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After decades, FDA finally moves to pull ineffective decongestant off shelves

By: Beth Mole
7 November 2024 at 23:27

In a long-sought move, the Food and Drug Administration on Thursday formally began the process of abandoning oral doses of a common over-the-counter decongestant, which the agency concluded last year is not effective at relieving stuffy noses.

Specifically, the FDA issued a proposed order to remove oral phenylephrine from the list of drugs that drugmakers can include in over-the-counter products—also known as the OTC monograph. Once removed, drug makers will no longer be able to include phenylephrine in products for the temporary relief of nasal congestion.

"It is the FDA’s role to ensure that drugs are safe and effective," Patrizia Cavazzoni, director of the FDA’s Center for Drug Evaluation and Research, said in a statement. "Based on our review of available data and consistent with the advice of the advisory committee, we are taking this next step in the process to propose removing oral phenylephrine because it is not effective as a nasal decongestant."

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“Havard”-trained spa owner injected clients with bogus Botox, prosecutors say

By: Beth Mole
6 November 2024 at 00:05

A Massachusetts spa owner has been arrested for what prosecutors describe as a blundering scheme in which she conspicuously smuggled counterfeit Botox and skin fillers into the US, then peddled them to clients by falsely claiming to be a nurse with a degree from "Havard" [sic] and a license from the state's "Estate Board."

Nevertheless, the woman—Rebecca Fadanelli, 38, of Stoughton—allegedly performed over 2,700 illegal injections between 2021 and 2024, raking in over $900,000 with the scam.

According to an affidavit from a special agent with the Food and Drug Administration, Fadanelli was smuggling in counterfeit Botox and fillers from China and Brazil. Between November 2023 and March 2024, Customs and Border Protection (CBP) seized at least six parcels from China addressed to Fadanelli or her employees. The packages included various counterfeit injectable drugs, including products labeled as Botox and skin fillers Sculptra and Juvederm.

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Drugmaker shut down after black schmutz found in injectable weight-loss drug

By: Beth Mole
4 November 2024 at 23:05

The Food and Drug Administration is warning consumers not to use any drugs made by a compounding pharmacy in California after regulators realized the pharmacy was making drugs that need to be sterile—particularly injectable drugs—without using sterile ingredients or any sterilization steps.

The products made by the pharmacy, Fullerton Wellness LLC, in Ontario, California, include semaglutide, which is intended to mimic brand-name weight-loss and diabetes drugs Wegovy and Ozempic. Fullerton also made tirzepatide, which is intended to mimic weight-loss and diabetes drugs Zepbound and Mounjaro.

The FDA became aware of the problem after a patient submitted a complaint to the regulator that a vial of semaglutide from Fullerton Wellness had an unidentified "black particulate" floating in it. Semaglutide, like tirzepatide, is injected under the skin and is intended to be sterile.

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Shady drugmaker used code words to sell knockoff weight-loss drug: Lawsuit

By: Beth Mole
22 October 2024 at 22:31

Amid ongoing legal battles over coveted GLP-1 therapies, a drug vendor in Washington state is accused of running an outlandish scheme to sell do-it-yourself kits to make illicit knockoff versions of weight-loss and diabetes drugs, Zepbound and Mounjaro.

For the alleged scheme, vendor Pivotal Peptides has customers buy a set of ingredients they have to mix together to create their own injectable versions of the drugs. Customers don't need a prescription or even a medical consultation to order the kit, even though the brand-name drugs are prescription-only. That may not be surprising, though, since the dubious white powder customers receive is stated to be "a research chemical for lab research and veterinary purposes only." Once purchased, the kit's instructions recommend users disinfect their home work surface before beginning and stress the importance of using the sterile water included in the kit to dissolve the powder to the desired concentration. The instructions then explain how to inject oneself with the homemade mixture using a 30-gauge syringe.

That's all according to a lawsuit filed Monday by pharmaceutical giant Eli Lilly, maker of tirzepatide-based Zepbound and Mounjaro, which are sold as ready-to-use medicines in single-dose pens or vials. The lawsuit against Pivotal Peptides is one of three that Lilly filed this week, all accusing questionable drugmakers of unlawfully selling knockoff versions of its tirzepatide drugs that have not been tested or approved. But the one against Pivotal Peptides stands out for the scheme the owners allegedly used to sell their knockoff version.

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Drugmakers can keep making off-brand weight-loss drugs as FDA backpedals

By: Beth Mole
15 October 2024 at 21:53

Facing a lawsuit, the Food and Drug Administration has decided to reconsider its decision to take popular weight-loss and diabetes drugs off of the national shortage list, which will allow compounding pharmacies to continue selling cheaper copycat versions—at least for now.

A trade organization representing compounding pharmacies sued the agency last week over its October 2 announcement that there was no longer a shortage of tirzepatide drugs, branded as Mounjaro for diabetes and Zepbound for weight loss. The products, members of the extremely popular and effective class of GLP-1 drugs, had been on the shortage list since December 2022.

Being on the list meant that compounding pharmacies were legally allowed to make "essentially copies" of the products; the only time these pharmacies—also called outsourcing facilities—can make imitation versions of approved drugs, such as tirzepatide, is when the products appear on the shortage list. So, with the FDA's announcement, compounders were immediately barred from making any more of the lucrative drugs and had 60 days to fulfill existing orders.

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Over 86% of surveyed health care providers are short on IV fluids

By: Beth Mole
11 October 2024 at 21:39

More than 86 percent of healthcare providers surveyed across the US are experiencing shortages of intravenous fluids after Hurricane Helene's rampage took out a manufacturing plant in western North Carolina that makes 60 percent of the country's supply.

IV fluids are used for everything from intravenous rehydration to drug delivery. The plant also made peritoneal dialysis fluids used to treat kidney failure.

Premier, a group purchasing organization for medical supplies that counts thousands of hospitals and health systems among its members, surveyed 257 such providers earlier this week. The poll makes clear that supplies are unsurprisingly imperiled.

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Drug makers can’t make knockoff weight-loss drugs anymore—and they’re mad

By: Beth Mole
9 October 2024 at 21:17

Compounding pharmacies are suing the Food and Drug Administration so they can keep making imitation versions of popular—and lucrative—tirzepatide drugs, namely knockoffs of Mounjaro for diabetes and Zepbound for weight loss.

Generally, compounding pharmacies make customized formulations of drugs for patients with specific needs, like when a patient has an allergy to a filler ingredient or if a child needs a liquid version of a drug that normally comes as a capsule. But larger compounding operations are also legally allowed to make imitations of branded drugs if those drugs are in short supply, acting as a stopgap for patients.

Tirzepatide has certainly been in short supply in recent years. Given the high prevalence of diabetes and obesity in America and the drug's effectiveness, demand for tirzepatide and other drugs in the new GLP-1 class have skyrocketed, and many patients have struggled to fill prescriptions. The FDA placed tirzepatide on its drug shortage list in December of 2022—and that's where it remained until last week.

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Homeopathic company refuses to recall life-threatening nasal spray, FDA says

By: Beth Mole
19 September 2024 at 18:40
Homeopathic company refuses to recall life-threatening nasal spray, FDA says

Enlarge (credit: Getty | Florian Gaertner)

The maker of a homeopathic nasal spray with a history of contamination is refusing to recall its product after the Food and Drug Administration once again found evidence of dangerous microbial contamination.

In a warning Thursday, the FDA advised consumers to immediately stop using SnoreStop nasal spray—made by Green Pharmaceuticals—because it may contain microbes that, when sprayed directly into nasal cavities, can cause life-threatening infections. The FDA highlighted the risk to people with compromised immune systems and also children, since SnoreStop is marketed to kids as young as age 5.

According to the regulator, an FDA inspection in April uncovered laboratory test results showing that a batch of SnoreStop contained "significant microbial contamination." But, instead of discarding the batch, FDA inspectors found evidence that Green Pharmaceuticals had repackaged some of the contaminated lot and distributed it as single spray bottles or as part of a starter kit.

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ADHD med shortages push DEA to up drug allotment by 23.5%

By: Beth Mole
6 September 2024 at 19:22
ADHD med shortages push DEA to up drug allotment by 23.5%

Enlarge (credit: Getty | George Frey)

While supplies of Adderall and its generic versions are finally recovering after a yearslong shortage, the Drug Enforcement Administration is now working to curb the short supply of another drug for attention-deficit/hyperactivity disorder: Vyvanse (lisdexamfetamine) and its generic versions.

This week, the DEA said it will increase the allowed production amount of lisdexamfetamine by roughly 23.5 percent, increasing the current 26,500 kg quota by 6,236 kg, for a new total of 32,736 kg. The DEA also allowed for a corresponding increase in d-amphetamine, which is needed for production of lisdexamfetamine.

"These adjustments are necessary to ensure that the United States has an adequate and uninterrupted supply of lisdexamfetamine to meet legitimate patient needs both domestically and globally," the DEA said.

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Tattoo ink sold on Amazon has high levels of weird and rare bacteria

By: Beth Mole
27 August 2024 at 19:21
BARCELONA, SPAIN - 2021/10/02: Spanish tattoo artist Oscar Garcia works on a man, during the Expo.
Fira de Barcelona hosts the XXIV edition of the Barcelona Tattoo Expo where tattoo artists from Spain and other countries exhibit tattoos and tattoo material such as ink, needles and special machinery for tattoo work. (Photo by Ramon Costa/SOPA Images/LightRocket via Getty Images)

Enlarge / BARCELONA, SPAIN - 2021/10/02: Spanish tattoo artist Oscar Garcia works on a man, during the Expo. Fira de Barcelona hosts the XXIV edition of the Barcelona Tattoo Expo where tattoo artists from Spain and other countries exhibit tattoos and tattoo material such as ink, needles and special machinery for tattoo work. (Photo by Ramon Costa/SOPA Images/LightRocket via Getty Images)

The Food and Drug Administration has been warning for years that some tattoo inks are brimming with bacteria—a large assortment that, when injected into your skin, can cause inflammatory reactions, allergic hypersensitivity, toxic responses, and, of course, straight-up infections. And, worse yet, the labels that say the inks are sterile are not reliable.

But, a recent recall of three tattoo pigments from the same manufacturer does a good job of illustrating the FDA's concerns. The water-based inks, all from Sierra Stain, had a bizarre array of bacteria, which were found at high levels, according to FDA testing.

One ink product—described as "Carolina Blue"—offered a microbial menagerie, with six odd species identified. They included a bacterium that often dwells in the gastrointestinal system and can inflame the mucosal lining of the intestines (Citrobacter braakii), a water-borne bacterium (Cupriavidus pauculus), and several that cause opportunistic infections (Citrobacter farmer, Achromobacter xylosoxidans, Ochrobactrum anthropi, and Pseudomonas fluorescens). These are bacteria that don't typically go about attacking humans but will if the conditions are right, including when they find themselves inside a human with a compromised immune system.

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COVID shot now or later? Just getting it at all is great, officials respond.

By: Beth Mole
23 August 2024 at 20:59
A 13-year-old celebrates getting the Pfizer-BioNTech COVID-19 vaccine in Hartford, Connecticut, on May 13, 2021.

Enlarge / A 13-year-old celebrates getting the Pfizer-BioNTech COVID-19 vaccine in Hartford, Connecticut, on May 13, 2021. (credit: Getty | JOSEPH PREZIOSO )

With the impending arrival of the 2024–2025 COVID-19 vaccines approved yesterday, some Americans are now gaming out when to get their dose—right away while the summer wave is peaking, a bit later in the fall to maximize protection for the coming winter wave, or maybe a few weeks before a big family event at the end of the year? Of course, the group pondering such a question is just a small portion of the US.

Only 22.5 percent of adults and 14 percent of children in the country are estimated to have gotten the 2023–2024 vaccine. By contrast, 48.5 percent of adults and 54 percent of children were estimated to have gotten a flu shot. The stark difference is despite the fact that COVID-19 is deadlier than the flu, and the SARS-CoV-2 virus is evolving faster than seasonal influenza viruses.

In a press briefing Friday, federal health officials were quick to redirect focus when reporters raised questions about the timing of COVID-19 vaccination in the coming months and the possibility of updating the vaccines twice a year, instead of just once, to keep up with an evolving virus that has been producing both summer and winter waves.

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With 145 sickened, 2 dead, microdosing candy poisonings are still a mystery

By: Beth Mole
22 August 2024 at 12:56
With 145 sickened, 2 dead, microdosing candy poisonings are still a mystery

Enlarge (credit: Diamond Shruumz)

The number of poisonings connected to Diamond Shruumz-brand microdosing candies has reached 145 cases across 29 states. Since the illnesses first came to light in early June, 59 of those sickened have required hospitalization, and health officials have reported people having seizures, needing intubation, and being admitted to intensive care units. Two deaths are under investigation. Yet, despite tireless efforts to analyze the candies' components, the cause of the poisonings remains a mystery.

Diamond Shruumz suggestively markets the chocolates—as well as its gummies and candy cones—as containing psychedelic drugs but doesn't say what's in them exactly. They're only said to contain a "primo proprietary blend of nootropic and functional mushrooms," and the company has identified non-hallucinogenic mushrooms, including Lion's mane, Reishi, and Chaga.

In its latest investigation update Monday, the Food and Drug Administration laid out the testing results of 22 chocolate bars from Diamond Shruumz—and the list of illicit and troubling drugs found keeps growing. Stunningly, none of the drugs found so far can alone explain the severe illnesses.

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This year’s summer COVID wave is big; FDA may green-light COVID shots early

By: Beth Mole
19 August 2024 at 23:53
This year’s summer COVID wave is big; FDA may green-light COVID shots early

Enlarge (credit: Getty | Thomas Trutschel)

With the country experiencing a relatively large summer wave of COVID-19, the Food and Drug Administration is considering signing off on this year's strain-matched COVID-19 vaccines as soon as this week, according to a report by CNN that cited unnamed officials familiar with the matter.

Last year, the FDA gave the green light for the 2023–2024 COVID shots on September 11, close to the peak of SARS-CoV-2 transmission in that year's summer wave. This year, the summer wave began earlier and, by some metrics, is peaking at much higher levels than in previous years.

Currently, wastewater detection of SARS-CoV-2 shows "very high" virus levels in 32 states and the District of Columbia. An additional 11 states are listed as having "high" levels. Looking at trends, the southern and western regions of the country are currently reporting SARS-CoV-2 levels in wastewater that rival the 2022–2023 and 2023–2024 winter waves, which both peaked at the very end of December.

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MDMA for PTSD: Three studies retracted on heels of FDA rejection

By: Beth Mole
12 August 2024 at 22:32
MDMA

Enlarge / MDMA (credit: Getty | PYMCA/Avalon)

A scientific journal has retracted three studies underpinning the clinical development of MDMA—aka ecstasy—as a psychedelic treatment for post-traumatic stress disorder. The move came just a day after news broke that the Food and Drug Administration rejected the treatment, despite positive results reported from two Phase III clinical trials.

On Friday, the company developing the therapy, Lykos Therapeutics, announced that it had received a rejection letter from the FDA. Lykos said the letter echoed the numerous concerns raised previously by the agency and its expert advisory committee, which, in June, voted overwhelmingly against approving the therapy. The FDA and its advisers identified flaws in the design of the clinical trials, missing data, and a variety of biases in people involved with the trials, including an alleged cult-like support of psychedelics. Lykos is a commercial spinoff of the psychedelic advocacy nonprofit Multidisciplinary Association for Psychedelic Studies (MAPS).

FDA advisers also noted the public allegations of a sexual assault of a trial participant during a Phase II trial by an unlicensed therapist providing the MDMA-assisted psychotherapy.

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Path to precision: Targeted cancer drugs go from table to trials to bedside

By: Beth Mole
5 August 2024 at 11:00
Path to precision: Targeted cancer drugs go from table to trials to bedside

Enlarge (credit: Aurich Lawson)

In 1972, Janet Rowley sat at her dining room table and cut tiny chromosomes from photographs she had taken in her laboratory. One by one, she snipped out the small figures her children teasingly called paper dolls. She then carefully laid them out in 23 matching pairs—and warned her kids not to sneeze.

The physician-scientist had just mastered a new chromosome-staining technique in a year-long sabbatical at Oxford. But it was in the dining room of her Chicago home where she made the discovery that would dramatically alter the course of cancer research.

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Buying shady weight loss drugs online is a bad idea, in case you were wondering

By: Beth Mole
2 August 2024 at 21:52
Buying shady weight loss drugs online is a bad idea, in case you were wondering

Enlarge (credit: https://www.uschemlabs.com/product/semaglutide-2mg-5-vials/)

Buying counterfeit weight loss drugs from illegal online pharmacies that don't require prescriptions is, in fact, a very bad idea, according to a study published Friday in JAMA Network Open.

The counterfeit drugs are sold as equivalents to the blockbuster semaglutide drugs, Ozempic and Wegovy, which are prescription only. When researchers got their hands on three illegal versions, they found that the counterfeit drugs had low-purity semaglutide, had dosages that exceeded the labeled amount, and one had signs of bacterial contamination.

The three substandard drugs tested came from three different illegal online pharmacies, which sold them as generic semaglutide drugs for weight loss, appetite suppression, diabetes, and cardiovascular health. However, the researchers, led by scientists at the University of California, San Diego, and the University of Pécs in Hungary, had initially tried purchasing counterfeit drugs from six such sellers.

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People are overdosing on off-brand weight-loss drugs, FDA warns

By: Beth Mole
26 July 2024 at 21:22
Wegovy is an injectable prescription weight-loss medicine that has helped people with obesity.

Enlarge / Wegovy is an injectable prescription weight-loss medicine that has helped people with obesity. (credit: Getty | Michael Siluk)

The US Food and Drug Administration has approved two injectable versions of the blockbuster weight-loss and diabetes drug semaglutide (Wegovy and Ozempic). Both come in pre-filled pens with pre-set doses, clear instructions, and information about overdoses. But, given the drugs' daunting prices and supply shortages, many patients are turning to imitations—and those don't always come with the same safety guardrails.

In an alert Friday, the FDA warned that people are overdosing on off-brand injections of semaglutide, which are dispensed from compounding pharmacies in a variety of concentrations, labeled with various units of measurement, administered with improperly sized syringes, and prescribed with bad dosage math. The errors are leading some patients to take up to 20 times the amount of intended semaglutide, the FDA reports.

Though the agency doesn't offer a tally of overdose cases that have been reported, it suggests it has received multiple reports of people sickened by dosing errors, with some requiring hospitalizations. Semaglutide overdoses cause nausea, vomiting, abdominal pain, fainting, headache, migraine, dehydration, acute pancreatitis, and gallstones, the agency reports.

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Diamond Shruumz candies suspected of causing second death, FDA reports

By: Beth Mole
24 July 2024 at 21:14
Diamond Shruumz candies suspected of causing second death, FDA reports

Enlarge (credit: Diamond Shruumz)

Authorities have identified a second death that may have been caused by Diamond Shruumz microdosing candies, which are under investigation for causing a nationwide rash of severe illnesses involving seizures, and the need for intubation and intensive care.

In an update on Tuesday, the Food and Drug Administration reported that the total number of illnesses linked to the brand's candies has risen to 74 across 28 states. Of the 74 people sickened, 62 sought medical care, and 38 were admitted to a hospital. There are two potentially associated deaths that are now under investigation. The counts are up from 69 cases and 36 hospitalizations, with one potentially linked death reported in an update last week.

The FDA announced its investigation into Diamond Shruumz products on June 7, when there had been just eight cases reported from four states. The federal investigation—led by the FDA and the Centers for Disease Control and Prevention, with help from America’s Poison Centers and state and local partners—followed warnings from Arizona poison control officials.

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Soda additive “no longer considered safe,” gets long-awaited FDA ban

By: Beth Mole
3 July 2024 at 16:01
Tops of citrus sodas at a manufacturing plant.

Enlarge / Tops of citrus sodas at a manufacturing plant. (credit: Getty | Vincent Mundy)

After more than five decades of limbo, the Food and Drug Administration on Wednesday revoked the authorization of brominated vegetable oil (BVO) in food, banning an additive long known to have toxic effects that is already banned in Europe, Japan, Australia, New Zealand, and California.

BVO—simply vegetable oil that is modified with bromine—has been used in foods since the 1920s. It has often been used as a stabilizer for fruit flavorings, particularly in citrusy beverages, including sodas, to keep the citrus flavoring from separating and floating to the top. The FDA authorized the use of BVO just after gaining the authority to regulate food additives in 1958. By the early 1960s, the FDA had put BVO on its first inventory of food additives it deemed generally safe—designated "generally recognized as safe" or GRAS. But safety concerns quickly surfaced, and by the late 1960s, the FDA had already limited its use to a flavoring stabilizer and capped the amount that could be used to 15 parts per million.

That 15-ppm limit was authorized on an "interim basis," pending more safety studies. In 1970, the FDA revoked the GRAS designation for BVO, but continued to allow the 15-ppm limit—on an interim basis—given that safety studies "did not indicate an immediate health threat from the limited use."

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