Update: Ferring Pharmaceuticals issues voluntary product recall UPDATE of Desmopressin Acetate (Nasal Spray) 1.5 mg/mL Stimate.

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Update: Ferring Pharmaceuticals issues voluntary product recall UPDATE of Desmopressin Acetate (Nasal Spray) 1.5 mg/mL Stimate.
August 12, 2020

  Update: Ferring Pharmaceuticals issues voluntary product
  recall UPDATE of Desmopressin Acetate (Nasal Spray)
  1.5 mg/mL Stimate®.
  Dear ASD Healthcare Customer:

  This updated letter is to provide you with additional information regarding the Stimate®
  Nasal Spray recall communication that was sent to you on July 21, 2020. Stimate® Nasal
  Spray is owned and manufactured by Ferring Pharmaceuticals, Inc., and distributed and
  sold by CSL Behring LLC. After further collaboration with FDA, Ferring is now extending this
  recall to the consumer/user level.

  Ferring Pharmaceuticals US is voluntarily recalling all lots on the market of Stimate® Nasal
  Spray 1.5 mg/mL to the consumer level. This product is being recalled due to superpotency
  or amounts of desmopressin higher than specified. These out of specification results were
  identified during routine testing.

  The risks associated with higher than specified amounts of desmopressin relate to
  abnormally low levels of sodium in the blood (i.e., hyponatremia) which could potentially
  lead to seizure, coma, and death. To date, Ferring has not received an increase in adverse
  event reports due to increased concentrations of desmopressin from users of the nasal
  spray. A single non-fatal adverse event potentially associated with this issue was reported
  in the US during the timeframe that the affected product was distributed.

  Ferring is recalling all batches of Stimate® Nasal Spray. The table below provides detail for
  all impacted batches of Stimate® Nasal Spray that were shipped to CSL Behring beginning
  on December 15, 2017:
Update: Ferring Pharmaceuticals issues voluntary product recall UPDATE of Desmopressin Acetate (Nasal Spray) 1.5 mg/mL Stimate.
Ferring provided the affected lot information below:

 Product Description   NDC                   Lot Numbers            Expiration Date
                                             R15953C                30-Sep-22
                                             R14667A                31-Aug-22
                                             R14101A                31-Jul-22
                                             R13648A                30-Jun-22
                                             R13271A                30-Apr-22
                                             R11845A                30-Apr-22
                                             P13756P                31-Aug-21
 Stimate®              0053-6871-00          P13755A                30-Jun-21
                                             P13212H                30-Jun-21
                                             P13209L                30-Apr-21
                                             P11326C                28-Feb-21
                                             P11326AA               28-Feb-21
                                             N17445N                31-Dec-20
                                             N15378G                30-Sep-20
                                             N14134C                31-Jul-20

To comply with the withdrawal, we ask for your cooperation in taking the following
action:

   •   Please examine your stock immediately to determine if you have the affected lot on
       hand. If you have product from this lot, cease use immediately and quarantine the
       affected product.

   •   Use the Request a Return tool to get started. Return product to ASD
       Healthcare's warehouse (address listed below)

       Warehouse Supervisor
       ASD Healthcare
       345 International Blvd, #400A
       Brooks, KY 40109

For the full recall notice, please view the attached document on the following pages.

If you have any questions or concerns, please contact ASD Healthcare's customer service
at 800.746.6273.
Date:            August 11, 2020

URGENT: VOLUNTARY PRODUCT RECALL UPDATE
        Reclassification-Consumer/User Level
Subject:         Desmopressin Acetate (Nasal Spray) 1.5 mg/mL
                 Stimate®
                 Batch Numbers: See chart below
                 NDC Number: 0053-6871-00

Dear Customer:

This updated letter is to provide you with additional information regarding the Stimate® Nasal Spray recall
communication that was sent to you on July 21, 2020. Stimate® Nasal Spray is owned and manufactured by Ferring
Pharmaceuticals, Inc., and distributed and sold by CSL Behring LLC. After further collaboration with FDA, Ferring is now
extending this recall to the consumer/user level.

Ferring Pharmaceuticals US is voluntarily recalling all lots on the market of Stimate® Nasal Spray 1.5 mg/mL to the
consumer level. This product is being recalled due to superpotency or amounts of desmopressin higher than specified.
These out of specification results were identified during routine testing.

The risks associated with higher than specified amounts of desmopressin relate to abnormally low levels of sodium in
the blood (i.e., hyponatremia) which could potentially lead to seizure, coma, and death. To date, Ferring has not
received an increase in adverse event reports due to increased concentrations of desmopressin from users of the nasal
spray. A single non-fatal adverse event potentially associated with this issue was reported in the US during the
timeframe that the affected product was distributed.

Ferring is recalling all batches of Stimate® Nasal Spray. The table below provides detail for all impacted batches of
Stimate® Nasal Spray that were shipped to CSL Behring beginning on December 15, 2017:
              Product                        NDC                          Batch                      Expiry Date
                                                                         R15953C                      30-Sep-22
                                                                         R14667A                      31-Aug-22
                                                                         R14101A                       31-Jul-22
                                                                         R13648A                      30-Jun-22
                                                                         R13271A                      30-Apr-22
                                                                         R11845A                      30-Apr-22
                                                                         P13756P                      31-Aug-21
              Stimate®                  0053-6871-00                     P13755A                      30-Jun-21
                                                                         P13212H                      30-Jun-21
                                                                         P13209L                      30-Apr-21
                                                                         P11326C                      28-Feb-21
                                                                        P11326AA                      28-Feb-21
                                                                        N17445N                       31-Dec-20
                                                                        N15378G                       30-Sep-20
                                                                        N14134C                        31-Jul-20

CSL Behring
This recall is to be conducted to the consumer level and is being conducted with the knowledge and approval of the
Food and Drug Administration.

As previously communicated, examine your current inventory and if you have an impacted batch, contact your
Authorized Distributor’s Customer Service to facilitate a return to them.

We are requesting you take the following additional actions:
    Send the enclosed Dear Patient Letter to any patient that received the impacted product.
    Patient Returns will be handled directly through My SourceSM, CSL Behring’s Patient Resource Center (contact
        information below).

If patients have questions regarding returns, please direct them to My SourceSM , CSL Behring’s Patient Resource
Center:

  My SourceSM, CSL Behring’s Patient Resource Center Information: Phone: 1-800-676-4266
PLEASE NOTE THAT RETURNS ARE LIMITED TO INVENTORY OF STIMATE® NASAL SPRAY BATCHES LISTED IN THE TABLE
ABOVE ONLY. THERE WILL BE NO CREDIT GIVEN FOR RETURNS OF ANY OTHER BATCHES OF STIMATE® NASAL SPRAY
THAT YOU HAVE IN INVENTORY OR RETURNED BY YOUR CUSTOMERS.

If you have any questions concerning specifics of the recall, please contact CSL Behring Medical Information.

CSL Medical Information: Phone: 1-800-504-5434
                         Email: MedinfoNA@cslbehring.com

Thank you for your cooperation in this matter.

Sincerely,

Paul Stapel                                                            Brian Puglisi, PharmD
Director, Quality Assurance                                            Quality Assurance Manager
                                                                       Global Quality
Ferring Pharmaceuticals, Inc.                                          CSL Behring, L.L.C

CSL Behring
DDRA

URGENT: VOLUNTARY PRODUCT RECALL
Subject:         Desmopressin Acetate (Nasal Spray) 1.5 mg/mL
                 Stimate®
                 NDC Number: 0053-6871-00

 August 11, 2020

 Dear Valued Patient,

 CSL Behring is committed to ensuring that its products adhere to the highest quality standards. As such, we must
 notify you of a recall of Stimate® Nasal Spray. Stimate® Nasal Spray is owned and manufactured by Ferring
 Pharmaceuticals, Inc., and distributed and sold by CSL Behring LLC.

 Ferring has issued a voluntary recall of Stimate® Nasal Spray as a precaution due to the risk of amounts of
 desmopressin higher than specified, also known as superpotency. This risk was identified when routine testing
 showed higher than expected concentrations of desmopressin in some vials of the product. This recall is being
 conducted with the knowledge of the U.S. Food and Drug Administration.

 Exposure to a higher than expected amount of desmopressin can cause water retention and hyponatremia
 (decrease of sodium concentration in the blood). Mild symptoms can include nausea, headache and fatigue.
 Severe symptoms can include confusion, seizures, coma, and death as described in the Stimate® Prescribing
 Information. If you have medical questions about Stimate®, please contact CSL Medical Information by Phone at
 1-800-504-5434 or by emailing MedinfoNA@cslbehring.com.

 You are receiving this letter because you may have received product impacted by this recall.

 Patients using Stimate® Nasal Spray or their caregivers should contact their healthcare providers immediately to
 discuss available treatment options before returning the medication.

 If you have any quantity of Stimate® Nasal Spray in your possession, please contact My SourceSM, CSL
 Behring’s Patient Resource Center at 1-800-676-4266 for instructions on how to return it as a part of this
 recall. To further demonstrate our commitment to the patients who use CSL Behring products, we have
 established a program to allow you to receive remuneration upon return of the product. If you return
 Stimate® Nasal Spray purchased in the U.S. on or after January 10, 2018, you may be eligible for some
 remuneration. Please contact My SourceSM, CSL Behring’s Patient Resource Center at 1-800-676-4266.

 Adverse reactions or quality problems experienced with the use of this product may be reported to the FDA's
 MedWatch Adverse Event Reporting program either online, by regular mail or by fax.
     Complete and submit the report Online: www.fda.gov/medwatch/report.htm
          Regular Mail or Fax: Download form www.fda.gov/MedWatch/getforms.htm or
           call 1-800-332- 1088 to request a reporting form, then complete and return to the address on the pre-
           addressed form, or submit by fax to 1-800-FDA-0178
          Adverse events may also be reported to CSL Behring’s Adverse Event Reporting line by calling 1-866-915-
           6958 or by emailing adverse.events.global@cslbehring.com

 We thank you for your understanding and cooperation.

 Debra Bensen-Kennedy, MD
 VP Medical Affairs, CSL Behring
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