E-DRUG: Co-trimoxazole prophylaxis for HIV in children (2)
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Dear all,
Murtada rightly observes an increase in the demand for co-trimoxazole
syrups/suspensions.
Although I am not in position to comment on the stability question itself, I
would like to share a related warning regarding these products:
While most (essential) medicines have an expiry date of 3 or 4 years from
the date of production, most reputable manufacturers only give a 2 year
shelf-life to (powders for) co-trimoxazole suspensions. Especially in case
of international supply, it is not unusual to find that half of the shelf
life has already passed by the time it arrives in the country of need and I
have seen many programs in which paediatric co-trimoxazole formulations
ended up expired and had to be destroyed.
Especially in a phase of rapid program expansion, those involved with
quantification, procurement or distribution do well to give extra attention
to the shelf life of (powders for) co-trimoxazole suspensions and syrups.
Although applicable to any product, the following pro-active actions are
especially recommended for those few medicines with shelf lives of 2 years
and less:
* Extra careful, realistic estimation of quantities needed.
* More frequent ordering (rather then ordering a year's supply at once).
* Negotiation with the supplier(s) to obtain a guaranteed minimum remaining
shelf life at the moment of delivery.
* Supply by air rather then by sea. Unfortunately, the low "value per kg" of
this bulky product makes air supply relatively costly. This may be a reason
to look for reliable local manufacturers.
* FEFO adherence (First Expiry First Out)
* Timely signalling and adequate response to situations of excess stock.
I hope this alert may help in preventing waste of this valuable product.
Regards,
Ron Wehrens, MSc., MBA, Pharmacist
Phasuma Consultancy & Training
Pharmaceutical Supply Management
P.O. Box 36083
1020 MB Amsterdam
The Netherlands
Tel + 31 35 6550599
Mobile + 31 6 46293590
Fax-to-email +1 206 350 1182
r.wehrens@phasuma.com
www.phasuma.com
"Ron Wehrens, Phasuma" <r.wehrens@phasuma.com>