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From: Alpharma

January 8, 2004

Pharmacists:

We would like to inform you that we have received a number of complaints, mostly from patients, that Purepac's Lorazepam Tablets have crumbled during storage. Our investigation has shown that this may be caused by the use of a well-closed container when dispensing this product. It is important that our Lorazepam Tablets be dispensed in a tight, light-resistant container as required by the U.S. Pharmacopeia (USP) and as stated in our product labeling. The reason for this requirement is that well-closed containers are more permeable to moisture than tight containers, and as  a result, the tablets may break or crumble when exposed to high humidity. For your reference, specifications for multiple-unit dispensing containers can be found in USP 26, Section<671>.

If you have any questions or require further information, please contact our Medical Affairs Department at 1-800-432-8534.

Sincerely,

Robert Sanzen

Sr. Vice President, Sales and Marketing

 

 

                                                          

ABBOTT                                                             Dec   2001

Abbott is aware of the news reports circulating today regarding Synthroid.  Abbott wants to reassure patients, physicians and pharmacists that Synthroid is a safe and effective treatment for hyperthyroidism.  Abbott will be submitting a New Drug Application (NDA) in accordance with FDA guidelines in order to ensure that the eight million patients effectively treated with Synthroid have continued to access to their medication.  Abbott has notified the FDA of its intents to submit its NDA and is working cooperatively with the agency to meet the filling time frames.

Like some other drugs that were marketed before 1962, Synthroid and all other levothyroxine sodium products did not receive formal approval from FDA,  In 1997, FDA issued a Federal Register notice calling for all manufactures of levothyroxine sodium products to either submit an NDA, or to file a citizen petition to show that their products are not new drugs, and therefore do not require a NDA.  In compliance with this notice, Knoll, the manufacturer of Synthroid at the time, filed a citizen petition in 1997 requesting that FDA acknowledge that Synthroid could be given a legal designation, "generals recognized as safe and effective." (GRASE/E)

Abbott obtained Synthroid on March 2, 2001, through its acquisition of BASF Pharma/Knoll.  On April 27, 2001 FDA informed Abbott that it would not grant GRAS/E status for Synthroid under Knoll's citizen petition.  Abbott Laboratories promptly responded that it would submit an NDA for Synthroid.

Synthroid is the leading levothyroxine sodium product that has been trusted by physicians and patients for 42 years.  The safety and efficacy of Synthroid has been extensively studied and validated.  The results of these studies have been published in prominent peer-review journals such as New England Journal of Medicine.  The place of Synthroid in clinical practice is well established as a trusted therapy by physicians, and by the more than eight million patients with hypothyroidism depend on it every day.

"Synthroid is a tried and trusted product with decades of use and physicians and patients should continue to have confidence in Synthroid," Said Leonard Wartofsky, M.D., chairman, Department of Medicine, Washington Hospital Center, Washington, D.C.  "It would be dangerous for patients if Synthroid were removed from the market."

Physicians and patients should understand that FDA has not made a determination that any levothyroxine sodium product, on the market with or without NDAs, are interchangeable with another.  Therefore, these products have not been determined to be therapeutically equivalent by FDA.  The FDA publication Approved Drug Products with Therapeutic Equivalence Evaluations, does not list any levothyroxine sodium products as therapeutically interchangeable.  Switching from Synthroid to another levothyroxine sodium product would require individual alteration by a physician.

As part of the delicate endocrine system, the thyroid gland impacts essentially every cell, tissue, and organ in the body. Guidelines  several endocrinology organizations, such as the American Association of Clinical Endocrinologist (AACE), state that, once established, thyroid patients should be maintained on the same brand of medication throughout the treatment.  If changes in the medication brand are made, costly re-testing must occur to ensure proper dose adjustment treatment.

Thyroid hormones, either alone or together with other medications, should not be used for the treatment of obesity, and should not be taken by patients with untreated thyroticosis (excess of thyroid hormone), uncorrected adrenal insufficiency, or apparent hypersensitivity to thyroid hormones or any inactive product constituents.  Adverse events to Synthroid other that those related to thyrotoxicosis as a result of overdose are rare:  however, if a patient experiences any unusual symptoms, he or she should consult with their health care provider.

Abbott Laboratories is a global, diversified health care company devoted to the discovery, development, manufacture, and marketing of pharmaceuticals, nutritional, and medical products, including devices and diagnostics.  The company employs approximately 70,000 people and markets it products in more than 130 countries.

Abbott's news release and other information are available on the company's web site at 

http://www.abbott.com.

Responses to Synthroid News Reports for Pharmacists

Q:      Will Synthroid remain available?

A:       Abbot will be submitting a New Drug Application (NDA) in accordance with the FDA guidelines as part of its commitment to providing continued access to Synthroid to the eight million patients who rely on it everyday.  Abbott has notified the FDA of its intent to submit its NDA and is working cooperatively with the agency to meet the filing timeframes.

Q:       Can I continue to fill Synthroid prescriptions?

A:        Synthroid continues to be available for patients.  Abbott Laboratories reminds you of Synthroid's long history of clinical use in millions of patients.   Abbott wants patients, physicians and pharmacists to know that the clinical use of Synthroid has been extensively studied.  The results of these studies have been published in prominent peer-reviewed journals such as the New England Journal of Medicine.  More than eight million patients with hypothyroidism depend on Synthroid everyday.

Q:       What should pharmacists tell patients?

A:       Synthroid continues to be available for patients.  Patients should discuss this matter with their physician if they have other concerns.

            Physicians and patients should understand that FDA has not determined that any levothyroxine sodium product, on the market with or without and NDA, in interchangeable with another.  Therefore, these products have not been determined to be therapeutically equivalent by FDA.  The FDA publication, Approved Drug Products with Therapeutic Equivalence Evaluations (Orange Book), does not list any levothyroxine sodium products as therapeutically interchangeable.

            As part of the delicately-balanced endocrine system, the thyroid gland impacts the entire body.  Guidelines of several endocrinology organizations, such as the American Association of Clinical Endocrinologists (AACE), state that, once stabilized, thyroid patients should be maintained on the same brand of medication throughout treatment.  Switching brands requires re-testing in order to ensure proper dose adjustment.

Q:      Why doesn't Synthroid have FDA approval?

A:        Like some other drugs that were marketed before 1962, Synthroid and all other levothyroxine sodium products did not receive formal approval from FDA.  In 1997, FDA issued a Federal Register notice calling for all manufactures of levothyroxine sodium products to either submit and NDA, or to file a citizen petition to show that their products are not new drugs, and therefore do not require and NDA.  In compliance with this notice, Knoll, the manufacturer of Synthroid at the time, filed a citizen petition in 1997 requesting that FDA acknowledge that Synthroid could be given in a legal designation, "generally recognized as safe and effective." (GRAS/E).

 

Abbott obtained Synthroid on March 2, 2001, through its acquisition of BASF Pharma/Knoll.  On April 27, 2001 FDA informed Abbot that it would not grant GRAS/E status for Synthroid under Knoll's citizen petition.  Abbot Laboratories promptly responded that it would submit an NDA for Synthroid.

Clinical Use and Safety Information

Synthroid is used to treat hypothyroidism.  Thyroid hormones, either alone or together with other medicines, should not be used for the treatment of obesity, and should not be taken by patients with untreated thyrotoxlcosis (excess of thyroid hormone), uncorrected adrenal insufficiency, or apparent hypersensitivity to thyroid hormones or any inactive product constituents.  Adverse events to Synthroid other that those related to thyrotoxlcosis as a result of overdosage are rare; however, if a patient experiences any unusual symptoms, he or she should consult with their health care provider.

Please see Synthroid Full Prescribing Information go to Abbott.com

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