Patient Information Leaflet
Hyrimoz 40 mg pre-filled syringe
adalimumab
40 mg/0.4 ml
Read this leaflet carefully before you start using this medicine because it contains important information for you.
Keep thisPatient Information Leafletduring your treatment and for the 4 months following your last injection (or that of your child) of Hyrimoz.
Hyrimoz contains the active ingredient adalimumab, a medication that acts on the body's immune system.
Hyrimoz is indicated for the treatment of the inflammatory diseases described below:
The active ingredient of Hyrimoz, adalimumab, is a monoclonal antibody. Monoclonal antibodies are proteins that target a specific site in the body.
The target of adalimumab is another protein called tumor necrosis factor (TNFα), which is found in elevated concentrations in the aforementioned inflammatory diseases. By binding to TNFα, Hyrimoz blocks its action and reduces inflammation in these diseases.
Rheumatoid Arthritis
Rheumatoid arthritis is an inflammatory disease of the joints.
Hyrimoz is used to treat rheumatoid arthritis in adults. If you have active moderate to severe rheumatoid arthritis, you may be given Hyrimoz before other disease-modifying medications such as methotrexate. If these medications do not work well enough, you will be given Hyrimoz to treat your rheumatoid arthritis.
Hyrimoz can also be used in the treatment of severe, active, and progressive rheumatoid arthritis without prior treatment with methotrexate.
Hyrimoz can reduce the damage to the cartilage and bones of the joints caused by the disease and improve physical performance.
Hyrimoz is usually used in combination with methotrexate. If your doctor considers methotrexate not suitable, Hyrimoz can be administered alone.
Polyarticular Juvenile Idiopathic Arthritis
Polyarticular juvenile idiopathic arthritis is an inflammatory disease of the joints that typically appears for the first time in childhood.
Hyrimoz is used to treat polyarticular juvenile idiopathic arthritis in children and adolescents aged 2 to 17 years. Patients may have received first other disease-modifying medications, such as methotrexate. If these medications do not work well enough, patients will receive Hyrimoz.
Arthritis Associated with Enthesitis
Arthritis associated with enthesitis is an inflammatory disease of the joints and the sites of tendon attachment to bone. Hyrimoz is used to treat arthritis associated with enthesitis in patients aged 6 years and older. Patients may have received first other disease-modifying medications, such as methotrexate. If they do not respond sufficiently well to these medications, patients will be given Hyrimoz.
Ankylosing Spondylitis and Undifferentiated Axial Spondyloarthritis without Radiographic Evidence of Ankylosing Spondylitis
Ankylosing spondylitis and undifferentiated axial spondyloarthritis without radiographic evidence of ankylosing spondylitis are inflammatory diseases that affect the spine.
Hyrimoz is used in adults to treat these diseases. If you have ankylosing spondylitis or undifferentiated axial spondyloarthritis without radiographic evidence of ankylosing spondylitis, you will be treated first with other medications, and if these medications do not work well enough, you will receive Hyrimoz to reduce the signs and symptoms of your disease.
Plaque Psoriasis in Adults and Children
Plaque psoriasis is an inflammatory disease of the skin that causes red, scaly, crusty areas covered with silvery scales. Plaque psoriasis can also affect the nails, causing them to deteriorate, thicken, and lift from the nail bed, which can be painful. It is believed that plaque psoriasis is caused by a defect in the body's immune system that leads to an increase in skin cell production.
Hyrimoz is used to treat moderate to severe plaque psoriasis in adults. Hyrimoz is also used to treat severe plaque psoriasis in children and adolescents aged 4 to 17 years who have not responded or are not good candidates for topical medications or UV treatment.
Psoriatic Arthritis
Psiatic arthritis is an inflammatory disease of the joints associated with psoriasis.
Hyrimoz is used to treat psoriatic arthritis in adults. Hyrimoz can reduce the joint damage caused by the disease in cartilage and bone and improve physical performance.
Hidradenitis Suppurativa in Adults and Adolescents
Hidradenitis suppurativa (also known as inverse acne) is a long-lasting and often painful inflammatory disease of the skin. Symptoms can include sensitive nodules (lumps) and abscesses (boils) that can secrete pus.
It usually affects specific areas of the skin, such as under the chest, armpits, inner thighs, groin, and buttocks. It can also cause scarring in affected areas.
Hyrimoz is used to treat
Hyrimoz can reduce the number of nodules and abscesses and the pain that usually accompanies this disease. You may have received other medications previously. If these medications do not work well enough, you will receive Hyrimoz.
Crohn's Disease in Adults and Children
Crohn's disease is an inflammatory disease of the digestive tract.
Hyrimoz is used to treat
If you have Crohn's disease, you will be treated first with other medications. If you do not respond sufficiently well to these medications, you will receive Hyrimoz to reduce the signs and symptoms of Crohn's disease.
Ulcerative Colitis in Adults and Children
Ulcerative colitis is an inflammatory disease of the large intestine.
Hyrimoz is used to treat
If you suffer from ulcerative colitis, you may be given other medications first. If these medications do not work well enough, you will be given Hyrimoz to reduce the signs and symptoms of ulcerative colitis.
Non-Infectious Uveitis in Adults and Children
Non-infectious uveitis is an inflammatory disease that affects certain parts of the eye. Inflammation causes a decrease in vision and/or the presence of floaters in the eye (black dots or thin lines that move across the field of vision). Hyrimoz acts by reducing this inflammation.
Hyrimoz is used to treat
You may have received other medications previously. If you do not respond sufficiently well to these medications, you will receive Hyrimoz.
No use Hyrimoz
Warnings and precautions
Consult your doctor or pharmacist before starting to use Hyrimoz.
Allergic reaction
Infections
Tuberculosis (TB)
Travel/infection recurrence
Hepatitis B virus
Age 65 or older
Dental procedures or surgery
Demyelinating diseases
Vaccinations
Heart failure
Fever, petechiae, bleeding, or pale appearance
Cancer
Autoimmune diseases
Children and adolescents
Other medications and Hyrimoz
Inform your doctor or pharmacist if you are taking, have taken recently, or may need to take any other medication.
Hyrimoz can be taken with methotrexate or certain disease-modifying antirheumatic drugs (sulfasalazine, hydroxychloroquine, leflunomide, and injectable gold preparations), corticosteroids, or pain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs).
Do not use Hyrimoz with medications whose active ingredients are anakinra or abatacept due to an increased risk of severe infection. Do not recommend combining adalimumab and other TNF antagonists with anakinra or abatacept, as this may increase the risk of infections, including severe infections and other possible pharmacological interactions. If you have any doubts, consult your doctor.
Pregnancy and breastfeeding
Driving and operating machinery
The influence of Hyrimoz on your ability to drive, ride a bike, or operate machinery is minimal. You may experience dizziness and visual disturbances after using Hyrimoz.
Hyrimoz contains sodium
This medication contains less than 1 mmol (23 mg) of sodium per 0.4 ml dose; it is essentially "sodium-free."
Follow exactly the administration instructions of this medication as indicated by your doctor. In case of doubt, consult your doctor again.
The following table indicates the recommended doses of Hyrimoz for each of its approved uses. Your doctor may prescribe another dose of Hyrimoz if you need a different dose.
Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, or axial spondyloarthritis without radiographic evidence of ankylosing spondylitis | ||
Age or body weight | What amount and with what frequency should be taken? | Notes |
Adults | 40 mg every other week as a single dose | In the case of rheumatoid arthritis, treatment with methotrexate is maintained during the use of Hyrimoz. If your doctor determines that methotrexate is inappropriate, Hyrimoz may be administered alone. If you have rheumatoid arthritis and do not receive methotrexate during your treatment with Hyrimoz, your doctor may decide to give you 40 mg of Hyrimoz weekly or 80 mg every other week. |
Juvenile idiopathic polyarticular arthritis | ||
Age or body weight | What amount and with what frequency should be taken? | Notes |
Children, adolescents, and adults from 2 years of age with a body weight of 30 kg or more | 40 mg every other week | No applicable |
Children, adolescents from 2 years of age with a body weight between 10 kg and less than 30 kg | 20 mg every other week | No applicable |
Arthritis associated with enthesitis | ||
Age or body weight | What amount and with what frequency should be taken? | Notes |
Children, adolescents, and adults from 6 years of age with a body weight of 30 kg or more | 40 mg every other week | No applicable |
Children and adolescents from 6 years of age with a body weight between 15 kg and less than 30 kg | 20 mg every other week | No applicable |
Plaque psoriasis | ||
Age or body weight | What amount and with what frequency should be taken? | Notes |
Adults | A first dose of 80 mg (as two injections of 40 mg on the same day), followed by 40 mg every other week, starting one week after the first dose. | Continue injecting Hyrimoz for as long as your doctor has indicated. If that dose does not work well enough, your doctor may increase the dose to 40 mg weekly or 80 mg every other week. |
Pediatric plaque psoriasis | ||
Age or body weight | What amount and with what frequency should be taken? | Notes |
Children and adolescents from 4 to 17 years of age with a body weight of 30 kg or more | A first dose of 40 mg, followed by 40 mg one week later. From then on, the usual dose is 40 mg every other week. | No applicable |
Children and adolescents from 4 to 17 years of age with a body weight between 15 kg and less than 30 kg | A first dose of 20 mg, followed by 20 mg one week later. From then on, the usual dose is 20 mg every other week. | No applicable |
Hidradenitis supurativa | ||
Age or body weight | What amount and with what frequency should be taken? | Notes |
Adults | A first dose of 160 mg (as four injections of 40 mg on the same day or two injections of 40 mg per day for two consecutive days), followed by a dose of 80 mg (as two injections of 40 mg on the same day) two weeks later. After two weeks more, continue with a dose of 40 mg weekly or 80 mg every other week, as prescribed by your doctor. | It is recommended that you use a daily antiseptic liquid on the affected areas. |
Adolescents from 12 to 17 years of age with a body weight of 30 kg or more | A first dose of 80 mg (as two injections of 40 mg on the same day), followed by 40 mg every other week, starting one week after the first dose. | If that dose does not work well enough, your doctor may increase the dose to 40 mg weekly or 80 mg every other week. It is recommended that you use a daily antiseptic liquid on the affected areas. |
Crohn's disease | ||
Age or body weight | What amount and with what frequency should be taken? | Notes |
Adults | A first dose of 80 mg (as two injections of 40 mg on the same day), followed by 40 mg every other week, starting two weeks after the first dose. If a faster response is required, your doctor may prescribe a first dose of 160 mg (as four injections of 40 mg on the same day or two injections of 40 mg per day for two consecutive days), followed by 80 mg (as two injections of 40 mg on the same day) two weeks later. From then on, the usual dose is 40 mg every other week. | If that dose does not work well enough, your doctor may increase the dose to 40 mg weekly or 80 mg every other week. |
Pediatric Crohn's disease | ||
Age or body weight | What amount and with what frequency should be taken? | Notes |
Children and adolescents from 6 to 17 years of age with a body weight of 40 kg or more | A first dose of 80 mg (as two injections of 40 mg on the same day), followed by 40 mg every other week, starting two weeks after the first dose. If a faster response is required, your doctor may prescribe a first dose of 160 mg (as four injections of 40 mg on the same day or two injections of 40 mg per day for two consecutive days), followed by 80 mg (as two injections of 40 mg on the same day) two weeks later. From then on, the usual dose is 40 mg every other week. | If that dose does not work well enough, your doctor may increase the dose to 40 mg weekly or 80 mg every other week. |
Children and adolescents from 6 to 17 years of age with a body weight less than 40 kg | A first dose of 40 mg, followed by 20 mg every other week, starting two weeks after the first dose. If a faster response is required, your doctor may prescribe a first dose of 80 mg (as two injections of 40 mg on the same day), followed by 40 mg two weeks later. From then on, the usual dose is 20 mg every other week. | If that dose does not work well enough, your doctor may increase the frequency of the dose to 20 mg weekly. |
Ulcerative colitis | ||
Age or body weight | What amount and with what frequency should be taken? | Notes |
Adults | A first dose of 160 mg (as four injections of 40 mg on the same day or two injections of 40 mg per day for two consecutive days), followed by 80 mg (as two injections of 40 mg on the same day) two weeks later. From then on, the usual dose is 40 mg every other week. | If that dose does not work well enough, your doctor may increase the dose to 40 mg weekly or 80 mg every other week. |
Pediatric ulcerative colitis | ||
Age or body weight | What amount and with what frequency should be taken? | Notes |
Children and adolescents from 6 years of age with a body weight of 40 kg or more | A first dose of 160 mg (as four injections of 40 mg on the same day or two injections of 40 mg per day for two consecutive days), initially, followed by 80 mg (as two injections of 40 mg on the same day) two weeks later. From then on, the usual dose is 80 mg every other week. | Patients who are 18 years of age or older while on treatment with 80 mg every other week should continue with the prescribed dose. |
Children and adolescents from 6 years of age with a body weight less than 40 kg | A first dose of 80 mg (as two injections of 40 mg on the same day), initially, followed by 40 mg (as one injection of 40 mg) two weeks later. From then on, the usual dose is 40 mg every other week. | Patients who are 18 years of age or older while on treatment with 40 mg every other week should continue with the prescribed dose. |
Non-infectious uveitis | ||
Age or body weight | What amount and with what frequency should be taken? | Notes |
Adults | A first dose of 80 mg (as two injections of 40 mg), followed by 40 mg every other week, starting one week after the first dose. | In non-infectious uveitis, treatment with corticosteroids or other medications that affect the immune system may be continued during the use of Hyrimoz. Hyrimoz may also be administered alone. Continue injecting Hyrimoz for as long as your doctor has indicated. |
Children and adolescents from 2 years of age with a body weight of 30 kg or more | 40 mg every other week | Your doctor may also prescribe a first dose of 80 mg, which may be administered one week before starting with the usual dose of 40 mg every other week. It is recommended that you use Hyrimoz in combination with methotrexate. |
Children and adolescents from 2 years of age with a body weight less than 30 kg | 20 mg every other week | Your doctor may also prescribe a first dose of 40 mg, which may be administered one week before starting with the usual dose of 20 mg every other week. It is recommended that you use Hyrimoz in combination with methotrexate. |
Form and route of administration
Hyrimoz is injected under the skin (subcutaneously).
The detailed instructions on how to inject Hyrimoz are found in section 7, “Instructions for use”.
If you use more Hyrimoz than you should
If you accidentally inject Hyrimoz more frequently than you should, call your doctor or pharmacist and explain that you have taken more than necessary. Always carry the medication box with you, even if it is empty.
If you forget to use Hyrimoz
If you forget to administer an injection, you should inject the next dose of Hyrimoz as soon as you remember. Then, administer the next dose as usual, as if you had not forgotten a dose.
If you interrupt treatment with Hyrimoz
The decision to stop using Hyrimoz should be discussed with your doctor. Your symptoms may return after stopping treatment.
If you have any other questions about the use of this medication, ask your doctor or pharmacist.
Like all medicines, this medicine can cause side effects, although not everyone will experience them. Most side effects are mild to moderate. However, some can be serious and require treatment. Side effects can appear up to 4 months or more after the last injection of Hyrimoz.
Seek urgent medical attentionif you notice any of the following signs of allergic reaction or heart failure:
Contact your doctor as soon as possibleif you notice any of the following side effects:
The following side effects have been observed with adalimumab:
Very common(may affect more than 1 in 10 people)
Common(may affect up to 1 in 10 people)
Uncommon(may affect up to 1 in 100 people)
Rare(may affect up to 1 in 1,000 people)
Frequency not known(cannot be estimated from available data)
Some side effects observed in clinical trials with adalimumab can only be identified by blood tests and do not have symptoms. These include:
Very common(may affect more than 1 in 10 people)
Common(may affect up to 1 in 10 people)
Uncommon(may affect up to 1 in 100 people)
Rare(may affect up to 1 in 1,000 people)
Reporting of side effects
If you experience any type of side effect, consult your doctor or pharmacist, even if it is a possible side effect that does not appear in this leaflet.
You can also report them directly through thenational reporting system included in theAppendix V. By reporting side effects, you can contribute to providing more information on the safety of this medicine.
Keep this medication out of the sight and reach of children.
Do not use this medication after the expiration date that appears on the label/blister/package after “CAD” or “EXP”. The expiration date is the last day of the month indicated.
Store in refrigerator (between 2 °C and 8 °C). Do not freeze.
Store the preloaded pen in the outer packaging to protect it from light.
Alternative Storage:
When necessary (for example, when traveling), you may store Hyrimoz at room temperature (up to 25 °C) for a maximum period of 42 days (ensure it is protected from light). Once removed from the refrigerator for storage at room temperature, the preloaded penmust be used within the next 42 days or discarded, even if it is returned to the refrigerator later. You must note the date when you removed the preloaded pen from the refrigerator and the date after which it must be discarded.
Medicines should not be disposed of through drains or in the trash. Ask your pharmacist how to dispose of the containers and the medication that you no longer need. This will help protect the environment.
Composition of Hyrimoz
Appearance of the product and contents of the pack
Hyrimoz 40 mg solution for injection (injection) in pre-filled syringe is supplied as 0.4 ml of transparent to slightly opalescent, colourless or slightly yellowish solution.
Hyrimoz is supplied in a single-use pre-filled syringe attached to a triangular luer with transparent viewer and label. The syringe inside the luer is made of type I glass with stainless steel 29 gauge needle and internal needle cap of rubber (thermoplastic elastomer), with 0.4 ml of solution.
Boxes with 1, 2, and 4 pre-filled syringes of Hyrimoz.
Boxes of multiple packs with 6 (3 packs of 2) pre-filled syringes of Hyrimoz.
Only some pack sizes may be marketed.
Hyrimoz is available in pre-filled syringe and pre-filled luer.
Marketing authorisation holder
Sandoz GmbH
Biochemiestr. 10
6250 Kundl
Austria
Responsible for manufacturing
Sandoz GmbH Schaftenau
Biochemiestr. 10
6336 Langkampfen
Austria
Novartis Pharmaceutical Manufacturing GmbH
Biochemiestrasse 10
6336 Langkampfen
Austria
For more information about this medicine, please contact the local representative of the marketing authorisation holder:
België/Belgique/Belgien Sandoz nv/sa Tél/Tel: +32 2 722 97 97 | Lietuva Sandoz Pharmaceuticals d.d filialas Tel: +370 5 2636 037 |
Luxembourg/Luxemburg Sandoz nv/sa Tél/Tel.: +32 2 722 97 97 | |
Ceská republika Sandoz s.r.o. Tel: +420 225 775 111 | Magyarország Sandoz Hungária Kft. Tel.: +36 1 430 2890 |
Danmark/Norge/Ísland/Sverige Sandoz A/S Tlf: +45 63 95 10 00 | Malta Sandoz Pharmaceuticals d.d. Tel: +356 21222872 |
Deutschland Hexal AG Tel: +49 8024 908 0 | Nederland Sandoz B.V. Tel: +31 36 52 41 600 |
Eesti Sandoz d.d. Eesti filiaal Tel: +372 665 2400 | Österreich Sandoz GmbH Tel: +43 5338 2000 |
Ελλάδα Novartis (Hellas) A.E.B.E. Τηλ: +30 210 281 17 12 | Polska Sandoz Polska Sp. z o.o. Tel.: +48 22 209 70 00 |
España Sandoz Farmacéutica, S.A. Tel: +34 900 456 856 | Portugal Sandoz Farmacêutica Lda. Tel: +351 21 196 40 00 |
France Sandoz SAS Tél: +33 1 49 64 48 00 | România Sandoz SRL Tel: +40 21 407 51 60 |
Hrvatska Sandoz d.o.o. Tel: +385 1 23 53 111 | Slovenija Lek farmacevtska družba d.d. Tel: +386 1 580 21 11 |
Ireland Rowex Ltd. Tel: + 353 27 50077 | Slovenská republika Sandoz d.d. - organizacná zložka Tel: +421 2 48 200 600 |
Italia Sandoz S.p.A. Tel: +39 02 96541 | Suomi/Finland Sandoz A/S Puh/Tel: +358 10 6133400 |
Κύπρος Sandoz Pharmaceuticals d.d. Τηλ: +357 22 69 0690 | United Kingdom (Northern Ireland) Sandoz GmbH Tel: +43 5338 2000 |
Latvija Sandoz d.d. Latvia filiale Tel: +371 67 892 006 |
Last update of this leaflet
Other sources of information
The detailed information on this medicine is available on the website of the European Medicines Agency:http://www.ema.europa.eu.
7. Instructions for use
To help prevent possible infections and ensure correct use of Hyrimoz, it is essential to follow these instructions.
Make sure to read, understand, and follow these instructions for use before injecting Hyrimoz. Your healthcare professional should teach you how to prepare and inject Hyrimoz correctly with the single-use pre-filled syringe of Hyrimoz before using it for the first time. If you have any questions, consult your healthcare professional.
Your single-use pre-filled syringe of Hyrimoz
Figure A:parts of the Hyrimoz syringe
InFigure A, the syringe is shown once the cap has been removed. Do not remove the cap until you are ready to administer the injection.
It is essential to: |
|
Storage of the syringe |
Keep Hyrimoz and all medicines out of the reach of children. |
What is needed for the injection? |
Place the following items on a clean and flat surface. The pack includes:
The pack of the syringe does not include (seeFigure B):
Figure B:items not included in the pack |
Before the injection Preparation of the syringe | |
If the syringe does not pass any of the above checks, contact your pharmacist. | Figure C:pre-injection safety checks |
1. Selection of the injection site: | |
Figure D).
| Figure D:choose the injection site |
2. Cleaning of the injection site: | |
| Figure E:clean the injection site |
3. Removal of the needle cap: | |
| Figure F:remove the needle cap |
4. Holding the syringe: | |
| Figure G:hold the syringe |
Injection |
Before the injection, read the following: During the injection, you will hear2 loud clicks:
You must continue to hold the syringe firmly against the skin until you see that agreen indicatoroccupies the entire viewer and stops moving. |
5. Start of the injection: | |
| Figure H:start the injection |
6. End of the injection: | |
| Figure I:end the injection |
After the injection 7. Check that the green indicator occupies the entire viewer(seeFigure J): | |
| Figure J:check the green indicator |
8. Disposal of used syringes: | |
| Figure K:disposal of the used syringe |
If you have any questions, consult a doctor, pharmacist, or nurse who is familiar with Hyrimoz.
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