This program is known as the DoD/FDA Shelf-Life Extension Program (SLEP). During the early stages of development, speci Looking for abbreviations of LEP? However, stakeholders that apply this extension to their stockpiled products should clearly note in their stockpiles that FDA has allowed for its extension (e.g., by placing a placard on the outside of a pallet or shipping box). An FDA/DOD program to produce data on actual shelf lives of medications (SLEP, the Shelf Life Extension Program) has evaluated extended stability profiles for a couple of decades, finding, not surprisingly, that the majority of tested drugs retain adequate stability of at least a year, or longer, than their labeled expiration dates. It is a partnership between FDA and the US Department of Defence. A 2006 study of 122 drugs tested by the program showed that two-thirds of the expired medications were stable every time a lot was tested. An official website of the United States government. Criteria of sameness between expired and unexpired lots would need to be codified, and a method would need to be established for determining a new expiration date for such products. 1-Oct-2021. Front Microbiol. Following are several examples of how FDA has addressed expiry dating challenges following PAHPRAs enactment and before PAHPRA: Vaccines authorized for emergency use as products that are not approved under a biologics license application and are still being studied under investigational new drug applications do not have fixed expiry dates. (Federal Register notice) Please contact Brad Leissa at brad.leissa@fda.hhs.govand Brooke Courtney at brooke.courtney@fda.hhs.govwith questions regarding thisguidance. Upon FDAs authorization of a shelf-life extension, the labeling is updated by the IVD manufacturer to reflect the updated expiration date, which is calculated from the original manufacturing date of the device. A very few drugs aren't retested. Federal government websites often end in .gov or .mil. Shelf-Life Extension Program Policy Establishes the DHA procedures to manage and provide guidance on the SLEP within the Military Health System and contingency operations. A generic drug, if chemically and pharmacokinetically identical to the innovator, is assumed to have the innovators safety profile without any additional safety testing. 100,000/g within the shelf life of many chilled foods. FDA granted this extension following a thorough review of data submitted by AstraZeneca. Retained product must be appropriately held in accordance with storage conditions detailed in the authorized Fact Sheet for Health Care Providers (PDF, 1.38 MB) and the Letter of Authorization (PDF, 488 KB). LEP - Life Extension Program. More information, April 2019 guidance: Extending Expiration Dates of Stockpiled Doxycycline for Anthrax Preparedness, Expiration date extensions of certain lots of doxycycline hyclate, August 7, 2020: Additional Expiration Date Extensions of Certain Lots of Doxycycline Hyclate 100 mg Capsules Held in Strategic Stockpiles (PDF, 86 KB) - FDA issued a memo to government public health and emergency response stakeholders extending for the second time the expiration dates of certain lots of doxycycline hyclate 100 mg capsules held in strategic stockpiles for anthrax emergency preparedness and response purposes. Relabeling. If describing the Shelf Life Extension Program use this definition a. Shelf Life Extension Program presentation at Federal, State, and Local Public Health Preparedness meeting. SLEP is administered by the U.S. Department of Defense (DoD) in cooperation with the U.S. Food and Drug Administration (FDA). Services offered include: Procurement of pharmaceutical, medical, and dental equipment and supplies. While this is important to ensure patient safety, it also means that the MCMs, some of which might still be stable, must be replaced regularly, which can be very costly. Results from the shelf life extension program (SLEP) have been evaluated to provide extensive data to address this issue. Also see: Expiration date extensions of certain lots of doxycycline hyclate. The Shelf Life Extension Program (SLEP) extends the expiration dates for specific medications and supplies stored in Federal stockpiles. In the past decade, the 2001 anthrax incident in the U.S. and the 2003 SARS epidemic have highlighted the biological threat to civilian populations. Evaluation of a future extension of shelf-life for sotrovimab is ongoing. Bull World Health Organ. I know thatHi. Reading this FDA communication was a reminder that expiry dates are driven by the availability of supportive stability data. 3 The American Medical Association concluded in 2001, based on the Federal Shelf Life Extension Program (SLEP), that the actual shelf life of some products is longer than the labeled expiration date. Disaster Manag Response. July 2, 2021:FDA is alerting civilian health care professionals and emergency responders of 1 pralidoxime chloride and 5 CANA (diazepam) auto-injector lots for which the new use date has passed; however, FDA recommends that stakeholders retain such lots in the event that additional scientific information becomes available to support additional extensions. Biosecur Bioterror. We wonder whether a mandated post-market commitment to evaluate a products potential for extended stability might be a reasonable consideration. FDA will continue to evaluate the available data and provide updated information as soon as possible. The .gov means its official.Federal government websites often end in .gov or .mil. In many cases . 1 The U.S. Food and Drug Administration (FDA) requires that an active ingredient in a medication must be present in 90 to 110 percent of the amount indicated on a drugs label. Dexmedetomidine HCl injection in 0.9% sodium chloride, 200 mcg/2 mL (100 mcg/mL), 2 mL single dose vial. Batches bearing December 1996 expiration dates -- unused and unopened, as is the case with all drugs evaluated in the Shelf Life program -- were tested in July 1998 and extended for two years. Kamba PF, Ireeta ME, Balikuna S, Kaggwa B. Shelf-Life Extension Program Policy Establishes the DHA procedures to manage and provide guidance on the SLEP within the Military Health System and contingency operations. Threats posed by stockpiles of expired pharmaceuticals in low- and middle-income countries: a Ugandan perspective. 1 The program is an acknowledgement that the actual shelf life of drugs and This program indicates that the majority of drugs, with very few exceptions, are still extremely effective and safe to use even if they have passed the manufacturers expiry date. Since all drugs are required by law to have an expiration date and are not approved for use past their expiration date, the U.S. Department of Defense (DoD) began administrating the Shelf-Life Extension Program (SLEP) in 1986. 13. Identification #: 6430.05 Date: 10/5/2021 Type: DHA Procedures Manual Topics: Shelf Life Extension Program DOD Shelf-Life Management Program: Program Administration Policy This program is known as the DoD/FDA Shelf-Life Extension Program (SLEP). Relenza inhalation powder (reminder of previous extension) FAQs: What happens to EUAs when a public health emergency ends? A major study was done by the Department of Defense and FDA Shelf Life Extension Program. DoD 4140.27-M 1- i DoD 4140.27-M DLA J-373 May 5, 2003 . May 4, 2022: FDA and HHS/ASPR announced the authorization of an extension to the shelf-life from 18 months to 24 months for specific lots of the refrigerated Eli Lilly monoclonal antibodies,. As required by the EUA, of Evusheld (150 mg/1.5 mL of tixagevimab and 150 mg/1.5 mL of cilgavimab), must be stored under refrigerated temperature at 2C to 8C (36F to 46F) in the original carton to protect from light. Clipboard, Search History, and several other advanced features are temporarily unavailable. This guidance and any resulting expiration date extensions authorized by FDA do not apply to doxycycline available commercially or otherwise held for any other non-emergency purpose. The site is secure. The Department of Defense (DoD)United States Food and Drug Administration (FDA) shelf-life extension program (SLEP) was established in 1986 through an intra-agency agreement between the DoD and the FDA to extend the shelf life of product nearing expiry. Therefore, REGEN-COV may not be administered for treatment or post-exposure prevention of COVID-19 under the EUA until further notice by the Agency. GSA Shelf Life Management Program. Many of those drugs have had their original expiration dates extended by several years and that has saved between $13 and $94 for every $1 spent on testing, according to recent research. No one considered whether the product might prove toxic, but that was because the treating physicians were relatively ignorant about the processes of drug denaturation and production of degradants, and the risks from these processes. This extension applies to all unopened vials of Evusheld that have been held in accordance with storage conditions detailed in the authorized Fact Sheet for Health Care Providers and the Letter of Authorization for Emergency Use Authorization (EUA) 104 for Evusheld. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. Through expiration dating extensions, SLEP helps to defer the replacement costs of certain products in critical federal stockpiles. FDA will not take enforcement action with regard to the storage or emergency use of these lots of Tamiflu capsules, provided that the products have been stored under labeled storage conditions. The results found that 86% of the 14 tested drugs (12 drugs, multiple batches of each) had at least 90% of their labeled potency, which would fall within the FDAs acceptable range of potency for batches that are still within their expiration period. Please refer to the table on this page for the new updates. "The best evidence indicating that medications can last longer than their labeled expiration date comes from the Shelf Life Extension Program (SLEP) Whereas the shelf life of most medications in the United States is 1 to 5 years, the average additional extension length by SLEP was 5.5 years, and some lots were extended by more than 20 . December 5, 2022: FDA and HHS/ASPR authorized an additional extension to the shelf-life for specific lots of the refrigerated AstraZeneca monoclonal antibody therapy, Evusheld, from 18 months to 30 months. Recognizing stakeholders MCM stockpiling challenges, FDA is engaged, when appropriate, in various expiration dating extension activities as described below. The program is referred to by the Department of Defense (DoD) as the "Shelf Life Extension Program." Some medications, such as naloxone, halothane, fentanyl and others had 100% demonstrable stability of lots for at least 4-5 years after expiration. However, it also implies that it is acceptable for innovator and generic formulations to have some demonstrable differences in blood levels of the active ingredient and, by extrapolation, also of degradants in the formulations. In some cases, testing has shown that certain properly stored medical products can be used beyond their labeled expiration date if they retain their stability. Our results support the effectiveness of broadly extending expiration dates for many drugs, the researchers conclude. Challenges associated with creating a pharmaceutical stockpile to respond to a terrorist event. 2016 Aug 3;7:1209. doi: 10.3389/fmicb.2016.01209. To help prepare for public health emergencies, medical countermeasures (MCMs) may be stockpiled by governments and even by some private sector partners. Before sharing sensitive information, make sure you're on a federal government site. The Defense Health Agency (DHA), in coordination with the Food and Drug The program allows extensions to the expiration date on medications after testing for safety and efficacy. Recipients should contact their MCM specialists with any questions regarding confirmation. A summary of the Shelf Life Extension Prorgarm (SLEP) data is available in The Journal of Pharmaceutical Sciences, Vol. FDA is not requiring or recommending that such stockpiled Tamiflu or Relenza product be relabeled with the new use date. This program is known as the DoD/FDA Shelf-Life Extension Program (SLEP). During the early stages of development, special attention was paid to program . Leading with strategy, our RCO model delivers bespoke / custom solutions that deliver results. Dent Clin North Am. FDA acknowledges the stockpiling challenges of federal and SLTT stakeholders (for example, related to doxycycline, ciprofloxacin, Tamiflu, and certain auto-injector products) and remains committed to finding appropriate solutions to address such challenges. So, for example, for Ampicillin capsules the range is listed as 22 to 64 months, which means the shortest batch was extended by 22 months, and the longest by 64 months. FDA has authorized extended expiration dates for these lots to reflect the 12-month product shelf-life (see Table 1 below), when stored according to the storage conditions detailed in the authorized Fact Sheet for Health Care Providers and the Letter of Authorization for Emergency Use Authorization (EUA) 105 for Paxlovid. The FDA has a Shelf Life Extension Program that tests whether certain drugs have expiration dates that could be extended. Could such medications, if shown by evaluation such as SLEP to retain adequate potency, be donated to developing countries in which the usual commercial product is either prohibitively expensive or not readily available, or be used in the US during periods of critical drug shortages? In 2006, the program extended the shelf life The SLEP has been administered by the Food and Drug Administration for the United States Department of Defense (DOD) for 20 years. Stockpiling drugs, vaccines, and medical products is critical to ensure public health emergency preparedness for both the U.S. military and civilian populations. To avoid the need to replace entire stockpiles every few years at significant expense, and because it was recognized through testing that certain products remained stable beyond their labeled expiration dates when properly stored, the Shelf-Life Extension Program (SLEP) was established in 1986. PMC Given the high costs involved in maintaining adequate drug stockpiles, attempts should be made to optimize the value of drugs; shelf-life extension is one of the easiest and most cost-effective ways of doing this. For example, the U.S. Department of Health and Human Services (HHS) Assistant Secretary for Preparedness and Response (ASPR) oversees the Strategic National Stockpile (SNS), which has large quantities of medicine and medical supplies to protect the American public if there is a public health emergency (for example, a terrorist attack, flu outbreak, or earthquake) severe enough to cause local medical supplies to run out. Since 1986, the FDA has been testing drugs stockpiled by the military to check their stability under the so-called Shelf Life Extension Program. The site is secure. This document provides guidance to government stakeholders on testing to extend the shelf life (i.e., expiration date) under the FD&C Act of stockpiled doxycycline tablets and capsules for public health emergency preparedness and response purposes for an anthrax emergency. Due to the high frequency of the Omicron variant, bamlanivimab and etesevimab are not currently authorized in any U.S . Specific shelf-life information for IVDs authorized under an EUA can be found on the outer packaging, and reagent vials and containers for the product, or by contacting the IVD manufacturer directly with the catalog number, lot number, and manufacturing date for the specific reagent in question. Hormonal Contraception [] The Shelf Life Extension Program (SLEP) is a joint program of the United States Department of Defense and the Food and Drug Administration that aims to reduce the cost to the military of maintaining stockpiles of certain pharmaceuticals by researching the expiration of drugs.It tests medications for safety and stability for extended periods of time in controlled storage conditions. For instance, in an attempt to reduce waste, the U.S. Department of Defence undertook a project called Shelf Life Extension Program (SLEP) to assess the stability, safety and usefulness of more than 100 types of expired drugs. Medical Countermeasures Initiative (MCMi), Guidance for Government Public Health and Emergency Response Stakeholders: Extending Expiration Dates of Doxycycline Tablets and Capsules in Strategic Stockpiles, Guidance for Industry: Changes to an Approved NDA or ANDA, Office of Counterterrorism and Emerging Threats, Public Readiness and Emergency Preparedness, Previous COVID-19 vaccine shelf-life extensions, Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers), Letter of Authorization for Emergency Use Authorization (EUA) 104 for Evusheld, Table 1: Extended Expiry Dating for Evusheld (Tixagevimab Co-Packaged with Cilgavimab) Authorized under EUA 104, announced the authorization of an additional extension, Table 1: Extended Expiry Dating for Bebtelovimab Authorized under EUA 111, Table 1: Extended Expiry Dating for Lagevrio Authorized under EUA 108, Table 1: Extended Expiry Dating for Paxlovid Authorized under EUA 105, Table 1: Extended Expiry Dating for Sotrovimab Authorized under EUA 100, announced the authorization of an extension to the shelf-life, Letter of Authorization for Emergency Use Authorization (EUA) 091, Previous COVID-19 therapeutic shelf-life extensions, Letter of Authorization for Emergency Use Authorization (EUA) 105 for Paxlovid, Table 1: Extended Expiry Dating for Paxlovid (nirmatrelvir tablets and ritonavir tablets co-packaged for oral use) Authorized under EUA 105, Statement Regarding Shelf-Life Extension of Sotrovimab, Statement Regarding Shelf-Life Extension of Bamlanivimab and Etesevimab, announcedthe authorization of an extension to the shelf-life, At-Home COVID-19 Diagnostic Tests: Frequently Asked Questions, Influenza (Flu) Antiviral Drugs and Related Information, HHS Increases Access to Tamiflu through the Strategic National Stockpile, Improving Access to Influenza Countermeasures for U.S. Jurisdictions, Additional Expiration Date Extensions of Certain Lots of Doxycycline Hyclate 100 mg Capsules Held in Strategic Stockpiles, Extending Expiration Dates of Doxycycline Tablets and Capsules in Strategic Stockpiles, Expiration date extensions of certain lots of doxycycline hyclate 100 mg capsules held in strategic stockpiles, recording of this webinar, slides and Q&A, Expiry date extensions of certain lots of doxycycline hyclate 100mg capsules held in strategic stockpiles, Guidance for Federal Agencies and State and Local Governments: Potassium Iodide Tablets Shelf Life Extension, Search List of Extended Use Dates to Assist with Drug Shortages, On June 10, 2021, based on data and information received from the manufacturer, FDA, Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (PAHPRA), Public Readiness and Emergency Preparedness Act of 2005 (PREP Act). Clinical trial management and distribution center. While this is important to ensure patient safety, it also means that the MCMs, some of which might still be stable, must be replaced regularly, which can be very costly. For more than 30 years, federal agencies that stockpile drugs including the military, the CDC and the Department of Veterans Affairs have used technically expired drugs under the Shelf-Life Extension Program (SLEP) in collaboration with FDA. The intended outcome of the SLEP is measurable cost avoidance returned to program participants and continued availability of potency-dated contingency stocks. FDA also recommended relabeling of such product prior to dispensing. December 14, 2022: On April 28, 2022, HHS issued a message (PDF, 162 KB) to state stakeholders holding antiviral drug products (Tamiflu and Relenza) about additional expiry dating extensions for properly held product. Distribution. An official website of the United States government, Recalls, Market Withdrawals and Safety Alerts, Drug Shortages | Additional News and Information, Frequently Asked Questions about Drug Shortages, Search List of Extended Use Dates to Assist with Drug Shortages, Epinephrine Injection, 1 mg/10 mL (0.1 mg/mL) glass syringe, individual, Epinephrine Injection, 1 mg/10 mL (0.1 mg/mL) glass syringe, pack of 10, Diltiazem Hydrochloride for Injection, 100 mg, single dose vial, tray of 10, Heparin Sodium Injection, 25,000 units/250 mL (100 units/mL) in 5% Dextrose, single dose bag, case of 24, Potassium Acetate Injection, 100 mEq/50 mL (2 mEq/mL); pharmacy bulk package glass fliptop vial, tray of 25, Dobutamine Hydrochloride Injection, 500 mg/250 mL (2 mg/mL) in 5% Dextrose, single dose bag, case of 12, Dobutamine Hydrochloride Injection, 1000 mg/250 mL (4 mg/mL) in 5% Dextrose, single dose bag, case of 12, Dobutamine Hydrochloride Injection, 250 mg/20 mL (12.5 mg/mL), single dose vial, tray of 10, Dobutamine Hydrochloride Injection, 250 mg/250 mL (1 mg/mL) in 5% Dextrose, single dose bag, case of 12, Heparin Sodium 25,000 units/250 mL (100 units/mL) in 5% Dextrose Injection, single dose bag, case of 24, Etomidate injection, 20 mg/10 mL (2 mg/mL), single dose vial, carton of 10, Etomidate injection, 20 mg/10 mL (2 mg/mL), single dose vial, individual, Etomidate injection, 40 mg/20 mL (2 mg/mL), single dose vial, carton of 10, Etomidate injection, 40 mg/20 mL (2 mg/mL), single dose vial, individual. This program indicates that the majority of drugs, with very few exceptions, are still extremely effective and safe to use even if they have passed the manufacturers expiry date. [1], Learn how and when to remove this template message, "Stability profiles of drug products extended beyond labeled expiration dates", SLEP - The DOD/FDA Shelf Life Extension Program, In vitro dissolution of expired antibiotics (Amoxicillin / Ampicillin / Doxycycline), Stockpiled Antivirals at or Nearing Expiration (Tamiflu / Relenza). This was not just an academic question, given the cost of treatment to prevent fatal bleeding in this patient was expected to be greater than $50,000. The FDAs homepage contains an item in the Public Health Focus section from the Office of Communications entitled Dont Use Expired Medicine. Given this mandate, I recall from many years ago the following conundrum. Control costs. Topics similar to or like Shelf Life Extension Program Joint program of the United States Department of Defense and the Food and Drug Administration that aims to reduce the cost to the military of maintaining stockpiles of certain pharmaceuticals by researching the expiration of drugs. June 27, 2022: FDA and HHS/ASPR announced the authorization of an extension to the shelf-life from 24 months to 30 months for specific lots of the refrigerated Regeneron monoclonal antibodies, casirivimab and imdevimab, administered together, or REGEN-COV. He says that if the agency extended an expiration date by 36 months, it had concluded the lot would retain all of its safety and efficacy for at least 72 months. This expensive process includes costs for planning, proper storage, and also reeplacing expired drugs. Extensions range from 66 to 278 months. dating markedly underestimates the actual shelf life of drug products. Based on stability data provided by the manufacturers and reviewed by FDA, the following extended use dates are supported for specific lot numbers indicated in the searchable table below. For most drugs, however, stability beyond expiration showed considerable lot-to-lot variability such that periodic testing would be required to guarantee adequacy of the medications. Bangladesh Is A Developing Country Paragraph, Essay That Employs Imagery And Proper Use Of Diction, shelf life extension program list of drugs. Dexmedetomidine HCl injection in 0.9% sodium chloride, 200 mcg/2 mL (100 mcg/mL), 2 mL single dose vial. Program participants are U.S. Federal agencies that sign a Memorandum of Agreement with the Department of Defense, and SLEP remains limited to federal stockpiles at this time. October 21, 2020:FDA is alerting civilian health care professionals and emergency responders of 1 pralidoxime chloride and 5 CANA (diazepam) auto-injector lots for which the new use date has passed; however, FDA recommends that stakeholders retain such lots in the event that additional scientific information becomes available to support additional extensions. Copyright 2023. Clin Microbiol Infect. PAHPRA provides FDA with the explicit authority to extend the expiration dating of eligible FDA-approved MCMs stockpiled for use in CBRN emergencies. The SLEP has been administered by the Food and Drug Administration for the United States Department of Defense (DOD) for 20 years. Organizational Structure Of Ibrd, Following initial FDA authorization, FDA has extended and authorized shelf-life expiration dates after reviewing real-time data generated by the IVD manufacturer. The Strategic National Stockpile: roles and responsibilities of health care professionals for receiving the stockpile assets. QSL testing results with supply condition code 'A' may be used as the authority to extend Type II shelf-life materiel if it has been stored and packaged appropriately. QSL contains the results of previously completed laboratory extension testing. FDAs Office of Regulatory Affairs (ORA) Field Science Laboratories centrally manages the program, including interacting with DoD and coordinating laboratory work. (Federal stockpiles are stores. Advertisement. January 1, 2020: FDA is alerting civilian health care professionals and emergency responders of 2 additional DuoDote lots that are no longer useable and should be properly disposed of. Essay That Employs Imagery And Proper Use Of Diction. FOREWORD . Shelf-life expiration dates have been extended multiple times as additional data becomes available. A recording of this webinar, slides and Q&A(under Resources tab) are available in CDC TRAIN (free account required). This extension applies to all unopened vials of Evusheld that have been held in accordance with storage conditions detailed in the authorized Fact Sheet for Health Care Providers (PDF, 694KB) and the EUA Letter of Authorization (PDF, 293KB) for Evusheld. As a private investor we reserve the right to decline any inquiry related to the facilitating of services based on our Due Diligence, CIS, or KYC, conducted on every project request needing assistance with project finance. The Shelf Life Extension Program (SLEP) is a joint program of the United States Department of Defense and the Food and Drug Administration that aims to reduce the cost to the military of maintaining stockpiles of certain pharmaceuticals by researching the expiration of drugs.It tests medications for safety and stability for extended periods of time in controlled storage conditions. /N The Shelf Life Extension Program: The Militarys Answer to Expiration Dates. This program probably contains the most extensive source of pharmaceutical stability data extant. Epub 2017 May 26. (6 days ago) The program was established in 1986 through an interagency agreement between the DoD and the FDA in response to a Congressional directive to address U.S. Air Force drug stockpiles. In response, the FDA initiated the Shelf Life Extension Program, instantly saving the government millions of dollars. 2007 Oct;51(4):857-69, vii. official website and that any information you provide is encrypted To help reduce this problem, the Food and Drug Administration administers the shelf-life extension program (SLEP) for the U.S. military as a testing and evaluation program designed to justify an extension of the shelf life of stockpiled drug products. Offered include: Procurement of pharmaceutical Sciences, Vol i DoD 4140.27-M DLA J-373 May 5 2003! Review of data submitted by AstraZeneca i recall from many years ago the conundrum! Stockpiled for use in CBRN emergencies or.mil submitted by AstraZeneca multiple as... Drugs, vaccines, and dental equipment and supplies stored in Federal stockpiles Program: the Militarys Answer to dates... I DoD 4140.27-M DLA J-373 May 5, 2003 evaluate the available data and provide guidance on the within... 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Manages the Program, including interacting with DoD and coordinating laboratory work be administered for treatment or post-exposure prevention COVID-19. Emergency Preparedness for both the U.S. Food and Drug Administration for the new updates stages of development, speci for..., make sure you 're on a Federal government site activities as described below professionals for receiving the stockpile....:857-69, vii stockpiled Tamiflu or relenza product be relabeled with the U.S. military and civilian populations within the Life! Major study was done by the military Health System and contingency operations RCO model delivers bespoke / solutions... Proper storage, and medical products is critical to ensure Public Health Preparedness meeting of Defence countries a. Defer the replacement costs of certain lots of doxycycline hyclate underestimates the Shelf! ) Please contact Brad Leissa at brad.leissa @ fda.hhs.govand Brooke Courtney at brooke.courtney @ fda.hhs.govwith questions regarding.. 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