Optivate

Leaflet accompanying the package: information for the user

Optivate 250 IU, 500 IU, 1000 IU

Powder and solvent for solution for injection

Human blood coagulation factor VIII

Please read carefully the contents of the leaflet before using the medicine, as it contains important information for the patient.

• Please keep this leaflet, so that you can read it again if necessary.
• In case of any doubts, please consult a doctor.
• This medicine has been prescribed specifically for you. Do not pass it on to others. The medicine may harm another person, even if their symptoms are the same.
• If the patient experiences any side effects, including any side effects not listed in this leaflet, they should inform their doctor.

Table of contents of the leaflet

• 1. What is Optivate and what is it used for
• 2. Important information before using Optivate
• 3. How to use Optivate
• 4. Possible side effects
• 5. How to store Optivate
• 6. Contents of the package and other information

1. What is Optivate and what is it used for

Optivate is a highly purified concentrate of factor VIII obtained from human plasma from tested donors. It is a white or pale yellow sterile powder, supplied with water for injections. Optivate is administered by intravenous injection for the prevention and treatment of bleeding in patients with hemophilia A (congenital factor VIII deficiency in the blood). The doctor may explain in more detail why this medicine has been prescribed.

2. Important information before using Optivate

When not to use Optivate:

• if the patient is allergic (hypersensitive) to human factor VIII or any of the other ingredients of this medicine (listed in section 6).

Warnings and precautions

• In case of more abundant or longer bleeding than usual, and if the bleeding does not stop after injection of Optivate, the patient should consult a doctor. In some patients with factor VIII deficiency, during treatment, inhibitors (antibodies) against factor VIII may develop. As a result, the treatment may not work as it should. The treating doctor will regularly order tests to detect any antibodies, especially before surgery. Both before and after the end of treatment with this medicine, especially during the first treatment cycle, the doctor will likely order tests to check the level of factor VIII in the blood.
• This medicine may contain small amounts of antibodies against blood group antigens originally present in the donors' plasma. This is normal, and in most cases, these antibodies do not cause any problems. However, if it is necessary to administer large doses of Optivate, for example during surgery, and the patient has blood group A, B, or AB, the doctor may order a blood test to check if the medicine affects red blood cells.

Complications related to catheterization: if it is necessary to use a device that provides access to the central vein (CVAD, central venous access device), the risk of complications associated with the use of CVAD should be considered, including local infections, bacteremia, and thrombosis at the catheter insertion site. For medicines produced from human blood or plasma, certain measures are taken to prevent the transmission of infections to patients. These measures include:

• careful selection of blood and plasma donors to ensure the exclusion of donors who may be carriers of infections,
• testing of individual blood samples and plasma pools for the presence of viruses/infections,
• use of blood and plasma processing stages that can inactivate or remove viruses.

Despite these measures, during the administration of medicines prepared from human blood or plasma, it is not possible to completely exclude the possibility of transmitting an infection. This also applies to unknown or newly discovered viruses and other types of infections. The measures taken are considered effective against enveloped viruses, such as human immunodeficiency virus (HIV), hepatitis B virus, and hepatitis C virus, as well as non-enveloped hepatitis A virus. The effectiveness of these measures may be limited for non-enveloped viruses, such as parvovirus B19. Parvovirus B19 infection can be dangerous for pregnant women (fetal infection) and for people with weakened immune systems or with certain types of anemia (e.g., sickle cell or hemolytic). It is recommended that before each administration of a dose of Optivate to the patient, the name and batch number of the product be recorded for the purpose of recording the batches used. Patients who regularly or repeatedly receive products with factor VIII from human plasma may be advised by their doctor to consider vaccination against viral hepatitis A and B.

Optivate and other medicines

Optivate should not be mixed in the same syringe with other medicines. The patient should tell their doctor about all medicines they are currently taking or have recently taken, as well as any medicines they plan to take.

Pregnancy, breastfeeding, and fertility

If the patient is pregnant or breastfeeding, thinks they may be pregnant, or plans to have a child, they should consult their doctor before using this medicine.

Driving and using machines

The effect of this medicine on the ability to drive and use machines is not known.

3. How to use Optivate

Before injecting the medicine at home, patients will be trained at a hemophilia treatment center in the administration of the medicine. Only the recommended injection equipment supplied with the medicine should be used. This medicine should always be used exactly as prescribed by the doctor. In case of doubts, the patient should consult their doctor. The doctor will explain what dose to use and when to take the medicine. The doctor usually prescribes a dose in relation to the number of whole vials for the most suitable dose. If further treatment is needed, subsequent doses can be administered every 8, 12, or 24 hours, depending on the needs. The doctor will provide the patient with information if necessary. The following table shows the approximate doses of factor VIII needed to stop bleeding in different conditions:

Adults:

What dose is needed to prevent bleeding in adults?

Usually, a dose of 20 to 40 IU/kg every 2 or 3 days is sufficient.

Children

In children under 6 years of age, the doctor will recommend the appropriate dose, but it usually ranges from 17 to 30 IU/kg. It can be administered up to 3 times a week to prevent bleeding.

Patients who have not been treated before

The safety and efficacy of Optivate have not been established in patients who have not been treated before.

When to inject Optivate

• The medicine should be injected after the first symptoms of bleeding appear.
• Injections should be repeated as needed until the bleeding stops.
• Each bleeding episode should be evaluated individually in terms of severity.
• In case of first-time use of the product, the doctor should supervise the patient.

Dissolving the medicine before use

The medicine should be dissolved onlyin the sterile water for injections supplied with the product.

• 1. Optivate should be dissolved only in the water for injections supplied with the product.
• 2. Before removing the cap, check that the Optivate vial and the supplied water vial are at room temperature (between 20°C and 30°C).
• 3. The water for injections intended for use with Optivate is supplied in a glass vial with a rubber stopper.
• 4. Optivate is supplied with the appropriate amount of water for injections, as presented in the table.

How to dissolve Optivate

The medicine can be dissolved using a transfer system called Mix2Vial:

The Mix2Vial transfer system is supplied with the medicine to enable easy, safe use without the need for a needle. Preparation of the solution is as follows:

	Step 1 Remove the cap from the vial and wipe the top of the rubber stopper with an alcohol swab. Repeat this step for the vial of water for injections. Remove the top part of the Mix2Vial transfer system packaging, but leave it in the packaging.
	Step 2 Place the blue end of the Mix2Vial transfer system on the water vial and press down until the needle pierces the rubber stopper, until it clicks. Remove the outer plastic packaging from the Mix2Vial transfer system and discard it, being careful not to touch the exposed end of the Mix2Vial transfer system.
	Step 3 Turn the water vial upside down without removing the Mix2Vial transfer system from it. Place the transparent end of the Mix2Vial transfer system on the Optivate vial and press down until the needle pierces the rubber stopper, until it clicks.
	Step 4 The water for injections will automatically flow into the Optivate vial due to the vacuum in the vial. Gently turn the vial to mix the product thoroughly. Do not shake the vial. Usually, within 2 to 2.5 minutes (maximum 5 minutes), a clear or slightly pearl-like solution is obtained.
	Step 5 Separate the empty water vial and the blue part from the transparent part by twisting them in the opposite direction of the clock hands. Draw air into the empty syringe by pulling the plunger to the required volume of added water. Attach the syringe to the transparent part of the Mix2Vial transfer system. Inject air from the syringe into the vial.
	Step 6 Immediately turn the vial with the solution upside down and draw the solution into the syringe. Disconnect the filled syringe from the Mix2Vial transfer system. The product is now ready for administration. The patient should follow the usual safety procedures when administering the medicine. The product should be

Note:If more than one vial of the product is needed to administer a dose, the patient should repeat steps 1 to 6 by drawing the solution from the vial into the same syringe. The Mix2Vial transfer system supplied with the product is sterile and intended for single use. After completing the dissolution process, it should be discarded into a container for contaminated items. The patient should not use this medicine if:

• the water does notflow into the vial with the medicine (this means that the vacuum in the vial has been lost; in this case, the medicine must notbe used)
• if during step 6, there are any particles in the syringe, if the solution is cloudy, or if a gelor clotforms (in this case, the patient should inform Bio Products Laboratory, providing the batch number printed on the vial).

Using a higher dose of Optivate than recommended

In case of suspected overdose, the patient should stop injecting the medicine and consult a doctor. If the patient knows they have taken too much of the medicine, they should contact their doctor as soon as possible.

Missing a dose of Optivate

The patient should not take a double dose to make up for a missed dose. They should inject the normal dose as soon as possible and then continue dosing as recommended by their doctor or a specialized nurse in hemophilia treatment.

Stopping treatment with Optivate

Beforedeciding to stop treatment, the patient should consult their doctor.

4. Possible side effects

Like all medicines, Optivate can cause side effects, although not everybody gets them.

In case of any of the following symptoms, the patient should immediately stop injecting the medicine and inform their doctor or go to the emergency room of the nearest hospital:

• throat swelling
• sudden skin redness
• hives
• dizziness (low blood pressure)
• rapid heartbeat
• nausea or vomiting
• restlessness
• chest tightness or wheezing
• tingling. These symptoms can lead to severe shock. The above allergic reactions are very rare(occurring in less than 1 in 10,000 treated patients).

Other known side effects include:

Adults and children

Common side effects (may occur in more than 1 in 100 treated patients):

• headache
• feeling that objects around are moving, spinning, or tilting (dizziness)
• cough
• sneezing

• skin redness (rash) or pain at the injection site
• other skin rash
• swelling of limbs
• itching
• increased body temperature (fever)
• sudden chills, feeling of cold, and rapid temperature rise
• stiffness of muscles and joints
• drowsiness, lethargy, or malaise

If the patient experiences any side effects, they should talk to their doctor. This includes any possible side effects not listed in this leaflet.

Reporting side effects

If side effects occur, including any side effects not listed in the leaflet, the patient should tell their doctor, pharmacist, or nurse. Side effects can be reported directly to the Department of Adverse Reaction Monitoring of Medicinal Products, Medical Devices, and Biocidal Products, Al. Jerozolimskie 181C, 02-222 Warsaw, tel.: +48 22 49 21 301, fax: +48 22 49 21 309, e-mail: ndl@urpl.gov.pl. Side effects can also be reported to the marketing authorization holder. By reporting side effects, more information can be gathered on the safety of the medicine.

5. How to store Optivate

• Do not store above 25°C.
• Do not freeze.
• Store the vial in the outer packaging to protect it from light.
• The medicine should be stored out of sight and reach of children.
• Do not use this medicine after the expiry date stated on the packaging. The expiry date refers to the last day of the month stated.
• Do not use this medicine if small particles are visible in the solution. After dissolution, Optivate should be used within 1 hour.
• Medicines should not be disposed of via wastewater or household waste. The treatment center will provide the patient with a special container for the remains of the solution, used syringes, needles, and empty containers. This will help protect the environment.

6. Contents of the package and other information

What Optivate contains

The active substance is human blood coagulation factor VIII. The other ingredients are sodium chloride, calcium chloride, sodium citrate, polysorbate 20, sodium hydroxide (for pH adjustment), hydrochloric acid (for pH adjustment), and trehalose. The preparation contains human von Willebrand factor (Von Willebrand factor, VWF).

What Optivate looks like and what the package contains

Optivate is a white or pale yellow powder with a content of 250 IU (International Units), 500 IU, or 1000 IU in glass vials. The vials are closed under vacuum with a rubber stopper, secured with a polypropylene cap and an aluminum seal. Optivate should be dissolved only with the water for injections supplied with the Optivate medicine in transparent glass bottles. A transfer system called Mix2Vial is also supplied with the medicine to enable easy and safe dissolution of the product without the need for a needle.

Marketing authorization holder and manufacturer

Bio Products Laboratory Limited, Dagger Lane, Elstree, Hertfordshire, WD6 3BX, United Kingdom.

This medicinal product is authorized in the Member States of the European Economic Area under the following names:

Austria, Cyprus, Czech Republic, Estonia, Germany, Hungary, Ireland, Latvia, Lithuania, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, United Kingdom: Optivate Belgium: Optiwate.

Date of last revision of the leaflet:

March 2017 For further information, please contact BPL through the Marketing Department at the following address or at medinfo@bpl.co.uk. Bio Products Laboratory Limited, Dagger Lane, Elstree, Hertfordshire, WD6 3BX, United Kingdom.