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REPLAGAL 1 mg/ml CONCENTRATE FOR INFUSION SOLUTION

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About the medicine

How to use REPLAGAL 1 mg/ml CONCENTRATE FOR INFUSION SOLUTION

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This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

Package Leaflet: Information for the User

Replagal 1 mg/ml concentrate for solution for infusion

Agalsidase alfa

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

  • Keep this leaflet, you may need to read it again.
  • If you have any further questions, ask your doctor or pharmacist.
  • This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
  • If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

Contents of the pack:

  1. What is Replagal and what is it used for
  2. What you need to know before you are given Replagal
  3. How Replagal is given
  4. Possible side effects
  5. Storing Replagal
  6. Contents of the pack and other information

1. What is Replagal and what is it used for

The active substance of Replagal is agalsidase alfa (1 mg/ml). Agalsidase alfa is a form of the human enzyme α-galactosidase. It is produced by activating the α-galactosidase A gene in cells. The enzyme is then removed from the cells and converted into a sterile concentrate for solution for infusion.

Replagal is used to treat adult patients, as well as adolescents and children from 7 years of age, with a confirmed diagnosis of Fabry disease. It is used as long-term enzyme replacement therapy when the level of enzymes in the body is absent or lower than normal, as occurs in Fabry disease.

After 6 months of treatment, Replagal significantly reduced pain in patients compared to patients treated with placebo (inactive medicine). Replagal reduced left ventricular mass in treated patients compared to patients treated with placebo. These results suggest that the symptoms of the disease are improving or that the disease is stabilizing.

Doctor consultation

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2. What you need to know before you are given Replagal

You should not be given Replagal

  • if you are allergic to agalsidase alfa or any of the other ingredients of this medicine (listed in section 6).

Warnings and precautions

Talk to your doctor or pharmacist before you start taking Replagal.

If you notice any of these effects during or after an infusion, you should tell your doctor immediately:

  • high fever, chills, sweating, rapid heartbeat
  • vomiting
  • dizziness
  • hives (rash)
  • swelling of the hands, feet, ankles, face, lips, mouth, or throat, which may cause difficulty swallowing or breathing.

Your doctor may temporarily stop the infusion (5-10 minutes) until the symptoms disappear and then restart the infusion. Your doctor may also treat the symptoms with other medicines (antihistamines or corticosteroids). Most of the time, you can still receive Replagal even if these symptoms occur.

If you have a severe allergic reaction (anaphylactic type), the administration of Replagal will be stopped immediately and your doctor will start appropriate treatment.

If your body produces antibodies due to treatment with Replagal, this will not make Replagal less effective and the antibodies may disappear over time.

If you have advanced kidney disease, you may find that your treatment with Replagal has a limited effect on your kidneys. Talk to your doctor or pharmacist before you start taking Replagal.

Children

Experience in children from 0 to 6 years is limited and, therefore, no dose can be recommended for this age group.

Using Replagal with other medicines

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.

Tell your doctor if you are taking any medicine that contains chloroquine, amiodarone, benoquin, or gentamicin. There is a theoretical risk of decreased activity of agalsidase alfa.

Pregnancy and breastfeeding

The limited clinical data available on exposure to Replagal during pregnancy do not indicate any adverse effects on the mother or the newborn.

If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Driving and using machines

You can drive and use machines while you are receiving Replagal.

3. How Replagal is given

This medicine should be administered and supervised by trained personnel who will also calculate the dose to be administered.

The recommended dose is an infusion of 0.2 mg per kilogram of body weight. This corresponds to approximately 14 mg or 4 vials (glass bottles) of Replagal for a person weighing about 70 kg.

Use in children and adolescents

For children and adolescents from 7 to 18 years of age, a dose of 0.2 mg/kg every two weeks may be used.

Children and adolescents may be more likely than adults to experience an infusion-related reaction. Talk to your doctor if you experience any side effects during the infusion.

Method of administration

Replagal must be diluted in a 9 mg/ml sodium chloride solution (0.9%) before administration.

After dilution, Replagal is administered through a vein, usually in the arm.

The infusion will be given every two weeks.

Each time you receive treatment, it will take 40 minutes to administer Replagal through the vein. The treatment will be supervised by a doctor specializing in the treatment of Fabry disease.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

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4. Possible side effects

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

If you experience a severe allergic reaction (anaphylactic type), the administration of Replagal will be stopped immediately and your doctor will start appropriate treatment.

Most of them are mild or moderate. Approximately 1 in 7 patients (very common reaction) may have a reaction during or after the infusion of Replagal (infusion-related reaction). These reactions include chills, headache, nausea, fever, flushing of the face, fatigue, low blood pressure, instability, sweating, difficulty breathing, itching, tremors, cough, and vomiting. However, some side effects can be serious and may require treatment. Infusion-related reactions that affect the heart, including heart rhythm problems, myocardial ischemia, and heart failure, may occur in patients with Fabry disease that affects the heart (frequency not known). Your doctor may temporarily stop the infusion (5-10 minutes) until the symptoms disappear and then restart the infusion. Your doctor may also treat the symptoms with other medicines (antihistamines or corticosteroids). Most of the time, you can still receive Replagal even if these symptoms occur.

List of other side effects:

Very common: may affect more than 1 in 10 people

  • general pain or discomfort

Common: may affect up to 1 in 10 people

  • tingling, numbness, or pain in the fingers or toes, changes in taste, eye watering, abnormal eyelid reflex, ringing in the ears, muscle twitching, prolonged sleep
  • palpitations, increased heart rate, increased blood pressure
  • cough, chest pain or tightness, hoarseness, throat pain or tightness, sticky secretions in the throat, nasal secretions, cold symptoms
  • vomiting, abdominal pain or discomfort, diarrhea
  • acne, redness, itching, or rash on the skin, rash at the infusion site
  • back or limb pain, muscle pain, joint pain, bone and muscle discomfort, swelling of the limbs or joints
  • feeling of cold or heat, flu-like symptoms, nausea, feeling of lack of energy

Uncommon: may affect up to 1 in 100 people

  • severe allergic reaction (anaphylactic type)

Children and adolescents

The side effects reported in children were, in general, similar to those reported in adults. However, infusion-related reactions (fever, difficulty breathing, chest pain) and worsening of pain occurred more frequently.

Reporting of side effects

If you experience any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storing Replagal

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the label and carton after EXP. The expiry date is the last day of the month stated.

Store in a refrigerator (between 2°C and 8°C).

Do not use Replagal if you notice changes in color or presence of foreign particles.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help protect the environment.

6. Contents of the pack and other information

What Replagal contains

  • The active substance is agalsidase alfa. Each ml of Replagal contains 1 mg of agalsidase alfa.
  • The other ingredients are: Sodium phosphate monobasic monohydrate

Polysorbate 20

Sodium chloride

Sodium hydroxide

Water for injections

Appearance and packaging

Replagal is a concentrate for solution for infusion. Your medicine is available in vials containing 3.5 mg/3.5 ml of agalsidase alfa. Packs of 1, 4, or 10 vials are available. Not all pack sizes may be marketed.

Marketing authorisation holder

Takeda Pharmaceuticals International AG Ireland Branch

Block 2 Miesian Plaza

50–58 Baggot Street Lower

Dublin 2

D02 HW68

Ireland

Manufacturer

Takeda Pharmaceuticals International AG Ireland Branch

Block 2 Miesian Plaza

50–58 Baggot Street Lower

Dublin 2

D02 HW68

Ireland

Shire Pharmaceuticals Ireland Limited

Block 2 & 3 Miesian Plaza

50 – 58 Baggot Street Lower

Dublin 2

Ireland

Date of last revision of this leaflet

Other sources of information

Detailed information on this medicine is available on the European Medicines Agency web site: http://www.ema.europa.eu/. It also provides links to other web sites on rare diseases and orphan medicines.

This information is intended only for healthcare professionals:

Instructions for use, handling, and disposal

Treatment with Replagal should be supervised by a doctor experienced in the care of patients with Fabry disease or other inherited metabolic disorders.

Replagal is administered at a dose of 0.2 mg/kg body weight every other week, by intravenous infusion over 40 minutes.

  1. Calculate the dose and number of Replagal vials needed.
  2. Dilute the total volume of Replagal concentrate needed in 100 ml of a 9 mg/ml sodium chloride solution for infusion (0.9% w/v). Take precautions to ensure the sterility of the prepared solutions, as Replagal does not contain any preservative or bacteriostatic agent; an aseptic technique must be used. Once diluted, the solution should be gently mixed, without shaking.
  3. The solution should be visually inspected for particulate matter and color changes before administration.
  4. The infusion solution will be administered over 40 minutes, using an intravenous line with an in-line filter. Since there are no preservatives, it is recommended to start administration as soon as possible. However, the chemical and physical stability of the diluted solution has been demonstrated for 24 hours at 25 °C.
  5. Do not use the same intravenous line for the infusion of Replagal and the concomitant infusion of other agents.
  6. For single use. Disposal of unused medicine and all materials that have come into contact with it should be done in accordance with local regulations.

Online doctors for REPLAGAL 1 mg/ml CONCENTRATE FOR INFUSION SOLUTION

Discuss questions about REPLAGAL 1 mg/ml CONCENTRATE FOR INFUSION SOLUTION, including use, safety considerations and prescription review, subject to medical assessment and local regulations.

5.0 (3)
Doctor

Tomasz Grzelewski

Dermatology 21 years exp.

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques. For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance. Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults. In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions. Patients commonly seek his care for: 

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns

Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.

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Doctor

Yevgen Yakovenko

General surgery 12 years exp.

Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise:

  • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
  • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
  • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
  • General and paediatric surgery: hernias, appendicitis, congenital conditions, both planned and urgent surgeries.
  • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
  • Oncological surgery: diagnosis review, treatment planning, and long-term follow-up.
  • Obesity treatment and weight management: a medical approach to weight loss, including assessment of underlying causes, evaluation of comorbidities, development of a personalised plan (nutrition, physical activity, pharmacotherapy if needed), and ongoing progress monitoring.
  • Imaging interpretation: analysis of ultrasound, CT, MRI, and X-ray results, surgical planning based on imaging data.
  • Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
  • Certified in radiological diagnostics and robotic surgery.
  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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Doctor

Svetlana Kolomeeva

Cardiology 18 years exp.

Dr. Svetlana Kolomeeva is a general practitioner and internal medicine doctor providing online consultations for adults. She helps patients manage acute symptoms, chronic conditions, and preventive care. Her clinical focus includes cardiovascular health, hypertension control, and managing symptoms like fatigue, weakness, sleep issues, and overall low energy.

Patients commonly seek her help for:

  • High blood pressure, headaches, dizziness, swelling, palpitations.
  • Diagnosis and management of hypertension, arrhythmias, and tachycardia.
  • Metabolic syndrome, excess weight, high cholesterol.
  • Chronic fatigue, insomnia, poor concentration, anxiety.
  • Respiratory symptoms: colds, flu, sore throat, cough, fever.
  • Digestive issues: heartburn, bloating, constipation, IBS symptoms.
  • Chronic conditions: diabetes, thyroid disorders.
  • Interpretation of lab tests and medical reports, therapy adjustment.
  • Second opinion and decision-making support.
  • Cardiovascular disease prevention and metabolic risk reduction.
  • Long-term follow-up and dynamic health monitoring.

Dr Kolomeeva combines clinical expertise with personalised care. She clearly explains diagnoses, guides patients through symptoms and treatment options, and provides actionable plans. Her consultations are designed not only to address current complaints but also to stabilise chronic conditions and prevent future complications. She supports patients through every stage of care – from first symptoms to ongoing health management.

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Doctor

Anna Biriukova

General medicine 6 years exp.

Dr Anna Biriukova is an internal medicine doctor with clinical experience in cardiology, endocrinology, and gastroenterology. She provides online consultations for adults, offering expert medical support for heart health, hormonal balance, digestive issues, and general internal medicine.

Cardiology – Diagnosis and treatment of:

  • High blood pressure, blood pressure fluctuations, and cardiovascular risk prevention.
  • Chest pain, shortness of breath, arrhythmias (tachycardia, bradycardia, palpitations).
  • Leg swelling, chronic fatigue, reduced exercise tolerance.
  • EKG interpretation, lipid profile evaluation, cardiovascular risk assessment (heart attack, stroke).
  • Post-COVID-19 cardiac monitoring and care.
Endocrinology – Diabetes, thyroid, metabolism:
  • Diagnosis and management of type 1 and type 2 diabetes, and prediabetes.
  • Individual treatment plans including oral medications and insulin therapy.
  • GLP-1 therapy– modern pharmacological treatment for weight management and diabetes control, including drug selection, monitoring, and safety follow-up.
  • Thyroid disorders – hypothyroidism, hyperthyroidism, autoimmune thyroid diseases (Hashimoto’s, Graves’ disease).
  • Metabolic syndrome – obesity, lipid disorders, insulin resistance.
Gastroenterology – Digestive health:
  • Abdominal pain, nausea, heartburn, gastroesophageal reflux (GERD).
  • Stomach and intestinal conditions: gastritis, irritable bowel syndrome (IBS), indigestion.
  • Management of chronic digestive disorders and interpretation of tests (endoscopy, ultrasound, labs).
General internal medicine and preventive care:
  • Respiratory infections – cough, colds, bronchitis.
  • Lab test analysis, therapy adjustments, medication management.
  • Adult vaccinations – planning, contraindications assessment.
  • Cancer prevention – screening strategies and risk assessment.
  • Holistic approach – symptom relief, complication prevention, and quality of life improvement.
Dr Biriukova combines internal medicine with specialist insight, offering clear explanations, personalised treatment plans, and comprehensive care tailored to each patient.
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€60

Frequently Asked Questions

Is a prescription required for REPLAGAL 1 mg/ml CONCENTRATE FOR INFUSION SOLUTION?
REPLAGAL 1 mg/ml CONCENTRATE FOR INFUSION SOLUTION requires a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.
What is the active substance in REPLAGAL 1 mg/ml CONCENTRATE FOR INFUSION SOLUTION?
The active ingredient in REPLAGAL 1 mg/ml CONCENTRATE FOR INFUSION SOLUTION is agalsidase alfa. This information helps identify medicines with the same composition but different brand names.
Who manufactures REPLAGAL 1 mg/ml CONCENTRATE FOR INFUSION SOLUTION?
REPLAGAL 1 mg/ml CONCENTRATE FOR INFUSION SOLUTION is manufactured by Takeda Pharmaceuticals International Ag Ireland Branch. Pharmacy brands and packaging may differ depending on the distributor.
Which doctors can assess the use of REPLAGAL 1 mg/ml CONCENTRATE FOR INFUSION SOLUTION online?
Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether REPLAGAL 1 mg/ml CONCENTRATE FOR INFUSION SOLUTION is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.
What are the alternatives to REPLAGAL 1 mg/ml CONCENTRATE FOR INFUSION SOLUTION?
Other medicines with the same active substance (agalsidase alfa) include REPLAGAL 1 mg/ml CONCENTRATE FOR INFUSION SOLUTION, ALDURAZYME, 100 U/mL Concentrate for Infusion Solution, BRINEURA 150 MG SOLUTION FOR INFUSION. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.
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