An adapter for a pre-fillable device comprising: an adapter body (110 comprising: a coupling member (107,); and a spike with at least one conduit extending from a central portion, the central portion projecting from the adapter body; the at least one conduit extending through the spike, adapter body and the coupling member (107,); a spike cover sized to receive and seal the spike, the cover reversibly securable to the central portion; characterized in that the adapter body further comprises receiving means configured to receive a vial shroud; the adapter body further comprising an elastomeric plug contained in the coupling member; the adapter body further including a penetrating cannula having one end coupled to the central body and a second end extending at least partially into the coupling member (107,), the penetrating cannula fluidically coupled to the at least one conduit of the spike; wherein the adapter is configured in a first state wherein the second end of the penetrating cannula is sealed by the elastomeric plug to seal liquid contents of the pre-fillable device and/or control contact of the liquid contents of the pre-fillable device with: the penetrating cannula, the elastomeric plug, and the spike cover; and wherein the adapter is configurable to transition to a second state wherein the coupling member is configurable to slidably traverse within the adapter body to urge the second end of the penetrating cannula to penetrate the elastomeric plug and provide fluidic communication between the pre-fillable device and the at least one conduit of the spike; wherein the adapter body is configured with cylindrical side walls extending longitudinally from the central body; wherein the coupling member is cylindrical and configured to be slidably received within the cylindrical side walls of the adapter body; wherein the coupling member terminates with a threaded fitting for coupling to a Luer adapter of the prefillable device. a coupling member (107,); and a spike with at least one conduit extending from a central portion, the central portion projecting from the adapter body; the at least one conduit extending through the spike, adapter body and the coupling member (107,); a spike cover sized to receive and seal the spike, the cover reversibly securable to the central portion; characterized in that the adapter body further comprises receiving means configured to receive a vial shroud; the adapter body further comprising an elastomeric plug contained in the coupling member; the adapter body further including a penetrating cannula having one end coupled to the central body and a second end extending at least partially into the coupling member (107,), the penetrating cannula fluidically coupled to the at least one conduit of the spike; wherein the adapter is configured in a first state wherein the second end of the penetrating cannula is sealed by the elastomeric plug to seal liquid contents of the pre-fillable device and/or control contact of the liquid contents of the pre-fillable device with: the penetrating cannula, the elastomeric plug, and the spike cover; and wherein the adapter is configurable to transition to a second state wherein the coupling member is configurable to slidably traverse within the adapter body to urge the second end of the penetrating cannula to penetrate the elastomeric plug and provide fluidic communication between the pre-fillable device and the at least one conduit of the spike; wherein the adapter body is configured with cylindrical side walls extending longitudinally from the central body; wherein the coupling member is cylindrical and configured to be slidably received within the cylindrical side walls of the adapter body; wherein the coupling member terminates with a threaded fitting for coupling to a Luer adapter of the prefillable device.