New Epinephrine Twinject

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[url="http://www.veruspharm.com/news_releases_07_06_2005.html"]http://www.veruspharm.com/news_releases_07_06_2005.html[/url]

SAN DIEGO

On Aug 4, 2005

My son is actually due soon for renewal of his Epipen and I read about the Twinject this week in my FAAN newsletter. I spoke to Dave Carlander at Verus Pharmaceuticals two days ago and he said that it will be in the supplier wearhouses by next Wednesday or Thursday. He said that if I go to get my Rx filled at the end of next week, the pharmacy may have to order for it but it should be available within a matter of days.

On Aug 4, 2005

Mimi, any idea how it compares price wise? I think it will be good for Dey to finally have some competition.

On Aug 4, 2005

What does it look like? Is it any smaller than the Epipen? Oh please, [i]please[/i] make it smaller!

Amy

[This message has been edited by Going Nuts (edited August 04, 2005).]

On Aug 4, 2005

[url="http://www.twinject.com/"]http://www.twinject.com/[/url]

It looks similar - but two doses in one. And the case looks better to.

Wonder what the shelf life is. And when will it be available in Canada.

On Aug 4, 2005

The second dose is not as strong as the first dose?

I did think that it was good that Dey finally had some competition.

So, if you only had to use one dose, what would you do with the lesser second dose?

Can anyone tell I have a hard time dealing with change?

Would that mean, for most people, they'd be carrying around more epinephrine than before or less?

Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

On Aug 4, 2005

There are two different strengths,just like the Epi-Pen. It says right on the website that each dose delivers 0.3mg and on the other 0.15.

On Aug 4, 2005

momma2boys, thank-you, part of my confusion assuaged. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

On Aug 4, 2005

Reading the fine print:

Twinject 0.3 mg is capable of delivering two doses of 0.3 mg (0.3 mL of 1:1000 dilution of epinephrine) each. The first dose is available for auto-injection by the patient, [i]and the second dose is available for manual injection by the patient following a partial disassembly of the Twinject 0.3 mg device. [/i]

Wondering how hard the partial disassembly is.

Quite a dilemma...while carrying two Epi's is slightly more cumbersome, there is something to be said for both doses being auto-injectable...

Guess I'll have to wait for their fully interactive website (coming soon!)...

On Aug 5, 2005

hmmm, didn't catch that about manual injection! Another disadvantage is if you leave it out in the cold or heat, you just ruined 2 instead of one.

On Aug 5, 2005

Not sure that I like the idea of having to disassemble and manually inject a second dose. That may be difficult when under the stress of a reaction. The epipen sounds more user friendly.

Ali

On Aug 5, 2005

Yes but supposedly there are very clear instructions attatched to the device.

When I spoke to Dave Carlander, he said to have my sons allergist request the double pack because it also contains a trainer.

On Aug 6, 2005

This has been approved for Canada.

[url="http://www.veruspharm.com/news_releases_07_27_2005.html"]http://www.veruspharm.com/news_releases_07_27_2005.html[/url]

I checked the companies web-site, and there is nothing about the twinject. I have sent an e-mail and will post when I hear back.

On Aug 6, 2005

Quote:

Originally posted by momma2boys: [b]Mimi, any idea how it compares price wise? I think it will be good for Dey to finally have some competition.[/b]

Sorry, I have absolutely no idea and we have a prescription plan so I don't have to pay more than $15.00. I don't know how it would compare with Epipen.

On Aug 11, 2005

regarding the twinject vs. epi pen:

i'm concerned that after we train teachers, bus drivers, school volunteers on epi pens, there will be more confusion added once the twinject is brought to school...i'm not sure that people would be willing to give the second dose in a syringe....

just something to think about...

On Aug 11, 2005

I know. After thinking about it, I feel the same way. I waited for the Twinject to come out to get my son's new prescription filled. As it turns out, I ended up asking his Ped. All. for one Twinject and several Epipens. We can keep the Twinject for carrying in my purse (because I don't mind giving it manually) and give the Epipens to school, etc.

When my son gets older and he feels confident self treating, he may decide to carry the Twinject since it's more compact but for now, I think it may cause more confusion.

On Aug 17, 2005

It should be available in Canada this year. *******

MimiM, you have purchased the new twinject? Is the case it comes in strong enough to keep the epi in? Does the twinject fit in the purchased carrying cases for epi-pens (like e-belts, etc.)?

If anyone else has purchased the new twinject, feel free to answer the questions. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

*********

I spent the morning searching out information about Sabrina's Law. I'm not sure whether I want the epi-pen or the twinject for my son. Personally, I'm leaning towards having him carry the twin, and have an epi in the office. Kind of depends what my insurance company has to say. [img]http://uumor.pair.com/nutalle2/peanutallergy/wink.gif[/img]

Anyway, I checked the wording of Sabrina's Law - and it says *auto-injectable epinephrin*. No brand name. So, I would say in Ontario, school personnel will be required to be trained on BOTH auto-injectors. (But, may not be required to be trained to administer the second dose, because it's manual.)

On Aug 25, 2005

I just saw the Twinject trainer at the allergist today. It comes apart easily, however in many parts. The second dose is injected just like the first, only it's a tiny piece (sorry, it's hard to explain). I have to agree with Autin2001 that I would not feel comfortable giving it to the school. The Epi-Pen is much easier to use, the school is familiar with it, and the school can store two. I will carry the Twinject in my purse and my son will carry it in his epi-belt(hope it fits). It has a great hard case as well. At first look, I like it. I have called the company looking for a trainer, I don't think I want to teach someone how to pull a *real* one apart.

On Aug 26, 2005

I recieved a phone call from Peter Schineller 858-436-1614 re: the Twinject trainer. He is sending me 3 trainers. I spoke to him in length about the product. The needle is a 22 guage, epi is 25 guage. So smaller needle, however can go through everything the epi can. It also doesn't need the *swing and jab*, just place on the thigh and push. The second dose is not a syring, it uses the same needle,(the one that is exposed from the first shot) and you inject by inserting the needle into the thigh. That part is very hard to explain without someone looking at the device. The twin pack comes with a trainer and costs about 10% more than the twin pack epi, however has 4 doses not just two. He was great to talk to and welcomes questions and comments.

[This message has been edited by tamisly (edited August 26, 2005).]

[This message has been edited by tamisly (edited August 26, 2005).]

On Aug 26, 2005

Correct me if I am wrong.... This product is developed for those who need a SECOND injection during the same allergic episode.

Maybe those farther away from medical or 911 assistance? Or those who traditionally react much worse than anyone else? [b]Maybe a full second dose is what these people are trying to avoid and they are trying to be different than Dey.[/b]

[i]I am editing this above passage out. I am incorrect here. They are made in two doses for bigger and smaller patients not two doses in one pack.[/i]

I'll stick with my Dey Epi pens. Or my son will anyway.

Peggy

[This message has been edited by Peg541 (edited August 27, 2005).]

On Aug 26, 2005

If I understand correctly the second dose is a full dose. My son has never needed the epi-pen (yet), knock on wood!!! But I still always carry two. The reason being if I screw up with the first one, or if it malfuntions, or if 911 doesn't reach us within the 10-20 minute window. The learning curve is so easy with the epi-pen, I will still leave epi's with the school. But to save room in my purse, and my sons epi belt, we will carry the twinject. I'm sure people will prefer one over the other, I'm happy to have an option.

On Aug 26, 2005

So...if you had to use the twinjet (and hopefully no one ever has to) and you only use the first dose, then you later continue to carry around the twinjet with only one dose and a needle that has already been used?? I thought that a needle becomes slightly damaged (less sharp) with each use. Or do you dispose of the device after the one use? I would rather the carry 2 to 4 epipens that I already do.

Ali

On Aug 26, 2005

Years ago I used to carry around an Anakit. It was not auto-injector, it was a needle - but it had two doses of epinephrine in it. If only one dose was required, the Anakit still needed to be replaced and I would expect it would be the same with the twinject.

On Aug 26, 2005

So I would say that this Twinject is appropriate for people who traditionally need more than one dose of epi due to not being near emergency assistance? I cannot imagine any other reason.

Peg

On Aug 27, 2005

We did get the Twinject but it did not come with a trainer. It does have clear directions on it though.

I ended up getting one Twinject and several other Epipens because I was not comfortable having to train everyone else how to do it but I was curious about it.

I would have no problem giving it myself though and I must say, the case is much smaller than the Epipen case so it's definately more compact. It comes in a firm case to protect it as well. I would imagine that it would work in an e-belt fine since it is smaller than the Epipens.

I think that for a teen or an adult it will definately be nicer to have since it's more compact. For young kids however, it might not be the choice since they are dependent on others to inject the medication.

On Aug 27, 2005

Mimi, does the first shot go the same as the epi-pen? (i.e. hold against thigh and press)

I think I would like to have the twinject for my son because since he has an insect allergy he is more likely to be far from a hospital when he is in contact with his allergen. BUT, at school they would only need to give him one shot - and the ambulance should be there before he needs the second.

Peg, I can see a lot of reasons for wanting the double shot. Your son carries more then one epi doesn't he? (Not meaning that to sound sarcastic - but I think I remember you stating that he does.) For my son, he can't carry two epi's - it's just too bulky for him. I would prefer two shots in one for myself as well - for the space.

Depending on the cost - if it is close in price to one epi-pen, I'd rather have two shots together. If it is close in price to two epi-pens, I might chose the two separate pens.

********

I'm glad there will soon be a choice. (There is for Americans.) And a little bit of competition has already made at least one difference with Dey. Didn't they improve the case it's purchased in?

On Aug 27, 2005

We asked our allergist about the Twinject and he does not recommend it. He said the first dose is no easier to give than the Epipen and the second dose is so cumbersome to give that many people would have trouble using it...especially in a panic situation.

Perhaps the Twinject is being prescribed (despite its disadvantages) because the drug company is promoting it heavily and some doctors respond favorably to free dinners, tote bags, pens, etc. from the drug reps.

On Aug 27, 2005

Yes my son carried two epis. For all the reasons why he MIGHT carry a twinject but I think the twinject is to hedge your bets on needing another injection. If you don't need another injection during that episode I assume you have to discard it unused.

I like the predictability of the epi. Place it on your outer thigh and press, hold for 10 seconds and that's it. In a bad situation this is rote memory, easy to access and calming.

Having to push that twinject second needle in yourself I think might be too scary or complicated for someone (my son) who is already in a state of heightened fear.

By fear I mean the feeling of doom which is one of the hallmarks of anaphylaxis and no matter how well trained you are this feeling of doom is there to let you know this is something big and you had better act fast.

The automatic nature of the epi pen takes the skill out of your hands and just asks that you place it on the correct spot on your leg. I did not teach my son to "swing and jab" which I think could lead to accidents and also is so much more "violent" than just placing it on your outer thigh and pushing. That big CLICK the epi makes is reassuring that you are doing it right and after the click just count to 10 and call 911.

When I was teaching him at age 5 it seemed less scary to place it on his thigh than to swing and jab.

I see now that Twinject is available in two doses like epi and epi jr. not Two different doses in one package. Again, two epis work just as well for us. Hope so anyway, DS has not had to use a second epi ever although they always give him more epi once he gets to the ER.

Peg

[This message has been edited by Peg541 (edited August 27, 2005).]

On Aug 27, 2005

Quote:

Originally posted by Peg541: [B]I see now that Twinject is available in two doses like epi and epi jr. not Two different doses in one package.

[B]

I wanted to correct this. One twinject has two adult doses of epi. The other has two jr. strength doses.

**********

I totally understand your point of view. I don't disagree with it. For us, I think the option might be the new one. But, I'm glad people won't be forced to give up the epi-pen - I'm sure there are a lot of people that will choose to continue buying that.

On Aug 27, 2005

Thanks AnnaMarie, I was confused by their statement. It makes sense now.

I can definitely see where this is a valuable asset for some and not for others.

I'm just glad we/you have something, anything. Peggy

On Aug 27, 2005

This product is suppose to be available in Canada in September 2005!!

On Aug 31, 2005

The second page of this FAAN action plan actually has already updated to include Twinject administration!

[url="http://www.foodallergy.org/actionplan.pdf"]http://www.foodallergy.org/actionplan.pdf[/url]

------------------ Jana

[url="http://www.seattlefoodallergy.org"]www.seattlefoodallergy.org[/url]

On Aug 31, 2005

AAIA has already seen the new Epipen and it fits the EpiTube.

On Aug 31, 2005

Jana, thanks for providing that link. It's the first time I've seen *how to* use the twinject.

But, I noticed for the epi-pen it says *swing and jab*. Odd that hasn't been updated.

On Sep 23, 2005

I just received this to-day from Anaphylaxis Canada, so I don't know if it took a month or so later to announce in Canada, or what, but thought I would add to the thread:-

Dear Registrant,

We thought you'd like to know about Twinject, a new epinephrine auto-injector with a back-up dose.

To see the press release, go to: [url="http://www.paladinlabs.com"]www.paladinlabs.com[/url]

To learn more about the Twinject patient support program, go to: [url="http://www.twinject.ca"]www.twinject.ca[/url]

Kindly forward this information to others who may be interested in this announcement.

For your information,

Anaphylaxis Canada

Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

On Sep 23, 2005

csc, the reason it took so long to be announced in Canada is that it is only now being released.

Anyway, click on the link to paladin. Then, the link to the Sept. 22 press release. From there, click the link to twinject. The site is Canadian - and actually has info, including a picture of how to use. And a video showing a woman using it.

Whereas epi-pen has a trainer - the twinject has a demonstrator. However, it is not yet available from that web-site.

On Oct 11, 2005

The price for the Twinjet was published in the Fall edition of Allergic Living Magazine. Between $100 and $120 Canadian. Cheaper than two EpiPens.

Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

On Feb 5, 2006

Quote:

Originally posted by csc: [b]The price for the Twinjet was published in the Fall edition of Allergic Living Magazine. Between $100 and $120 Canadian. Cheaper than two EpiPens. [/b]

I worry about this because my insurance co-pay may go up, or they may refuse to pay for Epi-pens because of the existence of the Twinject.

I saw a demonstration of a trainer model & held/examined the trainer at our support group several months ago. I was not impressed with the device. I think the Twinject is much too complicated, even for the first dose. The instructions are included in a little scroll & require a lot of reading. The new epi-pens have pictorial instructions, much better in an emergency, IMHO.

You have to pull off two caps, first the green cap (the needle is behind the green cap) then the red cap. Stupid color choice, IMHO, making it red, I see red & think "Stop! don't touch," & I would assume the needle is behind the red cap. But there is a GRAY cap and the instructions read: "Never put your thumb, finger,or hand over the GRAY cap."

Now, once you are done with the first dose: "Unscrew and remove the GRAY cap. Beware of the exposed needle." Right. I am gasping for breathe, my first shot didn't work and I am panicking and I have to worry about the exposed needle? Or I am a teacher/parent/grandparent/babysitter who's been trained but never done this before, a child is possibly dying & I have to figure this all out?

The second dose is also very small and not very good for someone with an unsteady hand. Definately not good for someone with arthritis.

Also, both dosages use the same needle so if the needle bends or malfunctions, you are pretty screwed. With 2 epis at least you have a backup.

I think I may be able to use this if I had to (if the pharmacy were out-of-stock of epi-pens or my insurance forced me to buy it)but I would never leave a twinject with a babysitter or the school. (the school nurse could do it, but a teacher would have a hard time.)

FYI: Instructions for Twinject are here: [url="http://www.twinject.com/patient/howuse.asp"]http://www.twinject.com/patient/howuse.asp[/url]

[This message has been edited by ElleMo (edited February 05, 2006).]

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