Powder and solvent for solution for injection/infusion or for preparation of oral solution
Teicoplanin
Teicopix is an antibiotic. It contains the active substance teicoplanin, which kills bacteria (bactericidal action) that cause infection in the patient's body. Teicoplanin is used in adults and children (including newborns) to treat bacterial infections: skin and subcutaneous tissue (sometimes called soft tissue infections); joints and bones; lungs; urinary tract; heart (sometimes called endocarditis); abdominal cavity (peritonitis); blood, if caused by any of the above conditions. Teicopix can be used to treat some infections caused by Clostridium difficilebacteria in the gut. In the treatment of such infections, the solution is taken orally.
if the patient is allergicto teicoplanin or to any of the other ingredients of this medicine (listed in section 6).
Before using Teicopix, discuss with your doctor, pharmacist, or nurse if the patient: has an allergy to an antibiotic called vancomycin, has a red upper body („red man syndrome”), has a low platelet count (thrombocytopenia), has kidney problems, is taking other medicines that may cause hearing or kidney problems. The doctor may order regular tests to check the blood count and kidney and/or liver function (see „Teicopix and other medicines”). If any of these conditions apply to the patient (or the patient is not sure), consult a doctor, pharmacist, or nurse before Teicopix is given.
During treatment, the patient may have tests to check the blood, liver, kidney, and/or hearing function. This is more likely if: treatment is long-term, high loading doses are needed (12 mg/kg twice daily), the patient has kidney problems, the patient is taking or may take other medicines that may affect the nervous system, kidneys, or hearing. In patients receiving Teicopix for a long time, there may be a higher than usual increase in bacteria that are not affected by the antibiotic. The doctor will check for this.
Tell your doctor, pharmacist, or nurse about all medicines the patient is taking or has recently taken, as well as any medicines the patient plans to use. Teicopix may affect the action of other medicines, and other medicines may affect the action of Teicopix. In particular, tell your doctor, pharmacist, or nurse if the patient is taking: aminoglycoside antibiotics, as they should not be mixed with Teicopix in the same injection and may also cause hearing or kidney problems; amphotericin B (a medicine used to treat fungal infections) may cause hearing or kidney problems; cyclosporin (a medicine that affects the immune system) may cause hearing or kidney problems; cisplatin (a medicine used to treat cancer) may cause hearing or kidney problems; diuretics, such as furosemide (also called „water tablets”), may cause hearing or kidney problems. If the patient is taking any of these medicines (or the patient is not sure), consult a doctor, pharmacist, or nurse before Teicopix is given.
If the patient is pregnant or breastfeeding, thinks they may be pregnant, or plans to have a baby, they should consult a doctor, pharmacist, or nurse before using this medicine. The doctor will decide whether the medicine can be given to a pregnant woman. There is a risk of damage to the inner ear and kidney problems. If the patient is breastfeeding, they should tell their doctor before receiving this medicine. The doctor will decide whether the patient can breastfeed while using Teicopix. Studies in animals have not shown any effect on fertility.
Teicopix may cause headache or dizziness. If the patient experiences these symptoms, they should not drive or use any tools or machines.
Teicopix, 200 mg, 400 mg This medicine contains 9.45 mg of sodium (the main component of common salt) per vial. This corresponds to 0.47% of the maximum recommended daily intake of sodium in the diet for adults.
Skin and subcutaneous tissue, lung, and urinary tract infections Initial dose (first three doses): 6 mg per kilogram of body weight administered every 12 hours by intravenous injection or intramuscularly. Maintenance dose: 6 mg per kilogram of body weight administered once daily by intravenous injection or intramuscularly. Bone and joint infections, and heart infections Initial dose (first three to five doses): 12 mg per kilogram of body weight administered every 12 hours by intravenous injection. Maintenance dose: 12 mg per kilogram of body weight administered once daily by intravenous injection or intramuscularly. Infection caused by Clostridium difficilebacteria The recommended dose is 100 to 200 mg administered orally twice daily for 7 to 14 days.
Patients with kidney problems usually need a dose reduction after the fourth day of treatment: patients with mild and moderate kidney problems will receive a maintenance dose every two days or half the maintenance dose once daily; patients with severe kidney problems or undergoing hemodialysis will receive a maintenance dose every three days or one-third of the maintenance dose once daily. Peritonitis in patients undergoing peritoneal dialysis The initial dose is 6 mg per kilogram of body weight in a single intravenous injection, followed by: first week: 20 mg/L in each dialysis bag second week: 20 mg/L in every other dialysis bag third week: 20 mg/L in the dialysis bag left overnight.
Initial dose (on the first day): 16 mg per kilogram of body weight in an intravenous infusion. Maintenance dose: 8 mg per kilogram of body weight administered once daily in an intravenous infusion.
Initial dose (first three doses): 10 mg per kilogram of body weight administered every 12 hours by intravenous injection. Maintenance dose: 6 to 10 mg per kilogram of body weight administered once daily by intravenous injection.
The medicine is usually given by a doctor or nurse. The medicine will be given by intravenous injection (into a vein) or intramuscularly (into a muscle). It can also be given by intravenous infusion (drip). Infants from birth to 2 months should only receive the medicine by intravenous infusion. In the treatment of some infections, the solution may be taken orally.
It is unlikely that a doctor or nurse will give too much medicine. However, if the patient thinks they have received too much Teicopix or are feeling agitated, they should tell their doctor or nurse immediately.
The doctor or nurse will know when to give the patient Teicopix. It is unlikely that the patient will be given the medicine at the wrong time. However, if the patient has any doubts, they should consult their doctor or nurse.
The patient should not stop taking the medicine without consulting their doctor, pharmacist, or nurse. If the patient has any further questions about using this medicine, they should ask their doctor, pharmacist, or nurse.
Like all medicines, Teicopix can cause side effects, although not everybody gets them.
Uncommon(may affect up to 1 in 100 people):
life-threatening allergic reactionwith symptoms such as: difficulty breathing or wheezing, swelling, rash, itching, fever, chills.
Rare(may affect up to 1 in 1,000 people)
redness of the upper body.
Frequency not known(cannot be estimated from the available data)
blistering of the skin, mouth, eyes, or genitals – these may be symptoms of conditions called „toxic epidermal necrolysis” or „Stevens-Johnson syndrome” or „drug reaction with eosinophilia and systemic symptoms (DRESS)”. Initially, DRESS may appear as flu-like symptoms and a rash on the face, followed by a widespread rash with high fever, elevated liver enzymes in the blood, and an increased number of eosinophils (a type of white blood cell) and swollen lymph nodes.
If the patient experiences any of these side effects, they should seek medical help immediately.
Uncommon(may affect up to 1 in 100 people):
swelling of the vein and blood clot in the vein
difficulty breathing or wheezing (bronchospasm)
increased susceptibility to infections – these may be symptoms of a low white blood cell count.
Frequency not known(cannot be estimated from the available data)
lack of white blood cells – symptoms may include: fever, severe chills, sore throat, or mouth ulcers (agranulocytosis)
kidney problems or changes in their function – visible in tests. The frequency or severity of kidney problems may increase with higher doses of the medicine.
seizures.
low levels of all types of blood cells.
If the patient experiences any of these side effects, they should seek medical help immediately.
The patient should tell their doctor, pharmacist, or nurse if they experience any of the following side effects:
Common(may affect up to 1 in 10 people)
rash, redness, itching
pain
fever
Uncommon(may affect up to 1 in 100 people)
low platelet count
increased liver enzymes
increased creatinine levels in the blood (a measure of kidney function)
hearing loss, ringing in the ears, or feeling dizzy
nausea or vomiting, diarrhea
dizziness or headache
Rare(may affect up to 1 in 1,000 people)
infection (abscess)
Frequency not known(cannot be estimated from the available data)
reaction at the injection site, such as redness, pain, or swelling
If the patient experiences any side effects, including those not listed in this package leaflet, they should tell their doctor, pharmacist, or nurse. Side effects can be reported directly to the Department of Medicinal Product Monitoring of the Office for Registration 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, website: https://smz.ezdrowie.gov.pl. Side effects can also be reported to the marketing authorization holder. By reporting side effects, the patient can help provide more information on the safety of the medicine.
Keep the medicine out of the sight and reach of children. Do not use this medicine after the expiry date stated on the carton and vial after EXP. The expiry date refers to the last day of the month. Do not store above 25°C. Information on the storage conditions for Teicopix after reconstitution and the shelf-life of the reconstituted solution is described in the section „Practical information for healthcare professionals on handling and preparing Teicopix”. Do not store in a syringe. Medicines should not be disposed of via wastewater or household waste. Ask a pharmacist how to dispose of medicines no longer required. This will help protect the environment.
The active substance is teicoplanin. Each vial contains 200 mg of teicoplanin (200,000 IU). After reconstitution, the solution contains: 200 mg of teicoplanin in 3.0 mL or 400 mg of teicoplanin in 3.0 mL. The other ingredients are: powder: sodium chloride and, if necessary, sodium hydroxide to adjust the pH (see information on sodium in section 2); solvent: water for injections.
Teicopix is a powder for solution for injection/infusion or for preparation of oral solution, with a solvent provided. The powder is white to slightly yellowish. The solvent is a clear, particle-free liquid. The powder is packaged in: vials made of colorless glass type I with a usable capacity of 10 mL for 200 mg, closed with a bromobutyl rubber stopper, aluminum seal, and green plastic flip-off cap in a cardboard box; vials made of colorless glass type I with a usable capacity of 22 mL for 400 mg, closed with a bromobutyl rubber stopper, aluminum seal, and blue plastic flip-off cap in a cardboard box. The solvent is packaged in an ampoule made of colorless glass type I and contains 3 mL (for 200 mg and 400 mg). Pack sizes: 1 vial of powder + 1 ampoule of solvent, 5 vials of powder + 5 ampoules of solvent. Not all pack sizes may be marketed.
Marketing authorization holder Sandoz GmbH Biochemiestrasse 10 6250 Kundl Austria Manufacturer Lek Pharmaceuticals d.d. Verovškova 57 1526 Ljubljana Slovenia Salutas Pharma GmbH Otto-von-Guericke-Allee 1 39179 Barleben Germany
Sandoz Polska Sp. z o.o. ul. Domaniewska 50 C 02-672 Warsaw tel. 22 209 70 00
Teicoplanin Sandoz - Austria
Planitec - Bulgaria
Teicoplanina Sandoz - Italy
Teicoplanine Sandoz - Netherlands
Teicoplanin Sandoz - Sweden
Teicoplanin - United Kingdom (Northern Ireland)
Date of last revision of the package leaflet: 11/2022
(logo of the marketing authorization holder) ---------------------------------------------------------------------------------------------------------
This medicinal product is for single use only. Administration The reconstituted solution can be administered by direct injection or further diluted. The solution can be administered by intravenous injection (bolus) over 3 to 5 minutes or in a 30-minute infusion. In infants from birth to 2 months, the medicine should only be administered by infusion. The reconstituted solution can also be administered orally. Preparation of the solution To the vial of powder, slowly add the entire contents of the provided solvent. Rotate the vial gently until the powder is completely dissolved. If the solution becomes frothy, let it stand for about 15 minutes. Only clear and yellowish solutions should be used.
The resulting solution contains 200 mg of teicoplanin in 3.0 mL or 400 mg of teicoplanin in 3.0 mL. The final solution is isotonic with blood serum and has a pH of 7.2-7.8.
Nominal teicoplanin content in the vial | 200 mg | 400 mg |
Vial capacity | 10 mL | 22 mL |
Volume of solvent to be withdrawn from the ampoule for reconstitution | 3.2 mL | 3.2 mL |
Volume containing the nominal dose of teicoplanin (withdrawn with a 5 mL syringe and 23 G needle) | 3.0 mL | 3.0 mL |
Dilution of the solution before infusion Teicopix can be administered in the following infusion solutions: 9 mg/mL (0.9%) sodium chloride solution, Ringer's solution, Hartmann's solution, 5% glucose solution for injection, 0.18% sodium chloride solution with 4% glucose solution, peritoneal dialysis solution containing 1.36% or 3.86% glucose solution.
Shelf-life of the reconstituted solution The chemical and physical stability of the solution prepared as directed has been demonstrated for 24 hours at a temperature of 2 to 8°C. From a microbiological point of view, the product should be used immediately. If not used immediately, the in-use storage times and conditions are the responsibility of the user and would normally not be longer than 24 hours at 2 to 8°C.
Disposal Any unused medicinal product or waste material should be disposed of in accordance with local requirements.
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