You are correct. Female sex is NOT a predictor of opioid overdose. In fact, men were significantly more vulnerable than women to overdose deaths involving opioid and stimulant drugs in 2020-2021, according to a study analyzing death records data from across the U.S. The study found that men had a 2–3 times greater rate of overdose mortality from opioids (like fentanyl and heroin) and psychostimulants (like methamphetamine and cocaine).

Another meta-analysis of 28 studies (23,963,716 patients) published in CMAJ reported the association of 103 predictors with fatal or nonfatal opioid overdose.

Moderate- to high-certainty evidence supported large relative associations with:
- history of overdose (OR 5.85, 95% CI 3.78-9.04)
- higher opioid dose (OR 2.57, 95% CI 2.08-3.18 per 90-mg increment)
- 3 or more prescribers (OR 4.68, 95% CI 3.57-6.12)
- 4 or more dispensing pharmacies (OR 4.92, 95% CI 4.35-5.57)
- prescription of fentanyl (OR 2.80, 95% CI 2.30-3.41)
- current substance use disorder (OR 2.62, 95% CI 2.09-3.27)
- any mental health diagnosis (OR 2.12, 95% CI 1.73-2.61)
- depression (OR 2.22, 95% CI 1.57-3.14)
- bipolar disorder (OR 2.07, 95% CI 1.77-2.41)
- pancreatitis (OR 2.00, 95% CI 1.52-2.64)

Absolute risks among patients with the predictor ranged from 2-6 per 1,000 for fatal overdose and 4-12 per 1,000 for nonfatal overdose.

Sources:

Wang Li, et al. (2023, October 23). CMAJ. Predictors of fatal and nonfatal overdose after prescription of opioids for chronic pain: a systematic review and meta-analysis of observational studies. https://pubmed.ncbi.nlm.nih.gov/37871953/

(2023, June 14). NIH. News Release. Men died of overdose at 2-3 times greater a rate than women in the U.S. in 2020-2021. https://www.nih.gov/news-events/news-releases/men-died-overdose-2-3-times-greater-rate-women-us-2020-2021

You are correct. Azathioprine is an immunosuppressive drug used to prevent kidney transplant rejection. It's also indicated for rheumatoid arthritis and is an off-label treatment for Crohn disease and ulcerative colitis.

As a reminder, you can use the Pill ID feature to identify a pill based on its imprint code or physical characteristics, including shape, color, and scoring. Find Pill ID in the epocrates app or on epocrates web.

You are correct. Vaccination with Penbraya does not substitute for vaccination with a tetanus toxoid containing vaccine to prevent tetanus.

The FDA approved Pfizer's vaccine Penbraya on Oct. 20, making it the first vaccine to protect against the five most common serogroups of N. meningitidis. Following the FDA approval, CDC advisers are scheduled to meet on Oct. 25 to discuss recommendations for use of the new vaccine.

Source: Penbraya PI