TRACTOCILE 7.5 mg/ml INJECTABLE SOLUTION

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

Do not use Tractocile

• If you are less than 24 weeks pregnant.
• If you are more than 33 weeks pregnant.
• If your waters have broken (premature rupture of membranes) and you have completed 30 weeks of pregnancy or more.
• If your baby (fetus) has an abnormal heart rate.
• If you are bleeding from the vagina and your doctor wants you to go into labour so that your baby can be born immediately.
• If you have a condition called "severe pre-eclampsia" and your doctor wants you to go into labour so that your baby can be born immediately. Severe pre-eclampsia is when you have very high blood pressure, fluid retention and/or protein in the urine.
• If you have a condition called "eclampsia" which is similar to "severe pre-eclampsia" but you will also have fits. This will mean that labour should be started so that your baby can be born immediately.
• If your baby has died.
• If you have or may have an infection in the uterus.
• If your placenta is blocking the birth canal.
• If your placenta is separating from the wall of your uterus.
• If you or your baby have other conditions that could be dangerous to continue with the pregnancy.

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

Do not use Tractocile if you are affected by any of these conditions. If you are not sure, tell your doctor, midwife or pharmacist before you are given Tractocile.

Warnings and precautions

Talk to your doctor, midwife or pharmacist before you are given Tractocile:

• If you think your waters have broken (premature rupture of membranes).
• If you have kidney or liver problems.
• If you are between 24 and 27 weeks pregnant.
• If you are pregnant with more than one baby.
• If you have contractions again, treatment with Tractocile may be repeated up to three times more.
• If your baby is small for the length of your pregnancy.
• If your uterus, after your baby is born, is not able to contract. This can cause bleeding.
• If you are pregnant with more than one baby and/or are taking medicines that may delay the birth of your baby, such as medicines used for high blood pressure. This can increase the risk of fluid in the lungs (pulmonary oedema).

If you have any of these conditions (or are not sure), tell your doctor, midwife or pharmacist before you are given Tractocile.

Children and adolescents

Tractocile has not been studied in pregnant women under 18 years of age.

Using Tractocile with other medicines

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

Pregnancy and breast-feeding

If you are pregnant and breast-feeding, you should stop breast-feeding during treatment with Tractocile.

3. How Tractocile will be given to you

Tractocile will be given to you in a hospital by a doctor, nurse or midwife. They will decide how much you need. They will also check that the solution is clear and free of particles.

Tractocile will be given into a vein (intravenously) in three stages:

• A first injection of 6.75 mg in 0.9 ml will be given slowly into your vein over one minute.
• Then, an infusion of 18 mg per hour will be given for 3 hours.
• Then, an infusion of 6 mg per hour will be given for up to 45 hours, or until your uterine contractions have stopped.

The total duration of treatment should not be more than 48 hours. You can have more treatments with Tractocile if you have contractions again. Treatment with Tractocile should not be repeated more than three times during a pregnancy.

During treatment with Tractocile, your contractions and your baby's heart rate can be monitored.

It is recommended not to repeat treatment more than three times during a pregnancy.

4. Possible side effects

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

The side effects seen in mothers were generally mild. There are no known side effects on the fetus or newborn.

The following side effects may occur with this medicine:

Very common(affect more than 1 in 10 people)

• Feeling sick (nausea).

Common(affect less than 1 in 10 people)

• Headache.
• Feeling dizzy.
• Flushing.
• Being sick (vomiting).

• Fast heart rate.
• Low blood pressure. The signs may include feeling dizzy or faint.
• Reaction at the site of injection.
• Increased blood sugar.

Uncommon(affect less than 1 in 100 people)

• Increased temperature (fever).
• Difficulty sleeping (insomnia).
• Itching.
• Rash.

Rare(affect less than 1 in 1,000 people)

• Your uterus not being able to contract after the birth of your baby. This can cause bleeding.
• Allergic reactions.

You may experience difficulty breathing or fluid in the lungs (pulmonary oedema), particularly if you are pregnant with more than one baby and/or are taking other medicines that may delay the birth of your baby, such as medicines used for high blood pressure.

Reporting of side effects

If you experience any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard. By reporting side effects, you can help provide more information on the safety of this medicine.

5. Storage of Tractocile

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 after EXP. The expiry date refers to the last day of the month stated.

Store in a refrigerator (2°C - 8°C).

Store in the original package to protect from light.

Once the vial is opened, the product should be used immediately.

Do not use this medicine if you notice particles or discolouration of the contents before administration.

6. Contents of the pack and further information

Composition of Tractocile

• The active substance is atosiban.
• Each vial of Tractocile 6.75 mg/0.9 ml solution for injection contains atosiban acetate equivalent to 6.75 mg of atosiban in 0.9 ml.
• The other ingredients are mannitol, hydrochloric acid and water for injections.

Appearance of Tractocile and contents of the pack

Tractocile 6.75 mg/0.9 ml solution for injection is a clear, colourless solution without particles. One pack contains one vial containing 0.9 ml of solution.

Marketing authorisation holder and manufacturer

Marketing authorisation holder:

Ferring Pharmaceuticals A/S

Amager Strandvej 40, 2770 Kastrup, Denmark

Tel: +45 88 33 88 34

Manufacturer:

Ferring GmbH

Wittland 11, D-24109 Kiel, Germany

You can get more information about this medicine by contacting the local representative of the marketing authorisation holder.

Date of last revision of this leaflet

Detailed information on this medicine is available on the European Medicines Agency web site: http://www.ema.europa.eu.

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This information is intended only for healthcare professionals:

(See also section 3).

Instructions for use:

Before using Tractocile, the solution should be examined to ensure it is clear and free of particles.

Tractocile is administered intravenously in three successive stages:

• An initial injection of 6.75 mg in 0.9 ml is given slowly into a vein over one minute.
• An infusion of 18 mg per hour is given for 3 hours.
• An infusion of 6 mg per hour is given for up to 45 hours, or until uterine contractions have stopped.

The total duration of treatment should not be more than 48 hours. New cycles of treatment with Tractocile may be given if contractions occur again. It is recommended not to repeat treatment more than three times during a pregnancy.