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Myrelez 90 mg solucion inyectable en jeringa precargada efg

About the medicine

Como usar Myrelez 90 mg solucion inyectable en jeringa precargada efg

Introduction

Leaflet: information for the user

Myrelez 60mg pre-filled syringe EFG

Myrelez 90mg pre-filled syringe EFG

Myrelez 120mg pre-filled syringe EFG

lanreotida

Read this leaflet carefully before you start using this medicine, because it contains important information for you.

  • Keep this leaflet, as you may need to read it again.
  • If you have any questions, consult your doctor, pharmacist or nurse.
  • This medicine has been prescribed for you only, and you must not give it to others even if they have the same symptoms as you, as it may harm them.
  • If you experience any side effects, consult your doctor, pharmacist or nurse, even if they are not listed in this leaflet. See section 4.

1. What is Myrelez and what it is used for

2. What you need to know before using Myrelez

3. How to use Myrelez

4. Possible side effects

5. Storage of Myrelez

6. Contents of the pack and additional information

1. What is Myrelez and what is it used for

Myrelez contains the active ingredient lanreotide, which belongs to a group of drugs calledgrowth hormone inhibitors. It is similar to another substance (a hormone) calledsomatostatin.

Lanreotide decreases hormone levels in the body, such as growth hormone (GH) and insulin-like growth factor 1 (IGF-1), and inhibits the release of some hormones in the gastrointestinal tract and intestinal secretions. Additionally, it has an effect on some types of tumors (calledneuroendocrine tumors) of the intestine and pancreas, advanced, by stopping or delaying their growth.

What is Myrelez used for:

  • Treatment of acromegaly (a condition in which the body produces too much growth hormone).
  • Relief of symptoms, such as hot flashes and diarrhea, that sometimes occur in patients with neuroendocrine tumors (NETs).
  • Treatment and control of the growth of some tumors of the intestine and pancreas, in an advanced stage, calledgastroenteropancreatic neuroendocrine tumorsor NETs-GEP. It is used when these tumors cannot be removed.

2. What you need to know before starting to use Myrelez

Do not use Myrelez:

-if you are allergic to lanreotide, somatostatin, or similar medications (somatostatin analogs) or to any of the other components of this medication (listed in section6).

Warnings and precautions

Consult your doctor, pharmacist, or nurse before starting to use Myrelez:

  • If you arediabetic, as lanreotide may affect your blood sugar levels. Your doctor will check your blood sugar levels and may adjust your antidiabetic treatment while receiving lanreotide.
  • If you havegallstones(stones in the gallbladder), as lanreotide may promote the formation of gallstones in the gallbladder. In this case, you may need to undergo regular check-ups. Your doctor may decide to suspend lanreotide treatment if complications arise from gallstones.
  • If you havethyroid problems, as lanreotide may slightly decrease your thyroid function.
  • If you suffer fromheart problems, as lanreotide treatment may cause sinus bradycardia (decreased heart rate). Caution should be exercised when starting lanreotide treatment in patients with bradycardia.

Talk to your doctor or pharmacist if you experience any of the above before using Myrelez.

Children

Myrelez is not recommended for use in children.

Other medications and Myrelez

Inform your doctor or pharmacist if you are taking, have taken recently, or may need to take any other medication.

You should exercise special caution in the case of concomitant administration with:

  • Ciclosporin(a medication that reduces immune reactions; often used after a transplant or in autoimmune diseases).
  • Bromocriptine(a dopamine agonist, used in the treatment of certain types of brain tumors and Parkinson's disease or to prevent lactation after childbirth).
  • Medications that induce bradycardia(medications that decrease heart rate, such as beta-blockers).

Your doctor will decide if adjustments should be made to the dose of these medications.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, or if you think you may be pregnant or plan to become pregnant, consult your doctor or pharmacist before using this medication.

Lanreotide should only be administered if it is truly necessary.

Driving and operating machinery

It is unlikely that Myrelez treatment will affect your ability to drive vehicles or operate machinery, but it is possible that adverse effects, such as dizziness, may occur. If you experience them, be careful when driving or operating machinery.

3. How to use Myrelez

Follow exactly the administration instructions of this medication as indicated by your doctor. In case of doubt, consult your doctor or pharmacist again.

Recommended dose

Treatment of acromegaly

The recommended dose is an injection every 28days. Your doctor may adjust the dose of your injection using one of the three available doses of Myrelez (60, 90 or 120mg).

If you are well controlled with your treatment, your doctor may recommend a change in the frequency of your Myrelez 120mg injections to every 42 or 56days. Any change in dose will depend on the symptoms you experience and how you respond to the medication.

Your doctor will also decide the duration of treatment.

Relief of symptoms (such as hot flashes and diarrhea) associated with neuroendocrine tumors

The recommended dose is an injection every 28days. Your doctor may adjust the dose of your injection using one of the three available doses of Myrelez (60, 90 or 120mg).

If you are well controlled with your treatment, your doctor may recommend a change in the frequency of your Myrelez 120mg injections to every 42 or 56days.

Your doctor will also decide the duration of treatment.

Treatment of tumors of the intestine and pancreas, calledgastroenteropancreatic neuroendocrine tumors (GEP-NETs)or GEP-NETs. It is used when these tumors are advanced and cannot be removed by surgery.

The recommended dose is 120mg every 28days. Your doctor will decide the duration of treatment with Myrelez for tumor control.

Administration method

Myrelez must be administered by subcutaneous injection.

The injection should be administered in the upper outer quadrant of the buttock by a healthcare professional or a trained caregiver (family member or friend).

If after being taught how to self-administer the injection, you administer it yourself, the injection should be given in the upper outer thigh.

Your doctor should decide whether to administer the medication yourself or have it administered by another trained person.

USE INSTRUCTIONS

  1. Box contents

The following instructions explain how to inject Myrelez.

Please read all the instructions carefully before starting the product injection.

The contents of the pre-filled syringe are a semi-solid phase with a gelatinous appearance, viscous characteristics, and a color that varies from white to pale yellow. The supersaturated solution may also contain microbubbles that may clear during injection. These differences are normal and do not affect the quality of the product.

  1. Before starting

B1. Remove Myrelez from the refrigerator 30minutes before administration. Keep the laminated package closed until just before injection.

B2. Before opening the package, check that it is intact and that the medication has not expired. The expiration date is printed on the outer box and on the package.Do not use the pre-filled syringe if the product has expired or the bag is damaged.

B3.Wash your handswith soap and dry them well before starting.

B4. Ensure you have a clean surface to prepare the injection.

B5. Choose the injection site: see below.

B6. Ensure youclean the injection site.

B7. Tear the package to open it and remove the pre-filled syringe.

If a healthcare professional or a trained family member or friend is administering the injection:use the upper outer quadrant of thebuttock.

If you are self-administering the injection:use the upper outerthigh.

Alternating the injection sitebetween the left and right side each time you receive a Myrelez injection.

  1. Preparing the syringe

C1: Remove the syringe cap.

  • Hold the syringe barrel firmly (do not hold it by the plunger).
  • With the other hand, remove the cap by turning it.

C2: Open the needle package

  • Hold the needle package and remove the cap.
  • Caution: Do not touch the open end of the needle package, as it must remain clean.

C3: Insert the syringe tip into the needle package opening.

  • Hold the needle package with one hand and,
  • With the other, hold the syringe barrel firmly (do not hold it by the plunger) and turn it until the syringe and needle are fully connected.
  • They will be fully locked when you can turn it no more.

Important: Lock the syringe firmly so that it does not leak medication.

C4: Remove the needle from the package.

  • Hold the syringe barrel (do not hold it by the plunger).
  • Remove the needle from its package in a straight linewithout turning or bendingto ensure that the syringe is properly connected to the safety needle.

Caution: From this step, the needle is partially exposed.

  • NEVER TOUCH OR ATTEMPT TO OPEN THE GREEN NEEDLE PROTECTOR
  • THE GREEN NEEDLE PROTECTOR IS NOT A CAP OR REMOVABLE COVER FOR THE NEEDLE.
  • THE GREEN NEEDLE PROTECTOR WILL AUTOMATICALLY ACTIVATE DURING NEEDLE INSERTION.
  • THE GREEN NEEDLE PROTECTOR WILL COVER AND BLOCK THE NEEDLE AUTOMATICALLY ONCE THE INJECTION IS COMPLETE
  • THE GREEN NEEDLE PROTECTOR IS A SAFETY LOCKING MECHANISM THAT AUTOMATICALLY ACTIVATES.
  1. Administer the injection

D1: Position the syringe

  • To check where to administer the injection, see the sectionB.
  • Stretch the skin at the injection site using the thumb and index finger of the hand not holding the pre-filled syringe to make it taut and smooth.
  • With the other hand, hold the lower part of the syringe barrel (do not hold it by the plunger).
  • Place the syringe at a 90-degree angle to the skin.

D2: Insert the needle

  • Without pinching or pressing the skin at the injection site, push the needle firmly against the skin.
  • The green needle protector will retract and the safety mechanism will activate.
  • Continue until only the green collar of the needle protector is visible.
  • Do notpush the plunger at this step. Keep the syringe in this position for the next step.

D3: Push the plunger tip

  • Move the hand from the skin to the plunger.
  • Push the plungerslowlyuntil the tip touches the syringe barrel (it is easier to press the plunger with the dominant hand).
  • It usually takes about 20seconds.
  1. Remove the syringe and dispose of it

E1: Extract from the skin

  • Remove the syringe from the body in a straight line.
  • The green needle protector will cover the needle.

E2: Gently press

  • Apply a light pressure to the injection site with a dry cotton swab or a sterile gauze to prevent any bleeding.
  • Do notrub or massage the injection site after administration.

E3: Dispose of the syringe

  • Dispose of the used syringe and needle according to local regulations or your doctor's instructions.
  • Needles are not reusable.
  • Do notthrow away the needles or syringe in the trash.

If you use more Myrelez than you should

In case of overdose or accidental ingestion, consult your doctor or pharmacist immediately or call the Toxicological Information Service, phone 91 562 04 20, indicating the medication and the amount ingested.

If you have injected or have been given too much Myrelez, you may experience additional or more severe side effects (see section4 "Possible side effects").

If you forget to use Myrelez

As soon as you realize you have forgotten a dose, consult your doctor and they will decide when you should administer the next dose. Do not self-administer additional doses to compensate for missed doses without consulting your healthcare professional.

If you interrupt treatment with Myrelez

A break of more than one dose or premature termination of treatment with Myrelez may affect the effectiveness of treatment. Consult your doctor before interrupting treatment.

If you have any other questions about the use of this medication, ask your doctor or pharmacist.

4. Possible Adverse Effects

Like all medicines, this medicine may cause side effects, although not everyone will experience them.

Inform your doctor immediately if you notice any of the following side effects:

  • Feeling more thirsty or more tired than normal and having a dry mouth. These may be signs that you have high blood sugar levels or are developing diabetes.
  • Feeling hungry, trembling, excessive sweating, or feeling confused. These may be signs of low blood sugar levels.

The frequency of these side effects is common, and they may affect up to 1 in 10 people.

Inform your doctor immediately if you notice that:

  • Your face becomes red or swollen, or you develop spots or a rash.
  • You feel pressure in your chest, have difficulty breathing, or experience wheezing.
  • You feel dizzy, possibly due to a drop in blood pressure.

These symptoms may be a sign of an allergic reaction.

The frequency of these side effects is unknown; it cannot be estimated from the available data.

Other side effects

Inform your doctor or pharmacist immediately if you experience any of the following side effects.

The most common side effects are gastrointestinal disturbances, gallbladder problems, and reactions at the injection site. The side effects that can occur with Myrelez are listed below, according to their frequencies.

Very common: may affect more than 1 in 10 people:people:

  • Diarrhea, soft stools, abdominal pain
  • Gallstones and other gallbladder disturbances. You may have symptoms, such as severe and sudden abdominal pain, high fever, jaundice (yellowing of the skin and the white of the eyes), chills, loss of appetite, itching skin

Common: may affect up to 1 in 10 people:people:

  • Weight loss
  • Lack of energy
  • Slow heart rate
  • Feeling extremely tired
  • Loss of appetite
  • Feeling weak
  • Excess fat in the stool
  • Sensation of dizziness, having a headache
  • Loss of hair or decreased body hair
  • Muscle, ligament, tendon, and bone pain
  • Reactions at the injection site, such as pain and skin hardening
  • Abnormalities in liver and pancreas analytical results and changes in blood sugar levels
  • Nausea, vomiting, constipation, gas, bloated stomach, or discomfort, indigestion
  • Biliary dilation (enlargement of the bile ducts between the liver and the gallbladder and the intestine). You may have symptoms, such as abdominal pain, nausea, jaundice, and fever

Uncommon: may affect up to 1 in 100 people:people:

  • Hot flashes
  • Difficulty sleeping
  • Change in stool color
  • Changes in blood sodium levels and alkaline phosphatase results

Frequency not known: the frequency cannot be estimated from the available data):

  • Sudden, sharp pain in the lower part of the stomach. This may be a sign of pancreatitis (inflammation of the pancreas).
  • Redness, pain, heat, and swelling at the injection site that may feel filled with liquid when pressed, fever. This may be a sign of abscess.
  • Sudden, sharp pain in the upper right or central part of the abdomen, which may extend to the shoulder or back, abdominal sensitivity, nausea, vomiting, and high fever. This may be a sign of gallbladder inflammation (cholecystitis).
  • Pain in the upper right part of the abdomen, fever, chills, yellowing of the skin and eyes (jaundice), nausea, vomiting, clay-colored stools, dark urine, fatigue. These may be signs of bile duct inflammation (cholangitis).

Since lanreotide can alter your blood sugar levels, your doctor may want to monitor your blood sugar levels, especially at the beginning of treatment.

Similarly, as gallbladder disturbances can occur with this type of medication, your doctor may want to monitor your gallbladder at the beginning of treatment and occasionally once treatment has started.

Inform your doctor or pharmacist if you experience any of the side effects mentioned above.

Reporting side effects

If you experience any type of side effect, consult your doctor, pharmacist, or nurse,even if it is a possible side effect that does not appear in this prospectus. You can also report them directly through the Spanish System for Pharmacovigilance of Medicines for Human Use: www.notificaRAM.es. By reporting side effects, you can contribute to providing more information on the safety of this medicine.

5. Myrelez Storage

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

Do not use this medication after the expiration date that appears on the box and label after "CAD". The expiration date is the last day of the month indicated.

The product must be administered immediately after opening the protective aluminum pouch.

Store in refrigerator (between 2°C and 8°C) in the original packaging to protect it from light.

Each syringe is individually packaged.

Medicines should not be thrown down the drains or in the trash. Dispose of the containers and medicines you no longer need at the SIGRE point of the pharmacy. If in doubt, ask your pharmacist how to dispose of the containers and medicines you no longer need. In this way, you will help protect the environment.

6. Contents of the packaging and additional information

Composition of Myrelez

  • The active ingredient is lanreotide (60 mg, 90 mg, or 120 mg).
  • The other components are water for injection and glacial acetic acid (for pH adjustment).

Appearance of the product and contents of the package

Myrelez is an injectable viscous solution, contained in a semi-transparent plastic syringe of 0.5 ml volume and accompanied by a single-use needle with a safety device. Myrelez is presented in a semi-solid formulation of a light yellow color.

Each preloaded syringe is packaged in an aluminum bag and a cardboard box.

Box with a 0.5 ml syringe and a safety needle co-packaged (1.2 mm × 20 mm).

Multiple packaging with three boxes, each containing a 0.5 ml syringe with a co-packaged safety needle (1.2 mm × 20 mm).

Only some package sizes may be commercially available.

Holder of the marketing authorization and responsible for manufacturing

Holder of the marketing authorization

Amdipharm Limited

3 Burlington Road

Dublin 4,

Ireland

Responsible for manufacturing

Pharmathen S.A

Dervenakion 6,

Pallini Attiki, 15351,

Greece

Pharmathen International S.A

Industrial Park Sapes,

Rodopi Prefecture, Block No 5,

Rodopi 69300,

Greece

Local representative:

Advanz Pharma Spain S.L.U.

Paseo de la Castellana 135, 7ª

28046 Madrid (Spain)

Tel. +34 900 834 889

medicalinformation@advanzpharma.com

Last review date of this leaflet:June 2024.

Detailed information about this medication is available on the website of the Spanish Agency for Medicines and Medical Devices (AEMPS)http://www.aemps.gob.es/

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