Label: information for the user
ALTUVOCT 250 UI powder and solvent for injectable solution
ALTUVOCT 500 UI powder and solvent for injectable solution
ALTUVOCT 750 UI powder and solvent for injectable solution
ALTUVOCT 1 000 UI powder and solvent for injectable solution
ALTUVOCT 2 000 UI powder and solvent for injectable solution
ALTUVOCT 3 000 UI powder and solvent for injectable solution
ALTUVOCT 4 000 UI powder and solvent for injectable solution
efanesoctocog alfa (human recombinant coagulation factor VIII)
This medicine is subject to additional monitoring, which will facilitate the detection of new information about its safety. You can contribute by reporting any adverse effects you may experience. The final part of section 4 includes information on how to report these adverse effects.
Read this label carefully before starting to use this medicine, as it contains important information for you.
ALTUVOCT contains the active ingredient efanesoctocog alfa, a factor VIII replacement protein.
ALTUVOCT is used to treat and prevent bleeding episodes in patients with hemophilia A (a hereditary bleeding disorder caused by a deficiency of factor VIII) and can be used in patients of all age groups.
Factor VIII is a naturally occurring protein in the body that is necessary for blood to form clots and stop bleeding. In patients with hemophilia A, factor VIII is either absent or does not function properly.
ALTUVOCT replaces this deficient or absent factor VIII. ALTUVOCT increases factor VIII concentrations in the blood, thereby helping blood to form clots at the site of bleeding, which temporarily corrects the tendency to experience bleeding episodes.
Do not use ALTUVOCT
Warnings and precautions
Consult your doctor, pharmacist or nurse before starting to use ALTUVOCT.
Cardiovascular events
If you have a heart disease or are at risk of developing it, be especially careful when using factor VIII medications and consult your doctor.
Complications associated with the catheter
If you need a central venous access device (CVAD), the risk of complications related to the CVAD, including local infections, presence of bacteria in the blood and thrombosis at the catheter insertion site, should be taken into account.
Other medications and ALTUVOCT
Inform your doctor if you are using, have used recently or may need to use any other medication.
Pregnancy and breastfeeding
If you are pregnant or breastfeeding, or think you may be pregnant or plan to become pregnant, consult your doctor before using this medication.
Driving and operating machinery
The influence of ALTUVOCT on the ability to drive and operate machinery is negligible or insignificant.
ALTUVOCT treatment will be initiated by an experienced doctor in the care of patients with hemophilia A. ALTUVOCT is administered through an injection into a vein.
After receiving the necessary training in the correct injection technique, patients or caregivers can administer ALTUVOCT at home. Your doctor will calculate your dose (in international units [IU]). This will depend on your weight and whether it is for prevention or treatment of bleeding episodes.
Follow exactly the administration instructions for this medication indicated by your doctor. In case of doubt, consult your doctor, pharmacist, or nurse again.
Keep a record
Each time you use ALTUVOCT, note the date, the name of the medication, and the batch number.
Prevention of bleeding episodes
The usual dose of ALTUVOCT is 50 international units (IU) per kilogram of body weight. The injection is administered once a week.
Treatment of bleeding episodes
The dose of ALTUVOCT is 50 international units (IU) per kilogram of body weight. The dose and frequency may be adjusted according to the severity and location of the bleeding episode.
Use in children and adolescents
ALTUVOCT can be used in children of all ages; the dosage recommendation is the same as in adults.
How to administer ALTUVOCT
ALTUVOCT is administered through an injection into a vein. See «Instructions on how to use ALTUVOCT» for more information.
If you use more ALTUVOCT than you should
Inform your doctor as soon as possible. Follow exactly the administration instructions for ALTUVOCT indicated by your doctor. In case of doubt, consult your doctor, pharmacist, or nurse again.
If you forgot to use ALTUVOCT
Do not inject a double dose to compensate for the missed doses. Inject your dose as soon as you remember and then resume your normal dosing schedule. If you are unsure of what to do, consult your doctor, pharmacist, or nurse.
If you interrupt treatment with ALTUVOCT
If you interrupt treatment with ALTUVOCT, you may no longer be protected against bleeding episodes or a bleeding episode that already exists may not stop. Do not interrupt treatment with ALTUVOCT without consulting your doctor.
If you have any other questions about the use of this medication, ask your doctor.
Like all medicines, this medicine can cause side effects, although not everyone will experience them.
If an anaphylactic reaction occurs, the injection should be stopped immediately and you should contact your doctor immediately.
The symptoms of an anaphylactic reaction are, among others, the following:
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Risk of inhibitor formation
In children who have not received previous treatment with factor VIII medications, the formation of inhibitor antibodies (see section 2) is very common (can affect more than 1 in 10 patients); however, in patients who have received previous treatment with factor VIII (more than 150 days of treatment) the risk is rare (can affect up to 1 in 100 patients). If you or your child experience the formation of inhibitor antibodies, the medicine may not work properly and you or your child may experience persistent bleeding. If this occurs, you should contact your doctor immediately.
The following side effects may appear with this medicine.
Very common side effects (can affect more than 1 in 10 people)
Common side effects (can affect up to 1 in 10 people)
Rare side effects (can affect up to 1 in 100 people)
Reporting of 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 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 about 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 box and vial after «CAD/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 vial in the outer packaging to protect it from light.
Before reconstitution, the ALTUVOCT powder can be stored at room temperature (≤ 30 °C) for a single period not exceeding 6 months. The date of removal from the refrigerator must be noted on the box. After storage at room temperature, the medication must not be reintroduced into the refrigerator.
The medication must not be used after the expiration date printed on the vial or six months after removing the box from the refrigerator, whichever occurs first.
Once the ALTUVOCT powder has been dissolved in the solvent provided in the preloaded syringe, it must be used immediately. Do not refrigerate the prepared solution.
After reconstitution, the solution must be transparent and between colorless and slightly opalescent. Do not use this medication if it appears turbid or contains visible particles.
Medicines must not be disposed of through drains or in the trash. Ask your pharmacist how to dispose of the containers and medications that you no longer need. In this way, you will help protect the environment.
Composition of ALTUVOCT
Each vial of ALTUVOCT contains nominally 250, 500, 750, 1,000, 2,000, 3,000 or 4,000 IU of efanesoctocog alfa.
Aspect of the product and contents of the package
ALTUVOCT is presented in the form of a powder and a solvent for injectable solution. The powder is a loose or compact powder of white to off-white color. The solvent supplied for the preparation of the injectable solution is a transparent and colorless solution. After preparation, the injectable solution is transparent and between colorless and slightly opalescent.
Each package of ALTUVOCT contains 1 vial of powder, 3 ml of solvent in a pre-loaded syringe, 1 plunger rod, 1 vial adapter, and 1 infusion set.
Holder of the marketing authorization and responsible for manufacturing
Swedish Orphan Biovitrum AB (publ)
SE-112 76 Stockholm
Sweden
Swedish Orphan Biovitrum AB (publ)
Norra Stationsgatan 93
113 64 Stockholm
Sweden
Last review date of this leaflet:
The detailed information on this medicine is available on the website of the European Medicines Agency:https://www.ema.europa.eu.
Turn the leaflet over to see instructions for preparation and administration of the medicine.
Instructions for use of ALTUVOCT
READ THESE INSTRUCTIONS CAREFULLY BEFORE USING ALTUVOCT
ALTUVOCT is administered by intravenous injection after dissolving the injectable powder with the solvent supplied in the pre-loaded syringe.
If your dose requires more than one vial, you will receive several packages and, ideally, a large syringe.
Your healthcare professional should teach you how to prepare and inject ALTUVOCT correctly before you use it for the first time. Ask your healthcare professional if you have any doubts.
Important information
Check that the name and dose of the medicine are correct and that you know the frequency of administration of ALTUVOCT.
Do not use the medicine if it has expired, has been opened or appears to be damaged.
ALTUVOCT should not be mixed with other injectable solutions.
Ideally, ALTUVOCT should be stored in the refrigerator. Allow the vial and the solvent syringe to reach room temperature before use. Do not use external heat.
Check that none of the elements are damaged before use; do not use them if they appear to be damaged.
All elements are valid for single use.
Wash your hands and clean a flat surface before preparing the kit. Place the syringe safely on a flat surface when not handling it.
Guide to the components (included in the box)
ALTUVOCT is reconstituted by dissolving the injectable powder (A) in the solvent supplied in the pre-loaded syringe (B). Subsequently, the ALTUVOCT solution should be administered using the infusion set (E).
A. Vial of powder | B. Syringe of 3 ml (pre-loaded with solvent) | C. Plunger rod of the plunger | D. Vial adapter of the vial | E. Infusion set |
Additional components (not included in the box)
Ensure that you have alcohol wipes (F).
You may have been supplied a large syringe (G) by your pharmacist to extract the solution from several vials into a single syringe. If you have NOT been supplied a large syringe, follow steps 6 to 8 to administer the solution from each syringe.
F. Alcohol wipes | G. Large syringe |
Reconstitution
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Hold the vial of powder (A) over a clean and flat surface and remove the plastic closure cap. | |
Clean the top of the vial with an alcohol wipe. Ensure that nothing comes into contact with the top of the vial once it has been cleaned. | |
Remove the paper protective cover from the vial adapter package (D). Do not touch the vial adapter or remove it from its package. | |
Place the vial adapter package directly over the top of the vial. Press firmly down until the adapter fits into position. The piercer will penetrate the vial stopper. | |
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Insert the plunger rod (C) into the 3 ml syringe (B). Turn the plunger rod clockwise until it is securely attached. | |
Separate the top of the closure cap from the syringe by the perforations and set it aside. Do not touch the inside of the closure cap or the tip of the syringe. | |
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Elevate the package to separate it from the vial adapter and discard it. | |
Hold the vial adapter by the lower end. Place the tip of the syringe over the top of the vial adapter. Turn the syringe clockwise until it is securely attached. | |
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Press the plunger rod slowly to inject all the solvent into the vial. | |
With your finger on the plunger rod, gently move the vial in circles until the powder has dissolved. Do not shake. | |
Examine the solution before administration. It should be transparent and colorless. Do not use the solution if it is cloudy or contains visible particles. | |
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If your dose requires more than one vial, follow the steps indicated below (5a and 5b); otherwise, follow step 6. | |
Repeat steps 1 to 4 with all vials until you have prepared a sufficient amount of solution for your dose. Remove the 3 ml syringes from each vial (see step 6b), leaving the solution in each vial. | |
For each vial, attach the large syringe (G) to the vial adapter (see step 3b) and follow step 6 to combine the solution from each vial in the large syringe. If you only need part of a vial, use the graduation scale on the syringe to see the amount of solution you extract, as indicated by your healthcare professional. | |
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Place the syringe pointing upwards. Pull the plunger rod slowly to transfer all the solution into the syringe. | |
Detach the syringe from the vial by holding the vial adapter. Turn the syringe counterclockwise to detach it. |
Administration
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Open the package of the infusion set (E) (do not use if damaged). Remove the closure cap from the tube. Do not touch the exposed end of the tube. | |
Attach the prepared syringe to the end of the tube of the infusion set by turning the syringe clockwise. | |
If necessary, apply a tourniquet. Clean the injection site with an alcohol wipe (F). | |
Extract air by placing the syringe pointing upwards and pressing the plunger rod gently. Do not push the solution through the needle. The injection of air into the vein can be dangerous. | |
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Remove the protective cover from the needle. Insert the needle into a vein, as indicated by your doctor or nurse, and remove the tourniquet if you applied it. You can use a bandage to hold the plastic wings of the needle in place at the injection site to prevent it from moving. | |
The prepared solution should be injected intravenously over 1 to 10 minutes, depending on the patient's comfort level. | |
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Remove the needle. Fold the needle protector; it should fit into place. | |
Dispose of the used needle, any remaining unused solution, the syringe, and the empty vial safely in an appropriate medical waste container. Do not reuse the equipment. |
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