Drug safety notice – change of product
December 18, 2017
Due to a long term manufacturing problem with the supply of Clexane (enoxaparin) injections, the pharmacy department have sourced Inhixa, an alternative brand of enoxaparin.
Inhixa is available as prefilled syringes in the following strengths:
2,000 IU (20 mg) in 0.2 mL packaging with BLUE banners
4,000 IU (40 mg) in 0.4 mL packaging with YELLOW banners
6,000 IU (60 mg) in 0.6 mL packaging with ORANGE banners
8,000 IU (80 mg) in 0.8 mL packaging with RED banners
10,000 IU (100 mg) in 1 mL packaging with BLACK banners
Inhixa has the same licensed indications as Clexane, but fewer presentations.
Each syringe is graduated and has a needle safety device.
Safety Considerations:
Risk of needle stick injury – Inhixa has a different needle guard to Clexane
Inhixa pre-filled syringes are fitted with an “active” locking system which requires the plunger to remain pressed down after drug administration and firmly pressed down further after removal of the needle from the site of administration to release the guard over the needle.
The needle guard (plastic cylinder) will only be activated by maintaining pressure on the plunger when withdrawing the needle and pushing on it further. The needle guard will then completely cover the needle. Please note that a significant amount of pressure may be required.
All colleagues administering Inhixa should watch the following clip for further information:
https://www.youtube.com/watch?v=E8AytPojtVI
New Biosimilar – Monitoring required
Inhixa is a new biosimilar product and is subject to additional monitoring as a black triangle drug. Please fill in a yellow card report for any adverse drug reaction noted.
Care when selecting syringes & administering doses– check dose is correct
Inhixa syringe labels may be more difficult to read on the 100mg syringe due to the black banner. Please note the colour of syringes for each strength as above, this may be different to Clexane.
Prescribing
Ensure all enoxaparin is prescribed by brand. Clexane and Inhixa are not interchangeable and should not be automatically substituted. It may be necessary however to switch brands part way through a course to ensure continuity of supply. This should be discussed with the patient and medical team and the correct brand should be represcribed.
Patients who are self-administering
Patients should be assessed to ensure they can operate Inhixa syringes safely. If patients are unable to depress the plunger with enough force to activate the needle guard, they should be prescribed Clexane on discharge if available. If Clexane is not available, then alternative arrangements will need to be made utilising carers or community nursing.
If you have any questions regarding the switchover please contact your ward pharmacist or medicines information.