Naxcel - summary of medicine characteristics

SUMMARY OF PRODUCT CHARACTERISTICS

• 1. NAME OF THE VETERINARY MEDICINAL PRODUCT

2. QUALITATIVE AND QUANTITATIVE COMPOSITION

One ml contains:

Active substance:

Ceftiofur (as crystalline free acid)

For the full list of excipients, see section 6.1.

3. PHARMACEUTICAL FORM

Suspension for injection.

Opaque white to light brown suspension.

4. CLINICAL PARTICULARS4.1 Target species

Pigs.

• 4.2 Indications for use, specifying the target species

Treatment of bacterial respiratory disease associated with Actinobacillus pleuropneumoniae , Pasteurella multocida , Haemophilus parasuis and Streptococcus suis.

Treatment of septicaemia, polyarthritis or polyserositis associated with Streptococcus suis infection.

4.3 Contraindications

Do not use in cases of hypersensitivity to ceftiofur or other beta-lactam antibiotics, or to any of the excipients.

• 4.4 Special warnings for each target species

None.

• 4.5 Special precautions for use

Special precautions for use in animals

For systemically administered broad spectrum cephalosporins (3rd and 4th generation, such as ceftiofur), it should be reflected that these are to be reserved for the treatment of clinical conditions which have responded poorly, or are expected to respond poorly, to less critical antimicrobials. Increased use, including use of the product deviating from the instructions given in the SPC, may increase the prevalence of bacteria resistant to ceftiofur. Official, national and regional antimicrobial policies should be taken into account when the product is used.

Whenever possible, cephalosporins should only be used based on susceptibility testing. When considering the treatment strategy, it is appropriate to consider improvement of the herd management practice and use supporting treatment with suitable local products (e.g. disinfectants).

Special precautions to be taken by the person administering the veterinary medicinal product to animals

Penicillins and cephalosporins such as ceftiofur may cause hypersensitivity in people and in animals following injection, inhalation, ingestion or skin contact. Hypersensitivity to penicillins may lead to cross reactions to cephalosporins and vice versa. Allergic reactions to these substances may occasionally be serious.

People with known hypersensitivity to penicillins and cephalosporins should avoid contact with this veterinary medicinal product.

Avoid contact with skin or eyes. In the event of contact, wash with clean water.

If you develop symptoms following exposure such as a skin rash or persistent eye irritation, you should seek medical advice and show the package leaflet or the label to the physician. Swelling of the face, lips or eyes or difficulty with breathing are more serious symptoms and require urgent medical attention.

• 4.6 Adverse reactions (frequency and seriousness)

Occasionally, transient local swelling may occur following intramuscular injection.

Mild tissue reactions at the injection site, such as small areas (less than 6 cm2) of discolouration and small cysts have been observed for up to 42 days after injection. Resolution has been observed at 56 days post-injection. In very rare cases anaphylactic type reactions may occur following administration of the product.

The frequency of adverse reactions is defined using the following convention:

• – very common (more than 1 in 10 animals treated displaying adverse reaction(s))

• – common (more than 1 but less than 10 animals in 100 animals treated)

• – uncommon (more than 1 but less than 10 animals in 1,000 animals treated)

• – rare (more than 1 but less than 10 animals in 10,000 animals treated)

• – very rare (less than 1 animal in 10,000 animals treated, including isolated reports).

• 4.7 Use during pregnancy, lactation or lay

Laboratory studies in mice have not produced any evidence of teratogenic, foetotoxic or maternotoxic effects. Laboratory studies in rats revealed no teratogenic effects but maternotoxic (soft faeces) and foetotoxic (reduced foetal weight) effects were observed. No effects on the reproductive performance were observed. No studies have been conducted in pregnant or lactating sows, or in breeding pigs. Use only according to the benefit-risk assessment by the responsible veterinarian.

4.8 Interaction with other medicinal products and other forms of interaction

None known.

• 4.9 Amounts to be administered and administration route

Intramuscular use.

Dose of 5 mg ceftiofur/kg bodyweight (equivalent to 1 ml of Naxcel per 20 kg bodyweight) administered once in the neck by intramuscular injection.

Shake bottle vigorously for 30 seconds, or until all visual settlement has been resuspended.

To ensure a correct dosage, bodyweight should be accurately determined to avoid under-dosing.

It is recommended to limit injection volumes to a maximum of 4 ml.

4.10 Overdose (symptoms, emergency procedures, antidotes), if necessary

Owing to the low toxicity of ceftiofur in pigs, overdoses do not typically lead to any clinical signs other than transient local swellings as described in section 4.6 (Adverse reactions).

• 4.11 Withdrawal period(s)

Meat and offal: 71 days.

5. PHARMACOLOGICAL PROPERTIES

Pharmacotherapeutic group: Antibacterials for systemic use, third-generation cephalosporins. ATC vet code: QJ01DD90.

5.1 Pharmacodynamic properties

Ceftiofur is a third-generation cephalosporin antibiotic, which is active against many Gram-positive and Gram-negative pathogens. Ceftiofur inhibits the bacterial cell wall synthesis, thereby exerting bactericidal properties.

Ceftiofur is particularly active against the following target pathogens causing respiratory and other diseases in pigs: Actinobacillus pleuropneumoniae , Pasteurella multocida , Haemophilus parasuis and Streptococcus suis. Bordetella bronchiseptica is inherently insensitive to ceftiofur in vitro.

Desfuroylceftiofur is the principal active metabolite. It has an antimicrobial activity similar to that of ceftiofur against the target pathogens.

At the recommended therapeutic dose, concentrations in plasma were higher than the MIC90 values (<0.2 jAg/ml) for the target bacteria isolated in clinical studies for at least 158 hours.

• 5.2 Pharmacoki­netic particulars

After administration, ceftiofur is quickly metabolised to desfuroylceftiofur, the principal active metabolite.

Protein binding of ceftiofur and its major metabolite is approximately 70%. One hour after a single administration, plasma concentrations are above 1 ^g/ml. Maximum concentrations in plasma (4.2±0.9 ^g/ml) are reached at approximately 22 hours after administration. Plasma concentrations above 0.2 ^g/ml of ceftiofur and its metabolite are maintained for an appropriate period of time. Approximately 60% and 15% of the dose are excreted in the urine and faeces, respectively, within 10 days after administration.

6. PHARMACEUTICAL PARTICULARS6.1 List of excipients

Triglycerides, medium chain Cottonseed oil.

6.2 Major incompatibilities

In the absence of compatibility studies, this veterinary medicinal product must not be mixed with other veterinary medicinal products.

6.3 Shelf life

Shelf life of the veterinary medicinal product as packaged for sale: 2 years.

Shelf life after first opening the immediate packaging: 28 days.

6.4 Special precautions for storage

Do not store above 25 °C.

• 6.5 Nature and composition of immediate packaging

Cardboard box with one type I glass vial of 50 ml or 100 ml with a chlorobutyl-isoprene rubber stopper and an aluminium cap.

Not all pack sizes may be marketed.

• 6.6 Special precautions for the disposal of unused veterinary medicinal product or waste materials derived from the use of such products

Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal product should be disposed of in accordance with local requirements.

7. MARKETING AUTHORISATION HOLDER

Zoetis Belgium SA

Rue Laid Burniat 1

1348 Louvain-la-Neuve

BELGIUM

8. MARKETING AUTHORISATION NUMBER (S)

EU/2/05/053/001–002

9. DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION

Date of first authorisation: 19/05/2005.

Date of last renewal: 26/05/2010.

10. DATE OF REVISION OF THE TEXT

Detailed information on this veterinary medicinal product is available on the website of the European

Medicines Agency ).

PROHIBITION OF SALE, SUPPLY AND/OR USE

Not applicable.

• 1. NAME OF THE VETERINARY MEDICINAL PRODUCT

2. QUALITATIVE AND QUANTITATIVE COMPOSITION

One ml contains:

Active substance:

Ceftiofur (as crystalline free acid)               ­200 mg.

For the full list of excipients, see section 6.1.

3. PHARMACEUTICAL FORM

Suspension for injection.

Opaque white to light brown suspension.

4. CLINICAL PARTICULARS4.1 Target species

Cattle.

• 4.2 Indications for use, specifying the target species

Treatment of acute interdigital necrobacillosis in cattle also known as Panaritium or foot rot. Treatment of acute post-partum (puerperal) metritis in cattle, in cases where treatment with another antimicrobial has failed.

4.3 Contraindications

Do not use in cases of hypersensitivity to ceftiofur or other beta-lactam antibiotics, or to any of the excipients.

• 4.4 Special warnings for each target species

None.

• 4.5 Special precautions for use

Special precautions for use in animals

For systemically administered broad spectrum cephalosporins (3rd and 4th generation, such as ceftiofur), it should be reflected that these are to be reserved for the treatment of clinical conditions which have responded poorly, or are expected to respond poorly, to less critical antimicrobials. Increased use, including use of the product deviating from the instructions given in the SPC, may increase the prevalence of bacteria resistant to ceftiofur. Official, national and regional antimicrobial policies should be taken into account when the product is used.

Whenever possible, cephalosporins should only be used based on susceptibility testing. When considering the treatment strategy, it is appropriate to consider improvement of the herd management practice and use supporting treatment with suitable local products (e.g. disinfectants).

Do not use as prophylaxis in case of retained placenta.

Special precautions to be taken by the person administering the veterinary medicinal product to animals

Penicillins and cephalosporins such as ceftiofur may cause hypersensitivity in people and in animals following injection, inhalation, ingestion or skin contact. Hypersensitivity to penicillins may lead to cross reactions to cephalosporins and vice versa. Allergic reactions to these substances may occasionally be serious.

People with known hypersensitivity to penicillins and cephalosporins should avoid contact with this veterinary medicinal product.

Avoid contact with skin or eyes. In the event of contact, wash with clean water.

If you develop symptoms following exposure such as a skin rash or persistent eye irritation, you should seek medical advice and show the package leaflet or the label to the physician. Swelling of the face, lips or eyes or difficulty with breathing are more serious symptoms and require urgent medical attention.

• 4.6 Adverse reactions (frequency and seriousness)

Visible swellings have been noted at the injection site in about two thirds of treated animals, two days after injection in field conditions. These reactions will resolve within a maximum of 23 days. Injection site swellings may result in mild to moderate pain in some animals in the initial days following injection.

In very rare cases, sudden death has been reported following administration of the product. In such cases, death has been attributed to intra-vascular administration of the product or anaphylaxis.

The frequency of adverse reactions is defined using the following convention: – very common (more than 1 in 10 animals treated displaying adverse reaction(s)) – common (more than 1 but less than 10 animals in 100 animals treated) – uncommon (more than 1 but less than 10 animals in 1,000 animals treated) – rare (more than 1 but less than 10 animals in 10,000 animals treated) – very rare (less than 1 animal in 10,000 animals treated, including isolated reports).

• 4.7 Use during pregnancy, lactation or lay

Laboratory studies in mice have not produced any evidence of teratogenic, foetotoxic or maternotoxic effects. Laboratory studies in rats have shown no evidence of teratogenic effects but maternotoxic (soft faeces) and foetotoxic (reduced foetal weight) effects were observed. No effects on the reproductive performance were observed. No specific studies have been conducted in pregnant cows and breeding cattle. Use only according to the benefit-risk assessment by the responsible veterinarian. This veterinary medicinal product can be used during lactation.

4.8 Interaction with other medicinal products and other forms of interaction

None known.

• 4.9 Amounts to be administered and administration route

Single subcutaneous injection of 6.6 mg ceftiofur/kg bodyweight (equivalent to 1 ml of Naxcel per

• 30 kg bodyweight) administered at the base of the ear.

To ensure a correct dosage, bodyweight should be accurately determined to avoid under-dosing.

It is recommended to limit injection volumes to a maximum of 30 ml per injection site.

Shake the bottle vigorously for 30 seconds, or until all visual settlement has been resuspended.

Base of the ear administration:

• • Administer in the posterior part of the ear base (see Figure 1).
• • Hold the syringe and insert the needle behind the animal’s ear so the needle and syringe point in the direction of an imaginary line that would pass through the head toward the animal’s opposite eye (see Figure 2).
• • Take appropriate precautions to avoid intra-arterial or intravenous injection, such as restraining appropriately the animal (chute or head restraint for example) and using appropriate needles [1 inch (2.54 cm) long, 16 gauge].

• Figure 1. Injection location for the subcutaneous administration of Naxcel at the posterior aspect of the ear where it attaches to the head (base of ear)

If clinical signs have not improved 48 hours after treatment, the diagnosis and treatment of the condition should be re-evaluated.

4.10 Overdose (symptoms, emergency procedures, antidotes), if necessary

In cattle, although Naxcel has not been specifically tested for overdoses, no signs of systemic toxicity related to ceftiofur have been observed following 55 mg/kg parenteral daily overdoses of ceftiofur sodium for five days.

• 4.11 Withdrawal period(s)

Meat and offal: 9 days.

Milk: zero days.

It is essential that Naxcel is only administered subcutaneously at the base of ear location in non-edible tissue, as described in section 4.9, in order to comply with the meat withdrawal period.

5. PHARMACOLOGICAL PROPERTIES

Pharmacotherapeutic group: Antibacterials for systemic use, third-generation cephalosporins. ATC vet code: QJ01DD90.

5.1 Pharmacodynamic properties

Ceftiofur is a third-generation cephalosporin antibiotic, which is active against many Gram-positive and Gram-negative pathogens. Ceftiofur inhibits the bacterial cell wall synthesis, thereby exerting bactericidal properties.

In cattle, ceftiofur is active against the following micro-organisms which are involved in acute postpartum (puerperal) metritis: Escherichia coli , Arcanobacterium pyogenes and Fusobacterium necrophorum ; and interdigital necrobacillosis: Bacteroides spp., Fusobacterium necrophorum , Porphyromonas spp. and Prevotella spp.

Desfuroylceftiofur is the principal active metabolite. It has an antimicrobial activity similar to that of ceftiofur against the target pathogens.

• 5.2 Pharmacoki­netic particulars

Ceftiofur is well absorbed in cattle following base of the ear injection. After administration, ceftiofur is quickly metabolised to desfuroylceftiofur, the principal active metabolite. Protein binding of ceftiofur and its major metabolite is high, approximately 70% – 90%. One hour after a single administration, plasma concentrations are greater than 1 ^g/ml. Maximum concentrations in plasma (about 5 ^g/ml) occurred from 12 hours following administration. Total plasma concentrations above 0.2^g/ml and i^g/ml of ceftiofur and its active metabolites are maintained for at least 7 and 4 days, respectively.

6. PHARMACEUTICAL PARTICULARS6.1 List of excipients

Triglycerides, medium chain Cottonseed oil.

6.2 Major incompatibilities

In the absence of compatibility studies, this veterinary medicinal product must not be mixed with other veterinary medicinal products.

6.3 Shelf life

Shelf life of the veterinary medicinal product as packaged for sale: 2 years.

Shelf life after first opening the immediate packaging: 28 days.

6.4 Special precautions for storage

Do not store above 25 °C.

• 6.5 Nature and composition of immediate packaging

Cardboard box with one type I glass vial of 100 ml with a chlorobutyl-isoprene rubber stopper and an aluminium cap.

• 6.6 Special precautions for the disposal of unused veterinary medicinal product or waste materials derived from the use of such products

7. MARKETING AUTHORISATION HOLDER

Zoetis Belgium SA

Rue Laid Burniat 1

1348 Louvain-la-Neuve

BELGIUM

8. MARKETING AUTHORISATION NUMBER(S)

EU/2/05/053/003

9. DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION

Date of first authorisation: 08/10/2009.

Date of last renewal: 26/05/2010.