The DrugSmith is The Monthly Newsletter of The Smith Drug Company A Division of J M Smith Corporation Spartanburg, SC • Paragould, AR • Valdosta, GA

Men's Health Month Cataract Awareness Month

Statin Use In Diabetes • Continuing Education Stops The Sting • Russell Stover Ordering Change

Smith Drug Company will be closed Monday, July 4th, in observance of Independence Day. Please order accordingly! Statin Use In Diabetes By: Larry Kobiska, RPh, BS, PharmD, Senior Director Professional Pharmacy Service, Smith Drug Company The literature support for the benefits of statins has grown since their introduction to the market in 1987. Numerous trials have proven the reduction of morbidity and mortality in patients with heart disease. Additionally, the benefits of the use of statins in patients with Type 2 Diabetes has been demonstrated in numerous trials encompassing thousands of patients. Both the American Diabetes Association (ADA) Standard of Medical Care in Diabetes and the American College of Cardiology/American Heart Association (ACC/AHA) Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults recommend the use of statins in Type 2 Diabetes for the reduction of morbidity and mortality. Both groups recommend the use of statins in patients aged 40-75 years with Type 2 Diabetes for the primary prevention of atherosclerotic cardiovascular disease (ASCVD). Meta-analysis from 14 randomized trials including more than 18,000 patients with Type 2 diabetes, demonstrated a 9% proportional reduction in all-cause mortality and a 13% reduction in vascular mortality for each 39mg/dl reduction in LDL cholesterol. Three random controlled trials for the primary prevention of ASCVD are cited by the ACC/AHA guideline. In patients 40-75 years of age, with LDL-C 70-189 mg/ dl, and an estimated 10 year risk of ASCVD of greater than or equal to 7.5%, a high level of risk reduction was found. As Type 2 diabetes in and of itself increases the risk for ASCVD, the ADA guideline suggests that calculating the 10 year risk of ASCVD may have limited use in patients with Type 2 diabetes. The ADA guideline recommends the use of a statin in all patients with Type 2 Diabetes, regardless of LDL-C level. One may reason that considering the high proportion of dyslipidemia in patients with Type 2 diabetes, most patients would likely have an LDL-C level greater than 70mg/dl. In Type 2 diabetic patients greater than 75 years of age and no other risk factors, there is limited data in the primary prevention of ASCVD. However, statin therapy for other risk factors or for secondary prevention remains recommended. For patients 40-75 years of age with no other risk factors, moderate intensity statin therapy should be initiated. For those with risk factors, high intensity statin therapy should be initiated. See the charts on the following page. Secondary to this compelling evidence, statin use in patients with diabetes is a quality measure for 5-Star Ratings. Pharmacist intervention for these patients provides a large opportunity to increase the quality of care for patients with Type 2 diabetes by decreasing both morbidity and mortality.

Reference: 2016 American Diabetes Association (ADA) Standard of Medical Care in Diabetes, Diabetes Care Vol 39, Sup 1, Jan 2016

2 Table 8.1 Recommendations for Statin and Combination Treatment in People with Diabetes Reference: 2016 American Diabetes Association (ADA) Standard of Medical Care in Diabetes, Diabetes Care Vol 39, Sup 1, Jan 2016

Age Risk Factors Recommended Statin Intensity None None <40 Years ASCVD risk factor(s)** Moderate or high ASCVD High None Moderate ASCVD risk factors High ASCVD High 40-75 Years ACS and LDL cholesterol >50mg/dl Moderate plus ezetimibe in patients who cannot tolerate high dose statins

None Moderate ASCVD risk factors Moderate or High ASCVD High >75 ACS and LDL cholesterol >50mg/dl Moderate plus ezetimibe in patients who cannot tolerate high dose statins *In addition to lifestyle therapy. **ASCVD risk factors include LDL cholesterol >=100 mg/dL (2.6 mmol/L), high blood pressure, smoking, overweight and obesity, and family history of premature ASCVD.

Table 8.2 High-Intensity and Moderate-Intensity Statin Therapy Reference: 2016 American Diabetes Association (ADA) Standard of Medical Care in Diabetes, Diabetes Care Vol 39, Sup 1, Jan 2016

High-intensity statin therapy Moderate-intensity statin therapy (Lowers LDL cholesterol >= 50%) (Lowers LDL cholesterol 30%-50%)

Atorvastatin 40-80mg daily Atorvastatin 10-20mg daily Rosuvastatin 20-40mg daily Rosuvastatin 5-10mg daily Simvastatin 20-40mg daily Pravastatin 40-80mg daily Lovastatin 40mg daily Fluvastatin XL 80mg daily Pitavastatin 2-4mg daily

3 Tresiba® U-200 FlexTouch®—2 to 160 units in a single injection (in 2-unit increments)

® ® U-100 Also available in Tresiba U-100 FlexTouch —Maximum dose of 80 units per injection (in 1-unit increments)

® ® 76 For both the Tresiba U-100 and U-200 FlexTouch pens, the dose window shows the number of units to be delivered

Tresiba® FlexTouch® has no push-button extension, regardless of dose

OR O M E T N H Y A A N ® P $ With the Tresiba Instant Savings Card, eligible patients can pay no more P 15 E N ® a R O P TI RESCRIP than $15 per Tresiba prescription – Patients can apply either by going online to Tresiba.com or by calling 1-855-834-3466. Patients should activate the card before filling their prescription a Eligibility and other restrictions apply. Offer valid for select Novo Nordisk products. Offer not valid for patients enrolled in any government, state, or federally funded medical or prescription benefit program, including Medicare, Medicaid, VA, DoD, and TRICARE®. The federal employee health benefits program is not a federal or state government health care program for purposes of this savings program. Offer is valid for a maximum benefit of $500/month. Card is valid for up to 24 prescriptions. Complete details are provided with the card. Explore additional Tresiba® support resources at TresibaPro.com

Needles are sold separately and may require a prescription in some states. Needles and FlexTouch® are for single patient use only. FlexTouch® and Tresiba® are registered trademarks of Novo Nordisk A/S. Novo Nordisk is a registered trademark of Novo Nordisk A/S. TRICARE® is a registered trademark of the Department of Defense (DoD), DHA. © 2016 Novo Nordisk All rights reserved. USA16TSM00594 April 2016 Healthwise™ Clinical Solutions Healthwise™ Circular Program DollarWise™ Program Good Sense® Controlled Label Program Greeting Cards Program Continuing Education Gift and Trade Show Rx QuickShip™ Third Party Station Pharmacy First DrugSmith™ Monthly Newsletter ON THE INSIDE Smith Weekly e-Blast Diabeticare Program Hamacher Retail Zone Pricing Statin Use in Diabetes 2 Home Health Care Catalog Men's Health Month: Get Screened 6 HealthWise Signage Program Men's Health Facts 8 Smith Gift Box Gift Category Vials and Vitamin Program 2016 Continuing Education Curriculum 9 Direct Mail Advertising Cataract FAQs 10 Well Staffed Customer Service Excellent Service Levels Pharmacy Solutions: Drug Name Change 11 Store Fixture Program Russell Stover Ordering Procedure Change 11 Merchandising Services New Product: Stops The Sting™ 12 Spotlight Program Repeat Rewards Loyalty Cards The Smith Drug CE/Gift & Trade Show 15

The Entire

family would like to take this opportunity to congratulate RANDY LAWTER on his recent retirement, after 25 years of service. We wish you peace and enjoyment for years to come! IT'S ALWAYS TIME FOR ROUTINE SCREENING. The Importance of Routine Screening:

It is important to diagnose a health issue before it starts or when it is at its initial stage. One has to take the right treatment at the right time that helps to increase the chances of a long and healthy life. In this regard, health screenings can give you a proper report of your health status.

Important exams and screening for men’s health:

Traditionally, men are not concerned with their health issues and remain less interested in routine health checkups. But the fact is, men die earlier than women, as their life expectancy is lower than women. Cancer rates are found more in men compared to women, and many other men’s health issues are also on the same page. So, here we discuss about six necessary screenings for men’s health that include:

Blood Pressure Test:

The body’s strength applies by the heart to drive blood throughout your body, a function denoted by the blood pressure. If your blood pressure reading comes 120/80 then it’s normal and you are healthy but, if the reading consistently comes 140/ 90 i.e. you have high blood pressure, then there is always a risk of heart attack, stroke and also kidney diseases. During low blood pressure, you feel dizziness, fainting and lightheadedness.

A blood pressure test is very simple and quick. You can even check it at your home. In case you find any sign of doubt then consult your doctor, he can prescribe you medicines or suggest changing your lifestyle. Some particular practices like losing weight, change in eating habits, exercising, etc. are highly recommended to control blood pressure.

Cholesterol Test:

Cholesterol is a fat found in the blood. It is good as well as bad. Low-Density Lipoprotein (LDL) is the bad cholesterol and unhealthy for you, while High-Density Lipoprotein (HDL) is the good cholesterol. According to medical science, 200 mg per dL is perfect. But, the range of cholesterol is below 100 mg per dL and above 240 mg per dL indicates a risk to men’s health. High levels of cholesterol cause heart attack and stroke. The amount of cholesterol is checked by the blood test. Before the test you can't drink or eat anything for approx 9 hours, to ensure accurate results.

6 Prostate Cancer Screening: Skin Cancer Check:

This type of cancer grows in the gland in the male Men’s skin is three times more influenced by the risk of reproductive system; this disease only affects men. As per skin cancer than women’s. Major types of skin cancers the research, 80% of men in their eighties are affected by are basal, squamous and melanoma. There are some skin a symptom of prostate cancer. The primary symptoms of tests to check the presence of any possible skin problem. this disease are: Skin cancer can be prevented by less exposure to sunlight, so you have to cover your body with clothes and • Painful urination use sunscreen protection before going out. • Painful ejaculation • Frequent Urination Diabetes Test: • Difficulty in achieving erection Diabetes is caused due to increased level of sugar in the • Leg weakness blood. To diagnose the blood sugar, doctors suggest • Spine, pelvis or ribs can be painful some blood tests, such as: A screening of prostate once in two years is beneficial to know its status if any. Doctors do two exams, first is • A1C test prostate specific antigen (PSA) test which shows four If it is less than 5.7%, then it’s normal, and 6.5% shows nanograms /milliliter for healthy men and, second, is diabetes. Digital Rectal Exam in which a doctor physically checks your rectum for cancer signs. Prostate Cancer is one • FPG (Fasting Plasma Glucose test) of the major men’s health issues. It requires a lot of Less than 100 mg/dl means healthy and at least 126 mg/dl preventions and changes in daily lives. Doctors may means diabetes. suggest you to go for vegetables and fruits, meditation, yoga and regular exercise beside some medicines. • OGTT (Oral Glucose Tolerance test) Less than 140 mg/dl indicates normal and at least 200 Colon Cancer Screening: mg/dl indicates diabetes.

This cancer begins in the colon or rectal. Colon cancer Get Involved: is also known as colorectal cancer, which grows when healthy cells get damaged in the colon and continuously As a Healthwise Community Pharmacy, this is a golden divide into cancerous cells and demolish normal tissue. opportunity to talk to your male customers either directly, Colonoscopy method is used to diagnose the whole colon or through their spouses, mothers or siblings. If you offer and rectum. Virtual colonoscopy is also done in which BP testing, you're ahead of the game. If not, pass this CT scan images show a clear inside view of the colon. To knowledge on as your own, and gain the confidence, trust reduce the risk of colon cancer, doctors suggest: and value, that all health conscious people are looking for in a pharmacist. • High intake of vegetables, fruits and whole grains • Avoid smoking You can also get involved by participating and promoting • Avoid alcohol or take in moderate amounts WearBlueDay on June 17. Find out how you can get • Do more exercise involved by visiting www.menshealthmonth.org.

• Maintain a healthy weight Source: menshealth.org

7 June is Men’s Health Month

01 02 03 Eat Healthy. Get Moving. Make Prevention a Priority. Start by taking small steps like Play with your kids or grandkids. Many health conditions can be saying no to super-sizing and yes Take the stairs instead of the detected early with regular checkups to a healthy breakfast. Eat many elevator. Do yard work. Play a sport. from your healthcare provider. different types of foods to get all the Keep comfortable walking shoes Regular screenings may include vitamins and minerals you need. handy at work and in the car. Most blood pressure, cholesteral, glucose, Add at least one fruit and vegetable importantly, choose activities that prostate health and more. to every meal. you enjoy to stay motivated.

“Recognizing and preventing men’s health problems is not just a man’s issue. Because of its impact on wives, mothers, daughters, and sisters, men’s health is truly a family issue.” — Congressman Bill Richardson (May 1994)

ONLINE RESOURCES 100% 1994 Men’s Health Month Women are 100% more likely than On May 31, 1994 President Bill MensHealthMonth.org men to visit the doctor for annual Clinton signed the bill establishing Men’s Health Network exams and preventative services. National Men’s Health Week. MensHealthNetwork.org Get It Checked GetItChecked.com 1 in 2 88.9 Talking About Men’s Health Blog TalkingAboutMensHealth.com 1 in 2 men are diagnosed with In 2010, there were 88.9 men cancer in their lifetime compared for every 100 women in the Men’s Health Resource Center MensHealthResourceCenter.com with 1 in 3 women. age group 65-69. AWARENESS • PREVENTION • EDUCATION • FAMILY MensHealthMonth MensHealthMonth [email protected] 8 MENSHEALTHMONTH AWARENESS. PREVENTION. EDUCATION. FAMILY. The Smith Drug Company 12TH Annual CE/Gift & Trade Show • July 15-17 [Tentative schedule and subjects to be covered. More information to follow.] Friday, 7/15/2016 • Managing COPD • Developing a Medication Synchronization and Monitoring Program • Preventing Chronic Diabetes Complications (not approved for Pharmacy Techs).

Saturday, 7/16/2016 • MTM Program in Diabetes • SDC/DEA sponsored program on being “Gate Keeper of Drugs” NOTE: There will be a special presentation made by Diplomat on opportunities for today’s pharmacy on Specialty drugs. You don’t want to miss this! Learn how you can become a Specialty Pharmacy and “Move Forward” by keeping in touch with the latest practices in pharmacy. (At time of print not determined whether it is CE approved.)

Sunday, 7/17/2016 • Prevention of Opioid Overdose/HIV • Immunization Updates • Law Class • Appointment Based Model Pharmacy All Classes are ACPE approved except for the luncheon on Friday and the presentation by Diplomat on Saturday.

Be sure to join us at breakfast and lunch breaks for Smith Management and clinical pharmacy services experts keeping you informed on turn-key pharmacy solutions. We look forward to seeing you there!

GET A HEAD START ON COLD & FLU SEASON! COMING IN JULY 2016!

9 FAQ's In developed countries like the United States, cataract blindness is rare because treatment is accessible. However in developing countries, where medical treatment may be difficult to obtain, cataracts often lead to blindness. In fact, 51% of global blindness - mostly in the developing world - are due to untreated cataracts.

Who is at risk? What happens after surgery?

Older people are generally more at risk of developing cataracts Recovery time after cataract surgery is usually about six weeks, but than younger people. Approximately 60% of people ages 60 and most discomfort should subside after a day or two. Immediately older have their vision significantly affected by cataract formation. following surgery, the patient may experience some pain and For people over age 55, cataracts are the leading cause of vision irritation of the eye. Many patients also experience increased light loss. sensitivity and a small amount of fluid discharge. Special pills and eye drops may be prescribed to promote healing and regulate the Diabetes, heredity, eye trauma and certain medications can pressure inside the eye. Pain relievers may also be taken during accelerate cataract development, and there is some evidence that the first few days if necessary. Follow-up exams allow the physician smoking can also accelerate cataract development. to monitor patient progress. Sunglasses or eye shields can help protect the eye while it is healing.

How is a cataract diagnosed? What is the chance of having normal vision again? Cataracts are usually detected during an examination by a qualified ophthalmologist. Eye Surgical Associates has many After surgery, there will be a period of recovery while the eyes ophthalmologists qualified to diagnose cataracts. Regular adjust to seeing without the cataract. If only one eye is treated, the appointments are important for early detection of cataracts. Some eyes must learn to work together again. Many everyday activities of the standard eye tests that may be used to diagnose cataracts can be resumed soon after surgery, although patients may include: experience blurry vision for a time. Driving may be impractical and unsafe at first; your physician will advise you on the appropriate • Visual acuity test - A chart is used to evaluate how well the time to begin driving again. Also, patients who receive intraocular patient sees at multiple distances. lenses (IOLs) may notice some color distortion at first. This should • Pupil dilation - Eye drops widen the pupil so that the lens and resolve itself within a few months, as the eyes adjust to the new, retina can be better examined. clear lenses of the IOLs. • Tonometry - Fluid pressure in the eye is gauged in this exam, which also helps detect glaucoma. Most people will still require reading glasses, bifocals or contacts after cataract surgery, despite the improvement in vision that the How effective is cataract surgery? procedure offers. However, Eye Surgical Associates is proud to offer a new generation of Advanced Lenses that can significantly reduce According to the American Society of Cataract and Refractive or even eliminate the need for reading glasses. Surgery (ASCRS), 98% of cataract surgeries are considered successful. Risk is even lower in patients who undergo the advanced procedures available from Eye Surgical Associates, both of which leave the eye’s capsule intact. Most patients report improved vision and few complications.

10 MAKING PHARMACY NEWS New Seasonal Candy ORDERING PROCEDURE

Brintellix (vortioxetine) Renamed Trintellix (vortioxetine) in U.S. to Avoid Name Confusion Deerfield, Ill., and Osaka, Japan (May 2, 2016) – Takeda Please make note, that beginning Pharmaceuticals U.S.A., Inc., a wholly-owned subsidiary of Takeda Pharmaceutical Company Limited (TSE:4502) with the Halloween Seasonal candy (collectively “Takeda”), and Lundbeck announced today that Brintellix (vortioxetine) will be marketed in the United States catalog that you will be receiving, under the new name Trintellix (vortioxetine) starting in June all seasonal candy will be following of 2016. The vortioxetine product is a prescription medicine approved to treat Major Depressive Disorder (MDD) in adults. this new procedure: The formulation, indication and dosages of Trintellix remain the same as that of Brintellix.

This name change comes after receiving reports of name confusion in the marketplace between Brintellix and the anti- blood clotting therapy Brilinta® (ticagrelor). In response, Takeda and Lundbeck, in coordination with the U.S. Food and Drug Administration (FDA), determined that a name change would • All orders will be pre- be the best way to minimize future product name confusion by booked and shipped patients and providers. to you one time, each individual holiday “Though the original name was fully screened prior to launch, after learning about name confusion issues with Brintellix season. and Brilinta, we quickly took action to educate healthcare professionals and pharmacies about the potential for name confusion,” said Thomas Harris, Vice President Global Regulatory • Pre-book orders for Affairs at Takeda. “Takeda and Lundbeck then proactively worked with the FDA and decided to change the name of our Halloween must be product as we believe this action will help minimize future risk of returned by June 15, patients inadvertently receiving the incorrect medication.” 2016.

“Even though the name of the product is changing, together with Takeda, we will work to ensure providers and patients are aware that the vortioxetine product itself has not changed. It’s • Fax your orders to still the same medication, dosing and expected outcomes,” said 800.831.1216 Gregg Pratt, Vice President, U.S. Regulatory Affairs at Lundbeck.

“Patient safety is our utmost priority at Takeda and Lundbeck,” said Ramona Sequeira, President, U.S. Business Unit at Takeda. • There are no returns for “Together, with our partners at Lundbeck, we will initiate a candy orders. robust communication campaign and actively work to ensure that patients, healthcare professionals and pharmacies have uninterrupted access to this important medication. We believe these actions speak to our goals of building our business around • Please place one order patients, trust and reputation.” for the entire applicable During the transition period this summer, healthcare providers holiday season. can still prescribe, and patients will still have access to, the product under its current brand name. The newly named Trintellix will be available in June 2016. Additionally, markings on the Trintellix tablets will be identical to the markings on tablets prior to the name change. Trintellix will have new National Drug Code (NDC) numbers associated with the product. Individuals and healthcare professionals who have questions about Brintellix, This new ordering procedure is only Trintellix and/or the name change, should contact Takeda at 1- 877-TAKEDA-7. applicable to seasonal candy. Russell Errors involving Brintellix/Trintellix or any other products should be reported Stover everyday candy is not affected. to the FDA MedWatch program online at www.fda.gov/medwatch.

11 DoctorRecommended! Insect stings and bites are both painful and irritating, but there’s a new product that quickly helps with that problem.

“Stops the Sting™!” is a soothing ointment that neutralizes toxins from insect bites and stings. It is not a scrub or ammonia based product and is safe for all ages.

Stops the Sting™ can help treat the pain and blistering of fire ant stings, as well as the pain of bee, wasp and jellyfish stings. It also stops the itching and swelling of mosquito bites.

When using Stops the Sting™, simply remove the stinger if necessary, and apply directly on the bite or sting, then rub gently. Re-apply as necessary.

The active ingredient in Stops the Sting™ is colloidal oatmeal. Inactive ingredients include Kaolin, Triethanolamine, Diethanolamine and water.

Easy to use and convenient to carry. Pack Stops the Sting!™ in your handbag, first aid kit, glove compartment, golf bag or the family camping gear.

Get fast, complete relief from the pain, itching and swelling from insect bites and stings with Stops the Sting!™

Fast Relief from:

Insect Bites and Stings Wasps Hornets Bees Fire Ants Jellyfish Smith # 628792 12 VACATIONS HAPPEN. Be Prepared.

being prepared means having a plan to: • Avoid known allergens • Know what symptoms to watch for • Use an EpiPen® (epinephrine injection) Auto-Injector if a life-threatening (severe) allergic reaction occurs • Get emergency medical help right away

have epipen® auto-injectors wherever you may need them Family vacations can be full of surprises, so have access to two EpiPen® Auto-Injectors wherever you go. Why two? Because 1 in 5 people will need a second dose of epinephrine to treat a severe reaction. If a third dose is required for a single episode, it should be administered only under direct medical supervision.

Pay as little as $0* every time you fill your EpiPen® Auto-Injector prescription with our savings card. Download your card at epipencoupon.com

* Eligibility Terms and Restrictions apply. Remember to keep your EpiPen® Auto-Injectors See full Terms and Conditions at epipencoupon.com. at room temperature (68° to 77°F). They should not be stored in extreme heat or cold. important safety information important safety information (continued) EpiPen® (epinephrine injection) 0.3 mg and EpiPen Jr® shakiness, headache, apprehension, nervousness or anxiety. (epinephrine injection) 0.15 mg Auto-Injectors contain a single These side effects may go away if you rest. Tell your healthcare dose of epinephrine, which you (or your caregiver or others who professional if you have any side effect that bothers you or may be in a position to administer EpiPen® or EpiPen Jr®) inject that does not go away. into the middle of your outer thigh (upper leg) (through clothing, if necessary). Get emergency medical help right away. You may indications need further medical attention. Only a healthcare professional EpiPen® and EpiPen Jr® Auto-Injectors are for the emergency should give additional doses of epinephrine if you need more treatment of life-threatening allergic reactions (anaphylaxis) than two injections for a single anaphylactic episode. DO NOT caused by allergens, exercise, or unknown triggers; and for INJECT INTO YOUR VEINS, BUTTOCKS, FINGERS, TOES, people who are at increased risk for these reactions. EpiPen® HANDS OR FEET. In case of accidental injection, please seek and EpiPen Jr® are intended for immediate administration as immediate medical treatment. Epinephrine should be used with emergency supportive therapy only. Seek immediate emergency caution if you have heart disease or are taking certain medicines medical help right away. that can cause heart-related (cardiac) symptoms. You are encouraged to report negative side effects of Tell your doctor if you have certain medical conditions such as prescription drugs to the FDA. Visit www.fda.gov/medwatch asthma, depression, thyroid disease, Parkinson’s disease, or call 1-800-FDA-1088. diabetes, high blood pressure or heart disease, have any other For additional information, please contact us at 800-395-3376. medical conditions, are pregnant or plan to become pregnant, or are breastfeeding or plan to breastfeed. Be sure to also tell Please see Brief Summary of full Prescribing Information your doctor all the medicines you take, especially medicines for on the adjacent page. asthma. If you have certain medical conditions, or take certain medicines, your condition may get worse or you may have longer lasting side effects when you use EpiPen® or EpiPen Jr®. The most common side effects may include increase in heart rate, stronger or irregular heartbeat, sweating, nausea or vomiting, difficulty breathing, paleness, dizziness, weakness,

EpiPen®, EpiPen Jr®, EpiPen 2-Pak®, EpiPen Jr 2-Pak® and LIFE HAPPENS. Be Prepared.® are registered trademarks owned by the Mylan companies. © 2016 Mylan Specialty L.P. All rights reserved. 2/16 EPI-2016-0026 BRIEF SUMMARY OF PATIENT What are EpiPen® and EpiPen Jr®? be injected into the middle of your outer INFORMATION • EpiPen ® and EpiPen Jr® are disposable, thigh (upper leg). Do not inject Please read this information before using prefilled automatic injection devices the EpiPen® or EpiPen Jr® into your: EpiPen® or EpiPen Jr® Auto-Injector and (auto-injectors) used to treat life- • veins each time you get a refill. Consult the Patient threatening, allergic emergencies including • buttocks Information and Instructions for Use. You, anaphylaxis in people who are at risk • fingers, toes, hands, or feet your parent, a caregiver or others who may for or have a history of serious allergic If you accidentally inject EpiPen® or EpiPen be in a position to administer EpiPen® or emergencies. Each device contains a Jr® into any other part of your body, go to the EpiPen Jr® Auto-Injector, should know how to single dose of epinephrine. nearest emergency room right away. Tell the use it before you have an allergic emergency. • EpiPen ® and EpiPen Jr® are for immediate health care professional where on your body This information does not take the place of self (or caregiver) administration and do you received the accidental injection. talking with your health care professional not take the place of emergency medical If you have certain medical conditions, about your medical condition or your care. You should get emergency help right or take certain medicines, your condition treatment. If you have any questions, ask away after using EpiPen® and EpiPen Jr®. may get worse or you may have longer your health care professional. • EpiPen ® and EpiPen Jr® are for people who lasting side effects when you use your What is the most important information have been prescribed this medicine by EpiPen® or EpiPen Jr®. Talk to your I should know about the EpiPen® and their health care professional. health care professional about all your EpiPen Jr®? • The EpiPen® Auto-Injector (0.3 mg) is for medical conditions. 1. EpiPen® and EpiPen Jr® contain patients who weigh 66 pounds or more Common side effects of EpiPen® and a medicine used to treat allergic (30 kilograms or more). EpiPen Jr® include: emergencies (anaphylaxis). Anaphylaxis • The EpiPen Jr® Auto-Injector (0.15 mg) • fast, irregular or “pounding” heartbeat can be life-threatening, can happen within is for patients who weigh about 33 to 66 • sweating minutes, and can be caused by stinging pounds (15 to 30 kilograms). • headache and biting insects, allergy injections, foods, • It is not known if EpiPen® and EpiPen Jr® • weakness medicines, exercise, or unknown causes. are safe and effective in children who • shakiness Symptoms of anaphylaxis may include: weigh less than 33 pounds (15 kilograms). • paleness • trouble breathing What should I tell my health care • feelings of over excitement, • wheezing professional before using the EpiPen® or nervousness or anxiety • hoarseness (changes in the way EpiPen Jr®? • dizziness your voice sounds) Before you use EpiPen® or EpiPen Jr®, tell • nausea or vomiting • hives (raised reddened rash your health care professional about all • breathing problems that may itch) your medical conditions, but especially if you: These side effects may go away with rest. • severe itching • have heart problems or high Tell your health care professional if you • swelling of your face, lips, mouth, blood pressure have any side effect that bothers you or or tongue • have diabetes that does not go away. • skin rash, redness, or swelling • have thyroid problems These are not all the possible side effects • fast heartbeat • have asthma of the EpiPen® or EpiPen Jr®. For more • weak pulse • have a history of depression information, ask your health care professional • feeling very anxious • have Parkinson’s disease or pharmacist. • confusion • have any other medical conditions Call your health care professional for medical • stomach pain • are pregnant or plan to become advice about side effects. • losing control of urine or bowel pregnant. It is not known if epinephrine General information about the safe and movements (incontinence) will harm your unborn baby. effective use of EpiPen® and EpiPen Jr®: • diarrhea or stomach cramps • are breastfeeding or plan to breastfeed. Medicines are sometimes prescribed for • dizziness, fainting, or “passing out” It is not known if epinephrine passes purposes other than those listed in a Patient (unconsciousness) into your breast milk. Information Leaflet. Do not use the EpiPen® 2. Always carry your EpiPen® or Tell your health care professional about or EpiPen Jr® for a condition for which it was EpiPen Jr® with you because you may all the medicines you take including not prescribed. Do not give your EpiPen® or not know when anaphylaxis prescription and over-the-counter medicines, EpiPen Jr® to other people. may happen. vitamins and herbal supplements. Talk to your health care professional if you Tell your health care professional of all Important Information need additional units to keep at work, school known allergies. • If an accidental injection happens, or other locations. Tell your family members, Especially tell your health care professional if get medical help right away. caregivers and others where you keep your you take certain asthma medicines. Manufactured for Mylan Specialty L.P., EpiPen® or EpiPen Jr® and how to use it EpiPen® or EpiPen Jr® and other medicines Morgantown, WV 26505, U.S.A. by Meridian before you need it. You may be unable to may affect each other, causing side effects. Medical Technologies, Inc., Columbia, MD speak in an allergic emergency. EpiPen® or EpiPen Jr® may affect the way 21046, U.S.A., a Pfizer company. 3. When you have an allergic emergency other medicines work, and other medicines EpiPen® and EpiPen Jr® are registered (anaphylaxis): may affect how EpiPen® or EpiPen Jr® works. trademarks owned by the Mylan companies. • Use EpiPen® or EpiPen Jr® right away. Use your EpiPen® or EpiPen Jr® for treatment © 2015 Mylan Specialty L.P. • Get emergency medical help right away. of anaphylaxis as prescribed by your health All rights reserved. You may need further medical attention. care professional, regardless of your medical 10/15 EPI-2015-0811 You may need to use a second EpiPen® or conditions or the medicines you take. EpiPen Jr® if symptoms continue or recur. What are the possible side effects of the Only a health care professional should EpiPen® and EpiPen Jr®? give additional doses of epinephrine if you EpiPen® and EpiPen Jr® may cause need more than 2 injections for a single serious side effects. anaphylaxis episode. • The EpiPen® or EpiPen Jr® should only REGISTER ONLINE: HTTPS://WWW.REGONLINE.COM/SDCCETS-2016 an event rich in tradition JULY 15-17, 2016 THE SMITH DRUG COMPANY 12th ANNUAL CONTINUING EDUCATION & GIFT AND TRADE SHOW The westin Savannah harbor • Savannah,GA PRICING EVENT MENU OPTIONS The Continuing Education & Gift and Trade Show is an a la carte menu to select from: One time fee for all available CE hours - each individual planning to attend CE MUST fill out a separate registration form – you CANNOT have a guest listed Continuing $120 that plans to attend CE; i.e. if you and your spouse are both pharmacists and Education both plan on taking advantage of the CE hours made available at this time you will EACH need to fill out a registration form individually.

Per person over the age of 18, this includes your guest(s). If they plan to walk Trade Show $50 the trade show floor with you the fee will need to be applied to that individual.

The President/Owner (and their guest) of each pharmacy will receive a complimentary meal for Saturday night’s (7/16/16) Customer Appreciation Dinner $75 Dinner; all other registrants and guests from the same pharmacy (if they choose to attend the dinner) will have the dinner fee applied. Your pharmacy will be invoiced for your CE/Trade Show registration approximately two (2) weeks prior to the event date. DEADLINE TO REGISTER IS: June 13, 2016 ACCOMMODATIONS If your participation in the CE/Trade Show requires an overnight stay, room Room Rate: $209 booking is separate from the registration process. Please call (912) 201-2000 Westin Nightly which will connect you directly to the Westin Savannah Harbor. To receive this Savannah Plus Resort Fees. special rate, please make sure you identify yourself as part of the Smith Harbor Drug Company room block. Special room rate expires: 6.13.16.

15 an event rich in tradition JULY 15-17, 2016

THE SMITH DRUG COMPANY 12th ANNUAL CONTINUING EDUCATION & GIFT AND TRADE SHOW The WESTIN savannah harbor Savannah,GA

REGISTER ONLINE HTTPS://WWW.REGONLINE.COM/SDCCETS-2016