Epinephrine


Hf Acquisition Co Llc, Dba Healthfirst
Human Prescription Drug
NDC 51662-1321
Epinephrine is a human prescription drug labeled by 'Hf Acquisition Co Llc, Dba Healthfirst'. National Drug Code (NDC) number for Epinephrine is 51662-1321. This drug is available in dosage form of Injection, Solution. The names of the active, medicinal ingredients in Epinephrine drug includes Epinephrine - .15 mg/.15mL . The currest status of Epinephrine drug is Active.

Drug Information:

Drug NDC: 51662-1321
The labeler code and product code segments of the National Drug Code number, separated by a hyphen. Asterisks are no longer used or included within the product code segment to indicate certain configurations of the NDC.
Proprietary Name: Epinephrine
Also known as the trade name. It is the name of the product chosen by the labeler.
Product Type: Human Prescription Drug
Indicates the type of product, such as Human Prescription Drug or Human OTC Drug. This data element corresponds to the “Document Type” of the SPL submission for the listing.
Non Proprietary Name: Epinephrine
Also known as the generic name, this is usually the active ingredient(s) of the product.
Labeler Name: Hf Acquisition Co Llc, Dba Healthfirst
Name of Company corresponding to the labeler code segment of the ProductNDC.
Dosage Form: Injection, Solution
The translation of the DosageForm Code submitted by the firm. There is no standard, but values may include terms like `tablet` or `solution for injection`.The complete list of codes and translations can be found www.fda.gov/edrls under Structured Product Labeling Resources.
Status: Active
FDA does not review and approve unfinished products. Therefore, all products in this file are considered unapproved.
Substance Name:EPINEPHRINE - .15 mg/.15mL
This is the active ingredient list. Each ingredient name is the preferred term of the UNII code submitted.
Route Details:INTRAMUSCULAR
The translation of the Route Code submitted by the firm, indicating route of administration. The complete list of codes and translations can be found at www.fda.gov/edrls under Structured Product Labeling Resources.

Marketing Information:

An openfda section: An annotation with additional product identifiers, such as NUII and UPC, of the drug product, if available.
Marketing Category: NDA
Product types are broken down into several potential Marketing Categories, such as New Drug Application (NDA), Abbreviated New Drug Application (ANDA), BLA, OTC Monograph, or Unapproved Drug. One and only one Marketing Category may be chosen for a product, not all marketing categories are available to all product types. Currently, only final marketed product categories are included. The complete list of codes and translations can be found at www.fda.gov/edrls under Structured Product Labeling Resources.
Marketing Start Date: 21 Sep, 2018
This is the date that the labeler indicates was the start of its marketing of the drug product.
Marketing End Date: 01 Jan, 2026
This is the date the product will no longer be available on the market. If a product is no longer being manufactured, in most cases, the FDA recommends firms use the expiration date of the last lot produced as the EndMarketingDate, to reflect the potential for drug product to remain available after manufacturing has ceased. Products that are the subject of ongoing manufacturing will not ordinarily have any EndMarketingDate. Products with a value in the EndMarketingDate will be removed from the NDC Directory when the EndMarketingDate is reached.
Application Number: NDA201739
This corresponds to the NDA, ANDA, or BLA number reported by the labeler for products which have the corresponding Marketing Category designated. If the designated Marketing Category is OTC Monograph Final or OTC Monograph Not Final, then the Application number will be the CFR citation corresponding to the appropriate Monograph (e.g. “part 341”). For unapproved drugs, this field will be null.
Listing Expiration Date: 31 Dec, 2023
This is the date when the listing record will expire if not updated or certified by the firm.

OpenFDA Information:

An openfda section: An annotation with additional product identifiers, such as NUII and UPC, of the drug product, if available.
Manufacturer Name:HF Acquisition Co LLC, DBA HealthFirst
Name of manufacturer or company that makes this drug product, corresponding to the labeler code segment of the NDC.
RxCUI:1870205
1870232
The RxNorm Concept Unique Identifier. RxCUI is a unique number that describes a semantic concept about the drug product, including its ingredients, strength, and dose forms.
UPC:0060842022011
0060842023018
UPC stands for Universal Product Code.
NUI:N0000000209
N0000000245
N0000175552
N0000175555
N0000175570
M0003647
Unique identifier applied to a drug concept within the National Drug File Reference Terminology (NDF-RT).
UNII:YKH834O4BH
Unique Ingredient Identifier, which is a non-proprietary, free, unique, unambiguous, non-semantic, alphanumeric identifier based on a substance’s molecular structure and/or descriptive information.
Pharmacologic Class MOA:Adrenergic alpha-Agonists [MoA]
Adrenergic beta-Agonists [MoA]
Mechanism of action of the drug—molecular, subcellular, or cellular functional activity—of the drug’s established pharmacologic class. Takes the form of the mechanism of action, followed by `[MoA]` (such as `Calcium Channel Antagonists [MoA]` or `Tumor Necrosis Factor Receptor Blocking Activity [MoA]`.
Pharmacologic Class EPC:alpha-Adrenergic Agonist [EPC]
beta-Adrenergic Agonist [EPC]
Catecholamine [EPC]
Established pharmacologic class associated with an approved indication of an active moiety (generic drug) that the FDA has determined to be scientifically valid and clinically meaningful. Takes the form of the pharmacologic class, followed by `[EPC]` (such as `Thiazide Diuretic [EPC]` or `Tumor Necrosis Factor Blocker [EPC]`.
Pharmacologic Class CS:Catecholamines [CS]
Chemical structure classification of the drug product’s pharmacologic class. Takes the form of the classification, followed by `[Chemical/Ingredient]` (such as `Thiazides [Chemical/Ingredient]` or `Antibodies, Monoclonal [Chemical/Ingredient].
Pharmacologic Class:Adrenergic alpha-Agonists [MoA]
Adrenergic beta-Agonists [MoA]
Catecholamine [EPC]
Catecholamines [CS]
alpha-Adrenergic Agonist [EPC]
beta-Adrenergic Agonist [EPC]
These are the reported pharmacological class categories corresponding to the SubstanceNames listed above.

Packaging Information:

Package NDCDescriptionMarketing Start DateMarketing End DateSample Available
51662-1321-1.15 mL in 1 DOSE PACK (51662-1321-1)21 Sep, 2018N/ANo
51662-1321-22 DOSE PACK in 1 CARTON (51662-1321-2) / .15 mL in 1 DOSE PACK24 Aug, 2019N/ANo
Package NDC number, known as the NDC, identifies the labeler, product, and trade package size. The first segment, the labeler code, is assigned by the FDA. Description tells the size and type of packaging in sentence form. Multilevel packages will have the descriptions concatenated together.

Product Elements:

Epinephrine epinephrine epinephrine epinephrine sodium chloride water sodium bisulfite hydrochloric acid epinephrine epinephrine epinephrine epinephrine sodium chloride water sodium bisulfite hydrochloric acid

Drug Interactions:

7 drug interactions patients who receive epinephrine while concomitantly taking cardiac glycosides, diuretics, or anti-arrhythmics should be observed carefully for the development of cardiac arrhythmias [see warnings and precautions 5- (5.5)]. the effects of epinephrine may be potentiated by tricyclic antidepressants, monoamine oxidase inhibitors, levothyroxine sodium, and certain antihistamines, notably chlorpheniramine, tripelennamine, and diphenhydramine. the cardiostimulating and bronchodilating effects of epinephrine are antagonized by beta-adrenergic blocking drugs, such as propranolol. the vasoconstricting and hypertensive effects of epinephrine are antagonized by alpha-adrenergic blocking drugs, such as phentolamine. ergot alkaloids may also reverse the pressor effects of epinephrine.

Indications and Usage:

1 indications & usage auvi-q® is indicated in the emergency treatment of allergic reactions (type i) including anaphylaxis to stinging insects (e.g., order hymenoptera, which include bees, wasps, hornets, yellow jackets and fire ants) and biting insects (e.g., triatoma, mosquitoes), allergen immunotherapy, foods, drugs, diagnostic testing substances (e.g., radiocontrast media) and other allergens, as well as idiopathic anaphylaxis or exercise-induced anaphylaxis. auvi-q is intended for immediate administration in patients who are determined to be at increased risk for anaphylaxis, including individuals with a history of anaphylactic reactions. anaphylactic reactions may occur within minutes after exposure and consist of flushing, apprehension, syncope, tachycardia, thready or unobtainable pulse associated with a fall in blood pressure, convulsions, vomiting, diarrhea and abdominal cramps, involuntary voiding, wheezing, dyspnea due to laryngeal spasm, pruritus, rashes, urticaria or a
ngioedema. auvi-q is intended for immediate self-administration as emergency supportive therapy only and is not a substitute for immediate medical care.

Warnings and Cautions:

5 warnings and precautions 5.1 emergency treatment auvi-q is not intended as a substitute for immediate medical care. in conjunction with the administration of epinephrine, the patient should seek immediate medical or hospital care. more than two sequential doses of epinephrine should only be administered under direct medical supervision [see indications and usage ( 1 ), dosage and administration (2) and patient counseling information 17- (17.1)]. 5.2 injection-related complications auvi-q should only be injected into the anterolateral aspect of the thigh [see dosage and administration (2) and patient counseling information 17- (17.1)]. do not inject intravenously. large doses or accidental intravenous injection of epinephrine may result in cerebral hemorrhage due to sharp rise in blood pressure. rapidly acting vasodilators can counteract the marked pressor effects of epinephrine if there is such inadvertent administration. do not inject into buttock. injection into the buttock may not
provide effective treatment of anaphylaxis. advise the patient to go immediately to the nearest emergency room for further treatment of anaphylaxis. additionally, injection into the buttock has been associated with clostridial infections (gas gangrene). cleansing with alcohol does not kill bacterial spores, and therefore, does not lower this risk. do not inject into digits, hands or feet. since epinephrine is a strong vasoconstrictor, accidental injection into the digits, hands or feet may result in loss of blood flow to the affected area. advise the patient to go immediately to the nearest emergency room and to inform the healthcare provider in the emergency room of the location of the accidental injection. treatment of such inadvertent administration should consist of vasodilation, in addition to further appropriate treatment of anaphylaxis [see adverse reactions ( 6 )]. hold leg firmly during injection. to minimize the risk of injection-related injury when administering auvi-q to young children or infants, instruct caregivers to hold the child’s leg firmly in place and limit movement prior to and during injection. 5.3 serious infections at the injection site rare cases of serious skin and soft tissue infections, including necrotizing fasciitis and myonecrosis caused by clostridia (gas gangrene), have been reported at the injection site following epinephrine injection for anaphylaxis. clostridium spores can be present on the skin and introduced into the deep tissue with subcutaneous or intramuscular injection. while cleansing with alcohol may reduce the presence of bacteria on the skin, alcohol cleansing does not kill clostridium spores. to decrease the potential risk of a rare, but serious clostridium infection, do not inject auvi-q into the buttock [see warnings and precautions (5.2)]. advise patients to seek medical care if they develop signs or symptoms of infection, such as persistent redness, warmth, swelling, or tenderness, at the epinephrine injection site. 5.4 allergic reactions associated with sulfite epinephrine is the preferred treatment for serious allergic reactions or other emergency situations even though this product contains sodium bisulfite, a sulfite that may, in other products, cause allergic-type reactions including anaphylactic symptoms or life-threatening or less severe asthmatic episodes in certain susceptible persons. the presence of a sulfite in this product should not deter administration of the drug for treatment of serious allergic or other emergency situations even if the patient is sulfite-sensitive. the alternatives to using epinephrine in a life-threatening situation may not be satisfactory. 5.5 disease interactions some patients may be at greater risk for developing adverse reactions after epinephrine administration. despite these concerns, it should be recognized that the presence of these conditions is not a contraindication to epinephrine administration in an acute, life-threatening situation. therefore, patients with these conditions, and/or any other person who might be in a position to administer auvi-q to a patient experiencing anaphylaxis should be carefully instructed in regard to the circumstances under which epinephrine should be used. patients with heart disease epinephrine should be administered with caution to patients who have heart disease, including patients with cardiac arrhythmias, coronary artery or organic heart disease, or hypertension. in such patients, or in patients who are on drugs that may sensitize the heart to arrhythmias, epinephrine may precipitate or aggravate angina pectoris as well as produce ventricular arrhythmias [see drug interactions ( 7 ) and adverse reactions ( 6 )]. other patients and diseases epinephrine should be administered with caution to patients with hyperthyroidism, diabetes, elderly individuals, and pregnant women. patients with parkinson’s disease may notice a temporary worsening of symptoms.

Dosage and Administration:

2 dosage & administration selection of the appropriate dosage strength (auvi-q 0.3 mg, auvi-q 0.15 mg or auvi-q 0.1 mg) is determined according to patient body weight. patients greater than or equal to 30 kg (approximately 66 pounds or more): auvi-q 0.3 mg patients 15 to 30 kg (33 to 66 pounds): auvi-q 0.15 mg patients 7.5 to 15 kg (16.5 to 33 pounds): auvi-q 0.1 mg inject auvi-q intramuscularly or subcutaneously into the anterolateral aspect of the thigh, through clothing if necessary. instruct caregivers of young children and infants who are prescribed auvi-q and who may be uncooperative and kick or move during an injection to hold the child’s leg firmly in place and limit movement prior to and during an injection [see warnings and precautions 5- (5.2)]. each auvi-q contains a single dose of epinephrine for single-use injection. since the doses of epinephrine delivered from auvi-q are fixed, consider using other forms of injectable epinephrine if doses lower than 0.1 mg are deem
ed necessary. the prescriber should carefully assess each patient to determine the most appropriate dose of epinephrine, recognizing the life-threatening nature of the reactions for which this drug is indicated. with severe persistent anaphylaxis, repeat injections with an additional auvi-q may be necessary. more than two sequential doses of epinephrine should only be administered under direct medical supervision [see warnings and precautions 5- (5.1)]. the epinephrine solution in the viewing window of auvi-q should be inspected visually for particulate matter and discoloration. epinephrine is light sensitive and should be stored in the outer case provided to protect it from light [see storage and handling 16- (16.2)].

Dosage Forms and Strength:

3 dosage forms & strengths injection, 0.3 mg/0.3 ml epinephrine injection, usp, pre-filled auto-injector injection, 0.15 mg/0.15 ml epinephrine injection, usp, pre-filled auto-injector injection, 0.1 mg/0.1 ml epinephrine injection, usp, pre-filled auto-injector

Contraindications:

4 contraindications none.

Adverse Reactions:

6 adverse reactions due to lack of randomized, controlled clinical trials of epinephrine for the treatment of anaphylaxis, the true incidence of adverse reactions associated with the systemic use of epinephrine is difficult to determine. adverse reactions reported in observational trials, case reports, and studies are listed below. common adverse reactions to systemically administered epinephrine include anxiety; apprehensiveness; restlessness; tremor; weakness; dizziness; sweating; palpitations; pallor; nausea and vomiting; headache; and/or respiratory difficulties. these symptoms occur in some persons receiving therapeutic doses of epinephrine, but are more likely to occur in patients with hypertension or hyperthyroidism [see warnings and precautions 5- (5.5)]. arrhythmias, including fatal ventricular fibrillation, have been reported, particularly in patients with underlying cardiac disease or those receiving certain drugs [see warnings and precautions 5- (5.5) and drug interactions
( 7 )]. rapid rises in blood pressure have produced cerebral hemorrhage, particularly in elderly patients with cardiovascular disease [see warnings and precautions 5- (5.5)]. angina may occur in patients with coronary artery disease [see warnings and precautions 5- (5.5)]. rare cases of stress cardiomyopathy have been reported in patients treated with epinephrine. accidental injection into the digits, hands or feet may result in loss of blood flow to the affected area [see warnings and precautions 5- (5.2)]. adverse events experienced as a result of accidental injections may include increased heart rate, local reactions including injection site pallor, coldness and hypoesthesia or injury at the injection site resulting in bruising, bleeding, discoloration, erythema or skeletal injury. injection of epinephrine into the buttock has resulted in cases of gas gangrene [see warnings and precautions 5- (5.2)]. rare cases of serious skin and soft tissue infections, including necrotizing fasciitis and myonecrosis caused by clostridia (gas gangrene), have been reported at the injection site following epinephrine injection in the thigh [see warnings and precautions 5- (5.2)].

Drug Interactions:

7 drug interactions patients who receive epinephrine while concomitantly taking cardiac glycosides, diuretics, or anti-arrhythmics should be observed carefully for the development of cardiac arrhythmias [see warnings and precautions 5- (5.5)]. the effects of epinephrine may be potentiated by tricyclic antidepressants, monoamine oxidase inhibitors, levothyroxine sodium, and certain antihistamines, notably chlorpheniramine, tripelennamine, and diphenhydramine. the cardiostimulating and bronchodilating effects of epinephrine are antagonized by beta-adrenergic blocking drugs, such as propranolol. the vasoconstricting and hypertensive effects of epinephrine are antagonized by alpha-adrenergic blocking drugs, such as phentolamine. ergot alkaloids may also reverse the pressor effects of epinephrine.

Use in Specific Population:

8 use in specific populations 8.1 pregnancy teratogenic effects: pregnancy category c. there are no adequate and well controlled studies of the acute effect of epinephrine in pregnant women. epinephrine was teratogenic in rabbits, mice and hamsters. epinephrine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus (fetal anoxia, spontaneous abortion, or both). epinephrine has been shown to have teratogenic effects when administered subcutaneously in rabbits at approximately 30 times the maximum recommended daily subcutaneous or intramuscular dose (on a mg/m2 basis at a maternal dose of 1.2 mg/kg/day for two to three days), in mice at approximately 7 times the maximum daily subcutaneous or intramuscular dose (on a mg/m2 basis at a maternal subcutaneous dose of 1 mg/kg/day for 10 days), and in hamsters at approximately 5 times the maximum recommended daily subcutaneous or intramuscular dose (on a mg/m2 basis at a maternal subcutaneous dos
e of 0.5 mg/kg/day for 4 days). these effects were not seen in mice at approximately 3 times the maximum recommended daily subcutaneous or intramuscular dose (on a mg/m2 basis at a subcutaneous maternal dose of 0.5 mg/kg/day for 10 days). 8.3 nursing mothers it is not known whether epinephrine is excreted in human milk. because many drugs are excreted in human milk, caution should be exercised when auvi-q is administered to a nursing woman. 8.4 pediatric use auvi-q may be administered to pediatric patients at a dosage appropriate to body weight [see dosage and administration ( 2 2)]. clinical experience with the use of epinephrine suggests that the adverse reactions seen in children are similar in nature and extent to those both expected and reported in adults. since the doses of epinephrine delivered from auvi-q are fixed, consider using other forms of injectable epinephrine if doses lower than 0.1 mg are deemed necessary. 8.5 geriatric use clinical studies of auvi-q did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. other reported clinical experience has not identified differences in responses between the elderly and younger patients. epinephrine should be administered with caution in elderly individuals, who may be at greater risk for developing adverse reactions after epinephrine administration [see warnings and precautions 5- (5.5), overdosage ( 10 )].

Overdosage:

10 overdosage overdosage of epinephrine may produce extremely elevated arterial pressure, which may result in cerebrovascular hemorrhage, particularly in elderly patients. overdosage may also result in pulmonary edema because of peripheral vascular constriction together with cardiac stimulation. treatment consists of rapidly acting vasodilators or alpha-adrenergic blocking drugs and/or respiratory support. epinephrine overdosage can also cause transient bradycardia followed by tachycardia, and these may be accompanied by potentially fatal cardiac arrhythmias. premature ventricular contractions may appear within one minute after injection and may be followed by multifocal ventricular tachycardia (prefibrillation rhythm). subsidence of the ventricular effects may be followed by atrial tachycardia and occasionally by atrioventricular block. treatment of arrhythmias consists of administration of a beta-adrenergic blocking drug such as propranolol. overdosage sometimes results in extreme pallor and coldness of the skin, metabolic acidosis, and kidney failure. suitable corrective measures must be taken in such situations.

Description:

11 description auvi-q (epinephrine injection, usp) 0.3 mg, 0.15 mg and 0.1 mg is an auto-injector and a combination product containing drug and device components. auvi-q includes audible (electronic voice instructions, beeps) and visible (led lights) cues for use. the needle automatically retracts after the injection is complete. each auvi-q 0.3 mg delivers a single dose of 0.3 mg epinephrine from epinephrine injection, usp (0.3 ml) in a sterile solution. each auvi-q 0.15 mg delivers a single dose of 0.15 mg epinephrine from epinephrine injection, usp (0.15 ml) in a sterile solution. each auvi-q 0.1 mg delivers a single dose of 0.1 mg epinephrine from epinephrine injection, usp (0.1 ml) in a sterile solution . auvi-q 0.3 mg, auvi-q 0.15 mg and auvi-q 0.1 mg each contain 0.76 ml epinephrine solution. 0.3 ml, 0.15 ml and 0.1 ml epinephrine solution is dispensed for auvi-q 0.3 mg, auvi-q 0.15 mg and auvi-q 0.1 mg, respectively, when activated. the remaining solution is not available for future use and should be discarded. each 0.3 ml in auvi-q 0.3 mg contains 0.3 mg epinephrine, 2.3 mg sodium chloride, 0.5 mg sodium bisulfite, hydrochloric acid to adjust ph, and water for injection. the ph range is 2.2–5.0. each 0.15 ml in auvi-q 0.15 mg contains 0.15 mg epinephrine, 1.2 mg sodium chloride, 0.2 mg sodium bisulfite, hydrochloric acid to adjust ph, and water for injection. the ph range is 2.2–5.0. each 0.1 ml in auvi-q 0.1 mg contains 0.1 mg epinephrine, 0.78 mg sodium chloride, 0.15 mg sodium bisulfite, hydrochloric acid to adjust ph, and water for injection. the ph range is 2.2–5.0. epinephrine is a sympathomimetic catecholamine. chemically, epinephrine is (-)-3,4-dihydroxy-α-[(methylamino)methyl]benzyl alcohol with the following structure: epinephrine solution deteriorates rapidly on exposure to air or light, turning pink from oxidation to adrenochrome and brown from the formation of melanin. auvi-q is not made with natural rubber latex. auvi-q instructional and safety systems should be thoroughly reviewed with patients and caregivers prior to use [see patient counseling information 17 (17.1)]. structure

Clinical Pharmacology:

12 clinical pharmacology 12.1 mechanism of action epinephrine acts on both alpha and beta-adrenergic receptors. 12.2 pharmacodynamics through its action on alpha-adrenergic receptors, epinephrine lessens the vasodilation and increased vascular permeability that occurs during anaphylaxis, which can lead to loss of intravascular fluid volume and hypotension. through its action on beta-adrenergic receptors, epinephrine causes bronchial smooth muscle relaxation and helps alleviate bronchospasm, wheezing and dyspnea that may occur during anaphylaxis. epinephrine also alleviates pruritus, urticaria, and angioedema and may relieve gastrointestinal and genitourinary symptoms associated with anaphylaxis because of its relaxer effects on the smooth muscle of the stomach, intestine, uterus and urinary bladder. when given subcutaneously or intramuscularly, epinephrine has a rapid onset and short duration of action.

Nonclinical Toxicology:

13 nonclinical toxicology 13.1 carcinogenesis, mutagenesis, impairment of fertility long-term studies to evaluate the carcinogenic potential of epinephrine have not been conducted. epinephrine and other catecholamines have been shown to have mutagenic potential in vitro and to be an oxidative mutagen in a wp2 bacterial reverse mutation assay. epinephrine was positive in the dna repair test with b. subtilis (rec) assay, but was not mutagenic in the salmonella bacterial reverse mutation assay. the potential for epinephrine to impair fertility has not been evaluated. this should not prevent the use of epinephrine under the conditions noted under indications and usage (1).

How Supplied:

16 how supplied/storage and handling auvi-q(r) epinephrine injection, usp is supplied in the following dosage forms. ndc 51662-1320-1 auvi-q(r) epinephrine injection, usp 0.3mg auto injector ndc 51662-1320-2 auvi-q(r) epinephrine injection, usp 0.3mg 2pk auto injector ndc 51662-1321-1 auvi-q(r) epinephrine injection, usp 0.15mg auto injector ndc 51662-1321-2 auvi-q(r) epinephrine injection, usp 0.15mg 2pk auto injector hf acquisition co llc, dba healthfirst mukilteo, wa 98275 also supplied in the following manufacture supplied dosage forms 16.1 how supplied carton containing two auvi-q (epinephrine injection, usp) 0.3 mg auto-injectors and a single auvi-q trainer - ndc 60842-023-01 carton containing two auvi-q (epinephrine injection, usp) 0.15 mg auto-injectors and a single auvi-q trainer - ndc 60842-022-01 carton containing two auvi-q (epinephrine injection, usp) 0.1 mg auto-injectors and a single auvi-q trainer - ndc 60842-021-01 rx only 16.2 storage and handling epinephrine is light
sensitive and should be stored in the outer case provided to protect it from light. store at 20°to 25°c (68°to 77°f); excursions permitted to 15°to 30°c (59°to 86°f) [see usp controlled room temperature]. do not refrigerate. before using, check to make sure the solution in the auto-injector is clear and colorless. replace the auto-injector if the solution is discolored, cloudy, or contains particles.

Information for Patients:

Patient information/instructions for use auvi-q® (epinephrine injection) auto-injector for allergic emergencies (anaphylaxis) read this patient information leaflet before you have to use auvi-q and each time you get a refill. there may be new information. you should know how to use auvi-q before you have an allergic emergency. this information does not take the place of talking with your healthcare provider about your medical condition or your treatment. what is the most important information i should know about auvi-q? always carry auvi-q with you because you may not know when a life-threatening allergic reaction (anaphylactic reaction) may happen. talk to your doctor if you need additional units to keep at work, school, etc. an anaphylactic reaction is a life-threatening allergic reaction that can happen within minutes and can be caused by stinging and biting insects (bees, wasps, hornets, and mosquitoes), allergy shots, foods, medicines, exercise, or other unknown causes. follow
your healthcare provider’s instructions on when to use auvi-q if you have the symptoms of an anaphylactic reaction, which may include the symptoms listed below: trouble breathing wheezing hoarseness (changes in the way your voice sounds) hives (raised reddened rash that may itch) severe itching swelling of your face, lips, mouth or tongue skin rash, redness, or swelling fast heartbeat weak pulse feeling very anxious confusion stomach pain losing control of urine or bowel movements dizziness or fainting tell your family members and others where you keep auvi-q and how to use it before you need it. you may be unable to speak in an allergic emergency. get medical attention immediately after using auvi-q. if you have a serious allergic reaction, you may need more medicine. what is auvi-q? auvi-q is a prescription medicine used to treat life-threatening allergic reactions including anaphylaxis in people who are at risk for or have a history of serious allergic reactions. auvi-q is for immediate self (or caregiver) administration and does not take the place of emergency medical care. you should get emergency medical help right away after using auvi-q. it is not known if auvi-q is safe and effective in children who weigh less than 16.5 pounds (7.5 kg). what should i tell my healthcare provider before using auvi-q? before you use auvi-q, tell your healthcare provider if you: have heart problems or high blood pressure have diabetes have thyroid problems have history of depression have parkinson’s disease have any other medical conditions are pregnant or plan to become pregnant. it is not known if auvi-q will harm your unborn baby. are breastfeeding or plan to breastfeed. it is not known if auvi-q passes into your breast milk. tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. auvi-q and other medicines may affect each other, causing side effects. auvi-q may affect the way other medicines work, and other medicines may affect how auvi-q works. know the medicines you take. keep a list of them to show your healthcare provider and pharmacist when you get a new medicine. how should i use auvi-q? each auvi-q contains only 1 dose of medicine. auvi-q should only be injected into the muscle of your outer thigh. it can be injected through your clothing, if needed. read the instructions for use at the end of this patient information leaflet for information about the right way to use auvi-q. use auvi-q exactly as your healthcare provider tells you to use it. a trainer for auvi-q with a separate trainer instructions for use leaflet is included with auvi-q. additional training resources are available at www.auvi-q.com. practice with the trainer for auvi-q before an allergic emergency happens to make sure you are able to safely use the real auvi-q in an emergency. the trainer for auvi-q does not contain a needle or medicine and can be reused to practice your injection. what are the possible side effects of auvi-q? auvi-q may cause serious side effects. auvi-q should only be injected into your outer thigh. do not inject auvi-q into your: veins buttocks fingers, toes, hands or feet if you accidentally inject auvi-q into any other part of your body, go to the nearest hospital emergency room right away. tell the healthcare provider where on your body you received the accidental injection. rarely, patients who use auvi-q may develop infections at the injection site within a few days of an injection. some of these infections can be serious. call your healthcare provider right away if you have any of the following at an injection site: redness that does not go away swelling tenderness the area feels warm to the touch if you inject a young child or infant with auvi-q, hold their leg firmly in place before and during the injection to prevent injuries. ask your healthcare provider to show you how to properly hold the leg of a young child or infant during an injection. if you have certain medical conditions, or take certain medicines, your condition may get worse or you may have more or longer lasting side effects when you use auvi-q. talk to your healthcare provider about all your medical conditions. common side effects of auvi-q include: fast, irregular, or ‘pounding’ heart beat sweating shakiness headache paleness feelings of over excitement, nervousness, or anxiety weakness dizziness nausea and vomiting breathing problems tell your healthcare provider if you have any side effect that bothers you or that does not go away. these are not all of the possible side effects of auvi-q. for more information, ask your healthcare provider or pharmacist. call your doctor for medical advice about side effects. you may report side effects to fda at 1-800-fda-1088. how should i store auvi-q? store auvi-q at 68° to 77°f (20° to 25°c). do not expose to extreme heat or cold. for example, do not store in your vehicle’s glove box. do not store auvi-q in the refrigerator or freeze. examine contents in the viewing window periodically. solution should be clear. if the solution is discolored (pinkish color or darker than slightly yellow), cloudy or contains solid particles, replace the unit. your auvi-q has an expiration date. replace it before the expiration date. keep auvi-q in the outer case it comes in to protect it from light. keep auvi-q and all medicines out of the reach of children. general information about the safe and effective use of auvi-q: medicines are sometimes prescribed for purposes other than those listed in a patient information leaflet. do not use auvi-q for a condition for which it was not prescribed. do not give auvi-q to other people, even if they have an allergic reaction or the same symptoms that you have. it may harm them. this patient information leaflet summarizes the most important information about auvi-q. if you would like more information, talk to your healthcare provider. you can ask your pharmacist or healthcare provider for information about auvi-q that is written for health professionals. for more information and video instructions on the use of auvi-q, go to www.auvi-q.com or call 1-844-828-8472. what are the ingredients in auvi-q? active ingredient: epinephrine. inactive ingredients: sodium chloride, sodium bisulfite, hydrochloric acid, and water. auvi-q does not contain latex. instructions for use read these instructions for use carefully before you need to use your auvi-q. before you use auvi-q, make sure your healthcare provider shows you the right way to use it. if you have any questions, ask your healthcare provider. if you are administering auvi-q to a young child or infant, hold the leg firmly in place and limit movement prior to and while administering an injection. automated voice instructions auvi-q contains an electronic voice instruction system to help guide you through each step of your injection. if the voice instructions do not work for any reason, use auvi-q as instructed in these instructions for use. it will still work during an allergic reaction emergency. how to use your auvi-q figure a. 1. pull auvi-q up from the outer case. see figure b. do not go to step 2 until you are ready to use auvi-q. if you are not ready to use auvi-q, put it back in the outer case. figure b. 2. pull red safety guard down and off of auvi-q. see figure c. to reduce the chance of an accidental injection, do not touch the black base of the auto-injector, which is where the needle comes out. if an accidental injection happens, get medical help right away. note: the red safety guard is made to fit tight. pull firmly to remove. figure c. 3. place black end of auvi-q against the middle of the outer thigh (through clothing, if needed), then push firmly until you hear a click and hiss sound, and hold in place for 2 seconds. see figure d. only inject into the middle of the outer thigh. do not inject into any other part of the body. if you are administering auvi-q to a young child or infant, hold the leg firmly in place while administering an injection see figure e. figure d. (for auvi-q 0.3 mg and auvi-q 0.15 mg) figure e. (for auvi-q 0.1 mg) note: auvi-q makes a distinct sound (click and hiss) when you push it against your outer thigh. this is normal and indicates auvi-q is working correctly. do not pull auvi-q away from your leg when you hear the click and hiss sound. the needle automatically retracts after the injection is complete, so the needle will not be visible after the injection. auvi-q includes a 2-second countdown after it is activated, then the voice instruction will indicate the injection is complete, and to seek emergency medical attention, auvi-q will beep, and the lights will blink red. 4. get emergency medical help right away. replace the outer case and talk to your healthcare provider about the right way to throw away your auvi-q. ask your healthcare provider for an auvi-q prescription refill. after the use of auvi-q: the black base will lock into place. the voice instruction system will say “seek emergency medical attention”, say “this auvi-q has been used…”, and the lights will blink red. the red safety guard cannot be replaced. the viewing window will no longer be clear. it is normal for some medicine to remain in your auvi-q after you have received your dose of medicine. talk to your healthcare provider about the right way to throw away your auvi-q. auvi-q is a single-use auto-injector and cannot be reused. until you throw away your used auvi-q, the electronic voice instruction system will remind you that it has been used when the outer case is removed. if you will be administering auvi-q to a young child or infant, ask your healthcare provider to show you how to properly hold the leg in place while administering a dose. this patient information has been approved by the u.s. food and drug administration. rev nov 2017 manufactured for: kaleo, inc. richmond, va 23219 usa this product may be covered by one or more u.s. patents or pending patent applications. see www.kaleopharma.com/pat for details. *for california only: this product uses batteries containing perchlorate material – special handling may apply. see www.dtsc.ca.gov/hazardouswaste/perchlorate figure a figure b figure c figure d figure e

Package Label Principal Display Panel:

Principal display panel, outer case label- ndc: 60842-023-01 - 0.3 mg outer case label - ndc: 60842-023-01 - 0.3 mg outer case label auvi-q case label

Principal display panel ndc: 60842-023-01 - 0.3 mg device label - ndc: 60842-023-01 - 0.3 mg device label auvi-q device label

Principal display panel, 51662-1320-1 serialized label 0.3mg serialized label

Principal display panel - ndc: 60842-022-01 - 0.15 mg outer case label - ndc: 60842-022-01 - 0.15 mg outer case label auvi-q 0.15mg case

Principal display panel - ndc: 60842-022-01 - 0.15 mg device label - ndc: 60842-022-01 - 0.15 mg device label auvi-q 0.15mg device label

Principal display panel, 51662-1321-1 serialized 0.15mg label serialized 0.15mg

Principal display panel, 51662-1320-2 serialized labeling serialized 51662-1320-2

Principal display panel - 51662-1320-2 package 51662-1320-2 package labeling

Principal display panel, 51662-1321-2 package labeling 51662-1321-2 product package labeling

Principal display panel, 51662-1321-2 serialized package labeling serialized product labeling

Principal display panel, trainer labeling (1) included with 51662-1320-2 & 51662-1321-2 trainer part 1

Principal display panel, trainer labeling (2) included with 51662-1320-2 & 51662-1321-2 trainer part 2


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* Data of this site is collected from www.fda.gov. This page is for informational purposes only. Always consult your physician with any questions you may have regarding a medical condition.