Patient leaflet - Docetaxel Venus Pharma 80 mg / 4 ml concentrate for solution for infusion

1. What Docetaxel Venus Pharma is and what it is used for

For the treatment of lung cancer, Docetaxel could be administered either alone or in combination with cisplatin.

What is in this leaﬂet

if you are allergic (hypersensitive) to docetaxel or any of the other ingredients of Docetaxel Venus Pharma (listed in section 6).
How to use Docetaxel Venus Pharma

Warnings and precautions

1. WHAT DOCETAXEL VENUS PHARMA IS AND WHAT IT IS USED FOR
- If you get any side eﬀects, tell your doctor, pharmacist or nurse. This includes any possible side eﬀects not listed in this leaﬂet. See section 4.
- For the treatment of advanced breast cancer, Docetaxel could be administered either alone or in combination with doxorubicin, or trastuzumab, or capecitabine. The name of this medicine is Docetaxel Venus Pharma. Its common name is docetaxel. Docetaxel is a substance derived from the needles of yew trees. Docetaxel belongs to the group of anti-cancer medicines called taxoids.

You will be asked to take premedication consisting of an oral corticosteroid such as dexamethasone, one day prior to Docetaxel administration and to continue for one or two days after it in order to minimise certain undesirable eﬀects which may occur after the infusion of Docetaxel in particular allergic reactions and ﬂuid retention (swelling of the hands, feet, legs or weight gain).

Keep this leaﬂet. You may need to read it again.
If you have any further questions, please ask your doctor, pharmacist or nurse.
Contents of the pack and other information

Docetaxel has been prescribed by your doctor for the treatment of breast cancer, special forms of lung cancer (non-small cell lung cancer), prostate cancer, gastric cancer or head and neck cancer:

For the treatment of head and neck cancer, Docetaxel is administered in combination with cisplatin and 5-ﬂuorouracil.

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

4. Possible side eﬀects
5. How to store Docetaxel Venus Pharma
- For the treatment of early breast cancer with or without lymph node involvement, Docetaxel could be administered in combination with doxorubicin and cyclophosphamide.
- For the treatment of prostate cancer, Docetaxel is administered in combination with prednisone or prednisolone.
- For the treatment of metastatic gastric cancer, Docetaxel is administered in combination with cisplatin and 5-ﬂuorouracil.

2. WHAT YOU NEED TO KNOW BEFORE YOU USE DOCETAXEL VENUS PHARMA

You must not be given Docetaxel Venus Pharma:

if the number of white blood cells is too low.
if you have a severe liver disease.

Before each treatment with Docetaxel, you will have blood tests to check that you have enough blood cells and suﬃcient liver function to receive Docetaxel. In case of white blood cells disturbances, you may experience associated fever or infections.

Tell your doctor, hospital pharmacist or nurse if you have vision problems. In case of vision problems, in particular blurred vision, you should immediately have your eyes and vision examined.

Tell your doctor, hospital pharmacist or nurse if you have experienced an allergic reaction to previous paclitaxel therapy.

Tell your doctor, hospital pharmacist or nurse if you have heart problems. Tell your doctor, hospital pharmacist, or nurse immediately if you have abdominal pain or tenderness, diarrhoea, rectal haemorrhage, blood in stool or fever. These symptoms may be the ﬁrst signs of a serious gastrointestinal toxicity, which could be fatal. Your doctor should address them immediately.

If you develop acute or worsening problems with your lungs (fever, shortness of breath or cough), please tell your doctor, hospital pharmacist or nurse immediately. Your doctor may stop your treatment immediately.

During treatment, you may be given other medicines to maintain the number of your blood cells.

Docetaxel Venus Pharma contains alcohol. Discuss with your doctor if you suﬀer from alcohol dependency, epilepsy or liver impairment. See also section “Docetaxel Venus

PACKAGE LEAFLET: INFORMATION FOR THE USER

flushing, skin reactions, itching

Docetaxel Venus Pharma will be administered to you by a healthcare professional.

Your doctor may change the dose and frequency of dosing depending on your blood tests, your general condition and your response to Docetaxel. In particular, please inform your doctor in case of diarrhoea, sores in the mouth, feeling of numbness or pins and needles, fever and give her/him results of your blood tests. Such information will allow her/him to decide whether a dose reduction is needed. If you have any further questions on the use of this medicine, ask your doctor, or hospital pharmacist.

During the infusion at the hospital the following allergic reactions may occur (may aﬀect more than 1 in 10 people):

Method and route of administration

3. HOW TO USE DOCETAXEL VENUS PHARMA

You should usually receive your infusion once every 3 weeks.

Frequency of administration

The dose will depend on your weight and your general condition. Your doctor will calculate your body surface area in square meters (m2) and will determine the dose you should receive.

Your doctor will discuss these with you and will explain the potential risks and beneﬁts of your treatment.

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

The severity of adverse events of Docetaxel may be increased when Docetaxel is given in combination with other chemotherapeutic agents.

Docetaxel will be given by infusion into one of your veins (intravenous use). The infusion will last approximately one hour during which you will be in the hospital. Usual dose

fever or chills
chest tightness; diﬃculty in breathing

The most commonly reported adverse reactions of Docetaxel alone are: decrease in the number of red blood cells or white blood cells, alopecia, nausea, vomiting, sores in the mouth, diarrhoea and tiredness.

4. POSSIBLE SIDE EFFECTS

Other medicines and Docetaxel Venus Pharma

Pregnancy, breast-feeding and fertility

Pharma contains ethanol (alcohol)” below.

Please tell your doctor or hospital pharmacist if you are taking or have recently taken any other medicine, including medicines obtained without a prescription. This is because Docetaxel or the other medicine may not work as well as expected and you may be more likely to get a side eﬀect. The amount of alcohol in this medicinal product may alter the eﬀects of other medicines.

Ask your doctor for advice before being given any medicine.

Docetaxel must NOT be administered if you are pregnant unless clearly indicated by your doctor.

You must not become pregnant during treatment with this medicine and must use an eﬀective method of contraception during therapy, because Docetaxel may be harmful for the unborn baby. If pregnancy occurs during your treatment, you must immediately inform your doctor.

You must not breast-feed while you are treated with Docetaxel.

If you are a man being treated with Docetaxel you are advised not to father a child during and up to 6 months after treatment and to seek advice on conservation of sperm prior to treatment because docetaxel may alter male fertility.

The amount of alcohol in this medicine is not likely to have an eﬀect in adults and adolescents, and its eﬀects in children are not likely to be noticeable. It may have some eﬀects in younger children, for example feeling sleepy.

Driving and using machines

The alcohol in this medicine may alter the eﬀects of other medicines. Talk to your doctor or pharmacist if you are taking other medicines.

Docetaxel Venus Pharma 160 mg/8 ml: This medicine contains 2.608 g of alcohol (ethanol) in each 8 ml which is equivalent to 41.3 volume %. The amount in 8 ml of this medicine is equivalent to 66.08 ml beer or 26.40 ml wine.

If you are pregnant or breast-feeding, talk to your doctor or pharmacist before taking this medicine.

Docetaxel Venus Pharma contains ethanol (alcohol)

The amount of alcohol in this medicinal product may impair your ability to drive or use machines. You may experience side eﬀects of this medicine that may impair your ability to drive, use tools or operate machines (see section 4 Possible side eﬀects). If this happens, do not drive or use any tools or machines before discussing with your doctor, nurse or hospital pharmacist.

Docetaxel Venus Pharma 80 mg/4 ml: This medicine contains 1.304 g of alcohol (ethanol) in each 4 ml which is equivalent to 41.3 volume %. The amount in 4 ml of this medicine is equivalent to 33.04 ml beer or 13.20 ml wine.

If you are addicted to alcohol, talk to your doctor or pharmacist before taking this medicine. Docetaxel Venus Pharma 20 mg/1 ml: This medicine contains 326 mg of alcohol (ethanol) in each 1 ml which is equivalent to 41.3 volume %. The amount in 1 ml of this medicine is equivalent to 8.26 ml beer or 3.30 ml wine.

allergic reactions as described above
infections, decrease in the number of red (anaemia), or white blood cells (which are important in ﬁghting infection) and platelets
back pain

Between infusions of Docetaxel the following may occur, and the frequency may vary with the combinations of medicines that are received

change in the colour of your nails, which may detach
fever: if this happens you must tell your doctor immediately

More severe reactions may occur.

feeling of numbness or pins and needles or pain in the joints or muscles
inﬂammation of the eye or increased tearing of the eyes
swelling caused by faulty lymphatic drainage

The hospital staﬀ will monitor your condition closely during treatment. Tell them immediately if you notice any of these eﬀects.

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

loss of appetite (anorexia)
low blood pressure.
stomach upsets including nausea, vomiting and diarrhoea, constipation
abdominal pain
alteration in sense of taste

If you had an allergic reaction to paclitaxel, you may also experience an allergic reaction to docetaxel, which may be more severe.

headache
insomnia
nasal drainage; inﬂammation of the throat and nose; cough
bleeding from the nose
indigestion
shortness of breath
sores in the mouth
hair loss: in most cases normal hair growth should return. In some cases (frequency not known) permanent hair loss has been observed
redness and swelling of the palms of your hands or soles of your feet which may cause your skin to peel (this may also occur on the arms, face, or body)
muscle aches and pains; back pain or bone pain
change or absence of menstrual period
swelling of the hands, feet, legs
tiredness; or ﬂu-like symptoms
weight gain or loss.

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

decrease in blood pressure; irregular or rapid heart beat
oesophagitis
diﬃculty or painful swallowing
haemorrhage
raised liver enzymes (hence the need for regular blood tests).
hearing impaired
dry mouth
heart failure
dizziness
dehydration
oral candidiasis
pneumonia (infection of the lungs)
blood clots
at the injection site, skin reactions, phlebitis (inﬂammation of the vein) or swelling
interstitial lung disease (inﬂammation of the lungs causing coughing and diﬃculty breathing.
Inﬂammation of the lungs can also develop when docetaxel therapy is used with radiotherapy)
pulmonary ﬁbrosis (scarring and thickening in the lungs with shortness of breath)
ventricular arrhythmia or ventricular tachycardia (manifested as irregular and/or rapid heartbeat, severe shortness of breath, dizziness, and/or fainting). Some of these symptoms can be serious. If this happens, you must tell your doctor immediately Uncommon (may affect up to 1 in 100 people):
fainting

Rare (may affect up to 1 in 1,000 people):

inﬂammation of the colon, small intestine, which could be fatal (frequency not known); intestinal perforation.

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

decrease of the sodium, potassium, magnesium, and/or calcium in your blood (electrolyte balance disorders)
acute myeloid leukaemia and myelodysplastic syndrome (types of blood cancer) may occur in patients who are treated with docetaxel together with certain other anticancer treatments.
blurred vision due to swelling of the retina within the eye (cystoid macular oedema)
- non-Hodgkin lymphoma (a cancer aﬀecting the immune system) and other cancers may occur in patients who are treated with docetaxel together with certain other anticancer treatments.

Reporting of side effects

injection site reactions at the site of a previous reaction

If you get 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 website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side eﬀects you can help provide more information on the safety of this medicine.

5. HOW TO STORE DOCETAXEL VENUS PHARMA

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

This medicinal product does not require any special temperature storage conditions. Store in the original package in order to protect from light.

Chemical and physical in-use stability has been demonstrated in non-PVC bags for 6 hours at 25°C and for 48 hours at 2 to 8°C. It should be used within 6 hours (including the one-hour infusion intravenous administration).

From a microbiological point of view, the product should be used immediately. If not used immediately, in-use storage times and conditions prior to use are the responsibility of the user and would normally not be longer than 24 hours at 2 to 8°C, unless dilution has taken place in controlled and validated aseptic conditions.

Docetaxel infusion solution is supersaturated, therefore may crystallize over time. If crystals appear, the solution must no longer be used and shall be discarded.

What Docetaxel Venus Pharma contains

6. CONTENTS OF THE PACK AND OTHER INFORMATION

The active substance is docetaxel anhydrous

The other ingredients are polysorbate 80, ethanol anhydrous (see section 2), citric acid anhydrous and water for injection.

Each ml of concentrate for solution for infusion contains 20 mg docetaxel. Do not throw away any medicines via waste water. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

What Docetaxel looks like and contents of the pack

Docetaxel concentrate for solution for infusion is a yellow to pale yellow solution.

5 ml Type I glass vial with rubber stopper and sealed with an aluminium ﬂip-oﬀ seal (green colour) containing 20 mg of docetaxel

Docetaxel Venus Pharma 20 mg/1 ml concentrate for solution for infusion Do not use this medicine after the expiry date which is stated on the outer carton and on the label of the vial after EXP. The expiry date refers to the last day of that month.

Docetaxel Venus Pharma 80 mg/4 ml concentrate for solution for infusion

15 ml Type I glass vial with rubber stopper and sealed with an aluminium ﬂip-oﬀ seal (green colour) containing 80 mg of docetaxel

20 ml Type I glass vial with rubber stopper and sealed with an aluminium ﬂip-oﬀ seal (green colour) containing 160 mg of docetaxel

Docetaxel Venus Pharma 160 mg/8 ml concentrate for solution for infusion

Marketing Authorization Holder and Manufacturer

Each box of Docetaxel Venus Pharma 80 mg/4 contains one vial of 4 ml concentrate (80 mg docetaxel).

Each box of Docetaxel Venus Pharma 20 mg/1 contains one vial of 1 ml concentrate (20 mg docetaxel).

Venus Pharma GmbH

Am-Bahnhof 1-3,

59368, Werne,

Germany

Each box of Docetaxel Venus Pharma 160 mg/8 contains one vial of 8 ml concentrate (160 mg docetaxel).

This leaﬂet was last revised in February 2021.

Preparation of the intravenous administration

It is important that you read the entire contents of this guide prior to the preparation of the Docetaxel infusion solution.

Recommendations for the safe handling

Docetaxel is an antineoplastic agent and, as with other potentially toxic compounds, caution should be exercised when handling it and preparing its solutions. The use of gloves is recommended.

If Docetaxel concentrate or infusion solution should come into contact with skin, wash immediately and thoroughly with soap and water. If it should come into contact with mucous membranes, wash immediately and thoroughly with water.

PREPARATION GUIDE FOR USE WITH DOCETAXEL VENUS PHARMA 20 MG/1 ML, 80 MG/4 ML AND 160 MG/8 ML CONCENTRATE FOR SOLUTION FOR INFUSION

The following information is intended for healthcare professionals only:

DO NOT use other docetaxel medicinal products consisting of 2 vials (concentrate and solvent) with this medicinal product (Docetaxel Venus Pharma 20 mg/1 ml, 80 mg/4 ml and 160 mg/8 ml concentrate for solution for infusion, which contains only 1 vial).

Preparation of the infusion solution

Docetaxel Venus Pharma 20 mg/1 ml, 80 mg/4 ml and 160 mg/8 ml concentrate for solution for infusion requires NO prior dilution with a solvent and is ready to add to the infusion solution.

Each vial is for single use and should be used immediately after opening. If not used immediately, in-use storage times and conditions are the responsibility of the user. More than one vial of concentrate for solution for infusion may be necessary to obtain the required dose for the patient. For example, a dose of 140 mg docetaxel would require 7 ml docetaxel concentrate for solution.

Aseptically withdraw the required amount of concentrate for solution for infusion with a calibrated syringe ﬁtted with a 21G needle.

Then, inject via a single injection (one shot) into a 250 ml infusion bag or bottle containing either 5% glucose solution or sodium chloride 9 mg/ml (0.9%) solution for infusion. If a dose greater than 190 mg of docetaxel is required, use a larger volume of the infusion vehicle so that a concentration of 0.74 mg/ml docetaxel is not exceeded.

Mix the infusion bag or bottle manually using a rocking motion.
From a microbiological point of view, reconstitution /dilution must take place in controlled and aseptic conditions and the infusion solution should be used immediately. If not used immediately, in-use storage times and conditions are the responsibility of the user.
Docetaxel infusion solution is supersaturated, therefore may crystallize over time. If crystals appear, the solution must no longer be used and shall be discarded.
All materials that have been utilised for dilution and administration should be disposed of according to standard procedures. Do not throw away any medicines via waste water. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
As with all parenteral products, infusion solution should be visually inspected prior to use, solutions containing a precipitate should be discarded.
Disposal

Tear off Area ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Docetaxel Venus Pharma 20 mg/1 ml concentrate for solution for infusion Docetaxel Venus Pharma 80 mg/4 ml concentrate for solution for infusion Docetaxel Venus Pharma 160 mg/8 ml concentrate for solution for infusion

docetaxel

Active substance?	Docetaxel
Strength?	80 mg / 4 ml
Pharmaceutical form?	A yellow to pale yellow solution
Excipients?	Polysorbate 80, Ethanol anhydrous, Citric acid anhydrous, Water for injection
Shelf life?	Unopened vial 2 years After opening of the vial Each vial is for single use and should be used immediately after opening. If not used immediately, in-use storage times and conditions are the responsibility of the user. Once added to the infusion bag Chemical and physical in-use stability has been demonstrated in non-PVC bags for 6 hours at 25°C and for 48 hours at 2 to 8°C. It should be used within 6 hours (including the one-hour infusion intravenous administration). From a microbiological point of view, the product should be used immediately. If not used immediately, in-use storage times and conditions prior to use are the responsibility of the user and would normally not be longer than 24 hours at 2 to 8°C, unless dilution has taken place in controlled and validated aseptic conditions. Docetaxel infusion solution is supersaturated, therefore may crystallize over time. If crystals appear, the solution must no longer be used and shall be discarded.
Storage	This medicinal product does not require any special temperature storage conditions. Store in the original package in order to protect from light. For storage conditions of the diluted medicinal product, see section 6.3.
Drug group (ATC)?	Taxanes L Antineoplastic and immunomodulating agents L01 Antineoplastic agents L01C Plant alkaloids and other natural products, antineoplastic drugs L01CD Taxanes, antineoplastic L01CD02 docetaxel
Marketing authorisation?	PL 34985/0010 (first authorised 9 April 2021)
Marketing authorisation holder?	Venus Pharma GmbH

Docetaxel Venus Pharma 80 mg / 4 ml concentrate for solution for infusion – patient leaflet, side effects, dosage