-must be located at least 1 meter away from the C-PEC.
 
7.
If compounding BOTH sterile and nonsterile:
*C-PECs must be placed in separate rooms...UNLESS
*the C-PECs used for nonsterile are sufficiently effective the room can continuously maintain ISO 7 throughout the compounding activity.
*If so, they must be placed at least 1 meter apart and the particle-generating activity must not be performed with sterile compounding is in process.

Questions:

Owner (present several hours a day) in a community pharmacy that does compounding and has one pharmacist and a tech. Facility is set up for <800> compounding.

  • Is it necessary for the compounding pharmacist to remove ALL personal protective equipment (PPE) each time they step out to answer the phone?
  • Can the pharmacist just deglove if they answer a "hands-free" phone inside the room?
  • The compounding pharmacist does all the patient counseling when new Rx's are picked up; does the pharmacist have to remove ALL PPE EACH TIME during the day they counsel a patient?

NEXT WEEK:

5.3.1 Nonsterile Compounding


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

 

Announcements

More USP <800> SOPs added to www.CompoundingToday.com this week!

 

News

Natco Plant in India Not Meeting Standards
Another Indian pharmaceutical company has had plants cited by the FDA for not maintaining manufacturing standards. Natco reported it received Form 483s for its pharmaceutical formulations facility at Kothur, near Hyderabad, as well as an API plant at Manali, near Chennai, which it had to close in December because of flooding in the area.
http://corporates.bseindia.com/xml-data/corpfiling/AttachLive/
BE3A322C_E35D_4653_AC85_B7C2311E08EB_174624.pdf

Anuh Pharma Plant Criticized
Indian Anuh plant sourced ingredient from a China company EU banned two years ago. India's Anuh Pharma has informed authorities in India that its Boisar plant had been banned from shipping products to Europe after the European Medicines Agency (EMA) stopped its manufacturing certificate. In a report from a February visit, the EMA said French inspectors documented two dozen deficiencies at the plant and found overall quality so lacking that it recommended recalling from Europe all of the antibiotic APIs the plant manufactures because their original sources were unknown.
http://www.fiercepharmamanufacturing.com/story/anuh-pharma-plant-savaged-ema-report/2016-03-31

Dr. Reddy's Recalling Injectable
India's Dr. Reddy's Laboratories had to recently recall nearly 25,000 bottles of a dialysis drug after complaints of container leaks. Now, it is recalling 3,342 vials of zoledronic acid injection over questions of sterility after some were found to have defective seals. The drug product was produced by Gland Pharma. This recall comes at a bad time for Dr. Reddy's, which is already dealing with issues at three manufacturing plants the FDA cited last year.
http://www.fiercepharmamanufacturing.com/story/dr-reddys-recalling-injected-drug-manufactured-gland-pharma/2016-03-31

Records of 80,000 Novartis "Sham" Events for Doctors Being Investigated
Novartis AG is being required to provide records of about 80,000 "sham" events in which the government says doctors were wined and dined so they would prescribe the company's cardiovascular drugs to their patients. Novartis and the Manhattan U.S. Attorney are engaged in a whistle-blower lawsuit that alleges Novartis provided illegal kickbacks to healthcare providers through bogus educational programs at high-end restaurants and sports bars where the drugs were barely discussed. Last year, Novartis agreed to pay $390 million to settle a lawsuit in which the U.S. government claimed the Swiss company paid kickbacks to pharmacies to boost sales of some of its prescription drugs. The company neither admitted nor denied liability.
http://www.bloomberg.com/news/articles/2016-03-26/u-s-seeks-records-of-80-000-novartis-sham-events-for-doctors

Reliable Drug Pharmacy Recalling Compounded Products
Reliable Drug Pharmacy is recalling all unexpired lots of compounded products due to concern of lack of quality assurance and potential mislabeling. The products were distributed to patients and veterinarians within California as well as a few products that were shipped to Hawaii, New Mexico, and Michigan. The recall was issued after a series of onsite inspections by the FDA. The recall impacts all compounded products distributed between 09/24/2015 and 03/24/2016.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman
MedicalProducts/ucm492677.htm

 

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Did You Know ...

...that there's another "same-ole, same-ole" story being published from the FDA about compounding oversight being a "work in progress" with some "tales of horror" examples.

 

Tip of the Week

It would be great if stories by FDA employees would be required to be "documented" instead of being painted with broad-brush strokes. It appears that some of the examples are situations that may have occurred years ago and have long-sense been corrected! FDA loses credibility when they continue to propagate "old news" that is no longer news to justify their actions.

 

Looking Back

Careless driving,
Soon we hope,
Will go the way,
Of brush and soap!
     Burma Shave

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