Tubersol expiration --> was RE: Re: which vaccines giving in office to over 5

[Guest guest]

RE: expiration of Tubersol after opening...insert says...

http://www.vaccineshoppe.com/US_PDF/752-21_4611.pdf

HOW SUPPLIED

Vial - 5 TU 1 mL - NDC# 49281-752-21

Vial - 5 TU 5 mL - NDC# 49281-752-22

TUBERSOL® solutions do not require further dilution.

STORAGE

Store at 2º to 8ºC (35º to 46ºF).6,21 DO NOT FREEZE. Discard product if exposed to freezing. Tuberculin solutions can be adversely affected by

exposure to light. The product should be stored in the dark except when doses are actually being withdrawn from the vial.22

A VIAL OF TUBERCULIN PPD WHICH HAS BEEN ENTERED AND IN USE FOR 30 DAYS SHOULD BE DISCARDED BECAUSE OXIDATION AND

DEGRADATION MAY HAVE REDUCED THE POTENCY.23

Do not use after expiration date.

Locke, MD

[Guest guest]

I just wonder if that 30

day thing is fax or just fiction created by the manufacturer?  We all know that

drug samples do not really expire as quickly as the manufacturer claims.   I

find it hard to believe that the majority of doctor’s offices are really

throwing those PPD vials out every 30 days.  I can’t help but wonder if

that is not similar to the adage “don’t use a cell phone while

pumping gas as it might cause a fire?”

Tubersol expiration

--> was RE: Re: which vaccines giving in office to over

5

RE: expiration of

Tubersol after opening...insert says...

http://www.vaccineshoppe.com/US_PDF/752-21_4611.pdf

HOW SUPPLIED

Vial - 5 TU 1 mL - NDC# 49281-752-21

Vial - 5 TU 5 mL - NDC# 49281-752-22

TUBERSOL® solutions do not

require further dilution.

STORAGE

Store at 2º to 8ºC (35º to 46ºF).6,21 DO NOT

FREEZE. Discard product if exposed to freezing. Tuberculin solutions can be

adversely affected by

exposure to light. The product should be stored in

the dark except when doses are actually being withdrawn from the vial.22

A VIAL OF TUBERCULIN PPD WHICH HAS

BEEN ENTERED AND IN USE FOR 30 DAYS SHOULD BE DISCARDED BECAUSE OXIDATION AND

DEGRADATION MAY HAVE REDUCED THE POTENCY.23

Do not use after expiration date.

Locke, MD

[Guest guest]

According to this research article, it's not fiction, although maybe it doesn't have to be a strict 30 day cutoff:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=AbstractPlus & list_uids=3609454 & query_hl=1 & itool=pubmed_docsumEffect of oxidation on the stability of tuberculin purified protein derivative (PPD).It was shown that the presence of air in the headspace of multidose vials containing a dilute tuberculin PPD solution contributed to the lowering of its potency by approximately 50% over a period of 4 months at 5 degrees C, and that thereafter the potency remained constant for up to 12 months.  SetoSouth Pasadena, CAI just wonder if that 30 day thing is fax or just fiction created by the manufacturer?  We all know that drug samples do not really expire as quickly as the manufacturer claims.   I find it hard to believe that the majority of doctor’s offices are really throwing those PPD vials out every 30 days.  I can’t help but wonder if that is not similar to the adage “don’t use a cell phone while pumping gas as it might cause a fire?”  -----Original Message-----From: [mailto: ] On Behalf Of Locke's in ColoradoSent: Sunday, November 26, 2006 6:43 PMTo: Subject: Tubersol expiration --> was RE: Re: which vaccines giving in office to over 5 RE: expiration of Tubersol after opening...insert says...  http://www.vaccineshoppe.com/US_PDF/752-21_4611.pdfHOW SUPPLIEDVial - 5 TU 1 mL - NDC# 49281-752-21Vial - 5 TU 5 mL - NDC# 49281-752-22TUBERSOL® solutions do not require further dilution.STORAGEStore at 2º to 8ºC (35º to 46ºF).6,21 DO NOT FREEZE. Discard product if exposed to freezing. Tuberculin solutions can be adversely affected byexposure to light. The product should be stored in the dark except when doses are actually being withdrawn from the vial.22A VIAL OF TUBERCULIN PPD WHICH HAS BEEN ENTERED AND IN USE FOR 30 DAYS SHOULD BE DISCARDED BECAUSE OXIDATION ANDDEGRADATION MAY HAVE REDUCED THE POTENCY.23Do not use after expiration date.  Locke, MD

[Guest guest]

It would seem that by increasing the dosing after one month that one could get the same reliability then. Dang, I hate it when logic makes sense but the practice of medicine runs in the opposite direction!

Lynette I Iles MD 210 South Iowa Ste 3 Washington IA 52353 Flexible Family Care 'Modern medicine the old-fashioned way' This e-mail and attachments may contain information which is confidential and is only for the named addressee. If you have received this email in error, please notify the sender immediately and delete it from your computer.

[Guest guest]

I had the same thought, but figured there

are no studies to decide the validity of such a test. (Are the mm the same, if the

amount of fluid injected is more?) Could this be an area of research for

primary care?

Ramona Seidel, MD

From: [mailto: ] On Behalf Of Lynette Iles

Sent: Monday, November 27, 2006

7:32 PM

To:

Subject: Re: Tubersol expiration

--> was RE: Re: which vaccines giving in office to

over 5

It would seem that by increasing the dosing after one month that one

could get the same reliability then. Dang, I hate it when logic makes sense but

the practice of medicine runs in the opposite direction!

Lynette I Iles MD 210 South Iowa Ste 3 Washington IA 52353 Flexible

Family Care 'Modern medicine the old-fashioned way' This e-mail and attachments

may contain information which is confidential and is only for the named

addressee. If you have received this email in error, please notify

the sender immediately and delete it from your computer.

[Guest guest]

Another alternative would be to make prefilled TB syringes for single use only, but that probably makes too much sense. SetoSouth Pasadena, CAI had the same thought, but figured there are no studies to decide the validity of such a test. (Are the mm the same, if the amount of fluid injected is more?) Could this be an area of research for primary care? Ramona Seidel, MD From: [mailto: ] On Behalf Of Lynette IlesSent: Monday, November 27, 2006 7:32 PMTo: Subject: Re: Tubersol expiration --> was RE: Re: which vaccines giving in office to over 5 It would seem that by increasing the dosing after one month that one could get the same reliability then. Dang, I hate it when logic makes sense but the practice of medicine runs in the opposite direction! Lynette I Iles MD 210 South Iowa Ste 3 Washington IA 52353 Flexible Family Care 'Modern medicine the old-fashioned way' This e-mail and attachments may contain information which is confidential and is only for the named addressee.  If you have received this email in error, please notify the sender immediately and delete it from your computer.

[Guest guest]

What if

you don’t shoot the air in and just suck the serum out. If it is the air

that causes it to degrade, then don’t put any in. Yes, the last couple

might be hard to get out, but I would think by that time you are “wasting”

a lot less vaccine. Thoughts?

Re: Tubersol expiration --> was RE: Re: which vaccines giving in

office to over 5

It would seem

that by increasing the dosing after one month that one could get the same

reliability then. Dang, I hate it when logic makes sense but the practice of

medicine runs in the opposite direction!

Lynette I Iles

MD 210 South Iowa Ste 3 Washington IA 52353 Flexible Family Care 'Modern

medicine the old-fashioned way' This e-mail and attachments may contain

information which is confidential and is only for the named

addressee. If you have received this email in error, please notify

the sender immediately and delete it from your computer.

[Guest guest]

My thoughts exactly. In fact yesterday,

when I opened a new Tubersol vial after throwing out the one that was 32 days

open, I did just that. I wonder how much degradation there is in 1 month, 2

months, etc. It only tells 50% reduction in 4 months. But until someone does

a study, we might be doing less than diagnostic tests.

Kathy Saradarian, MD

Branchville, NJ

Solo low-staff practice since

4/03

In practice since 9/90

Practice Partner User since 5/03