Tigecycline Accord - patient leaflet, side effects, dosage

Patient leaflet - Tigecycline Accord

1. What Tigecycline Accord is and what it is used for

Tigecycline Accord is an antibiotic of the glycylcycline group that works by stopping the growth of bacteria that cause infections.

Your doctor has prescribed Tigecycline Accord because you or your child at least 8 years old has one of the following types of serious infections:

Complicated infection of the skin and soft tissues (the tissue below the skin), excluding diabetic

foot infections.

Complicated infection in the abdomen

Tigecycline Accord is only used when your doctor thinks other antibiotics are not suitable.

2. What you need to know before you receive Tigecycline Accord

Do not use Tigecycline Accord

If you are allergic to tigecycline, or any of the other ingredients of this medicine (listed in section 6). If you are allergic to tetracycline class antibiotics (e.g., minocycline, doxycycline, etc.), you may be allergic to tigecycline.

Warnings and precautions

Talk to your doctor or nurse before receiving Tigecycline Accord:

If you have poor or slow wound healing.
If you are suffering from diarrhoea before you are given Tigecycline Accord. If you develop

diarrhoea during or after your treatment, tell your doctor at once. Do not take any diarrhoea medicine without first checking with your doctor.

If you have or previously had any side effects due to antibiotics belonging to the tetracycline

class (e.g., skin sensitization to sun light, staining on developing teeth, pancreas inflammation, and alteration of certain laboratory values aimed at measuring how well your blood clots).

If you have, or previously had liver problems. Depending on the condition of your liver, your

doctor may reduce the dose to avoid potential side effects.

If you have blockage of the bile ducts (cholestasis).
If you suffer from a bleeding disorder or are in treatment with anticoagulant drugs, as this medicine can interfere with blood coagulation.

During treatment with Tigecycline Accord:

Tell your doctor immediately if you develop symptoms of an allergic reaction.
Tell your doctor immediately if you develop severe abdominal pain, nausea, and vomiting.

These may be symptoms of acute pancreatitis (inflamed pancreas which may result in severe abdominal pain, nausea, and vomiting).

In certain serious infections, your doctor may consider to use Tigecycline Accord in combination with other antibiotics.
Your doctor will monitor you closely for the development of any other bacterial infections. If you develop another bacterial infection, your doctor may prescribe a different antibiotic specific for the type of infection present.
Although antibiotics including Tigecycline Accord fight certain bacteria, other bacteria and fungi may continue to grow. This is called overgrowth. Your doctor will monitor you closely for any potential infections and treat you if necessary.

Children

Tigecycline Accord is not to be used in children less than 8 years of age due to the lack of data on safety and efficacy in this age group and because it may induce permanent dental defects such as staining on the developing teeth.

Other medicines and Tigecycline Accord

Tell your doctor if you are taking, have recently taken or might take any other medicines.

Tigecycline Accord may prolong certain tests that measure how well your blood is clotting. It is important that you tell your doctor if you are taking medicines to avoid an excess of blood clotting (named anticoagulants). If this were the case, your doctor will monitor you closely.

Tigecycline Accord may interfere with the contraceptive pill (birth control pill). Talk to your doctor about the need for an additional method of contraception while receiving Tigecycline Accord.

Tigecycline Accord may increase the effect of medicines used to suppress the immune system (such as tacrolimus or cyclosporine). It is important that you tell your doctor if you are taking these medicines so you can be closely monitored.

Pregnancy and breast-feeding

Tigecycline Accord may cause foetal harm. If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine.

It is not known if tigecycline passes into breast milk in humans. Ask your doctor for advice before breast-feeding your baby.

Driving and using machines

Tigecycline Accord may cause side effects such as dizziness. This may impair your ability to drive or operate machinery.

Tigecycline Accord contains sodium

This medicine contains less than 1 mmol sodium (23 mg) per vial, that is to say essentially 'sodium-free.

3. How Tigecycline Accord is given

Tigecycline Accord will be given to you by a doctor or a nurse.

The recommended dose in adults is 100 mg given initially, followed by 50 mg every 12 hours. This dose is given intravenously (directly into your blood stream) over a period of 30 to 60 minutes.

The recommended dose in children aged 8 to <12 years is 1.2 mg/kg given every 12 hours intravenously to a maximum dose of 50 mg every 12 hours.

The recommended dose in adolescents aged 12 to <18 years is 50 mg given every 12 hours.

A course of treatment usually lasts for 5 to 14 days. Your doctor will decide how long you should be treated.

If you receive more Tigecycline Accord than you should

If you are concerned that you may have been given too much Tigecycline Accord, talk to your doctor or nurse immediately.

If you miss a dose of Tigecycline Accord

If you are concerned that you may have missed a dose, talk to your doctor or nurse immediately.

4. Possible side effects

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

Pseudomembranous colitis may occur with most antibiotics including Tigecycline Accord. This consists of severe, persistent or bloody diarrhoea associated with abdominal pain or fever, which can be a sign of serious bowel inflammation, which may occur during or after your treatment.

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

Nausea, vomiting, diarrhoea.

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

Abscess (collection of pus), infections
Laboratory measurements of decreased ability to form blood clots
Dizziness
Vein irritations from the injection, including pain, inflammation, swelling and clotting
Abdominal pain, dyspepsia (stomach ache and indigestion), anorexia (loss of appetite)
Increases in liver enzymes, hyperbilirubinaemia (excess of bile pigment in the blood)
Pruritus (itching), rash
Poor or slow wound healing
Headache
Increase in amylase, which is an enzyme found in the salivary glands and pancreas, increased

blood urea nitrogen (BUN).

Pneumonia
Low blood sugar
Sepsis (severe infection in the body and blood stream)/septic shock (serious medical condition which can lead to multiple organ failure and death as a result of sepsis)
Injection site reaction (pain, redness, inflammation)
Low protein levels in the blood

Uncommon side effects are (may affect up to 1 in 100 people):

Acute pancreatitis (inflamed pancreas which may result in severe abdominal pain, nausea, and vomiting)
Jaundice (yellow coloration of the skin), inflammation of the liver
Low platelet levels in the blood(which may lead to an increased bleeding tendency and bruising/haematoma)

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

Low fibrinogen levels in the blood (a protein involved in blood clotting)

Not known side effects are (frequency cannot be estimated from the available data):

Anaphylaxis/anaphylactoid reactions (that may range from mild to severe, including a sudden, generalised allergic reaction that may lead to a life-threatening shock [e.g. difficulty in breathing, drop of blood pressure, fast pulse]).
Liver failure
Skin rash, which may lead to severe blistering and peeling of the skin (Stevens-Johnson Syndrome)

5. How to store Tigecycline Accord

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

This medicinal product does not require any special storage condition. Do not use this medicine after the expiry date which is stated on the vial. The expiry date refers to the last day of that month.

Storage after preparation

Reconstituted solution: Chemical and physical in-use stability has been demonstrated for 6 hours at 20–25 °C. 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 not be longer than the times stated above for the chemical and physical in-use stability.

Diluted solution: Chemical and physical in-use stability has been demonstrated for 24 hours at 20–25 °C and 48 hours at 2–8 °C. 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 not be longer than the times stated above for the chemical and physical in-use stability.

The Tigecycline Accord solution should be yellow to orange in colour after dissolving; if it is not, the solution should be discarded.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What Tigecycline Accord contains

The active substance is tigecycline. Each vial contains 50 mg of tigecycline.

The other ingredients are maltose monohydrate, hydrochloric acid, and sodium hydroxide.

What Tigecycline Accord looks like and contents of the pack

Tigecycline Accord is supplied as a powder for solution for infusion in a vial and looks like an orange powder or cake before it is diluted. These vials are distributed to the hospital in a one vial pack or ten vial pack. Not all pack sizes may be marketed.

The powder should be mixed in the vial with a small amount of solution. The vial should be gently swirled until the medicine is dissolved. Thereafter, the solution should be immediately withdrawn from the vial and added to a 100 ml intravenous bag or other suitable infusion container in the hospital.

Marketing Authorisation Holder and Manufacturer

Marketing Authorisation Holder:

Accord Healthcare S.L.U.

World Trade Center,

Moll de Barcelona, s/n,

Edifici Est 6a planta,

08039 Barcelona, Spain

Manufacturers:

Accord Healthcare Limited,

Sage House, 319 Pinner Road, North Harrow,

Middlesex, HA1 4HF,

United Kingdom

Accord Healthcare Polska Sp.z o.o.

ul. Lutomierska 50,

95–200 Pabianice

Poland

Laboratori Fundació Dau

C/ C, 12–14 Pol. Ind.

Zona Franca, Barcelona, 08040,

Spain

This leaflet was last revised in {MM/YYYY}.

Other sources of information

Detailed information on this medicine is available on the European Medicines Agency website:.

The following information is intended for healthcare professionals only:

Instructions for use and handling (

see also 3. How Tigecycline Accord is given in this leaflet)

The powder should be reconstituted with 5.3 ml of sodium chloride 9 mg/ml (0.9 %) solution for injection, dextrose 50 mg/ml (5 %) solution for injection, or Lactated Ringer’s solution for injection to achieve a concentration of 10 mg/ml of tigecycline. The vial should be gently swirled until the active substance is dissolved. Thereafter, 5 ml of the reconstituted solution should be immediately withdrawn from the vial and added to a 100 ml intravenous bag for infusion or other suitable infusion container (e.g. glass bottle).

For a 100 mg dose, reconstitute using two vials into a 100 ml intravenous bag for infusion or other suitable infusion container (e.g. glass bottle).

Note: The vial contains a 6 % overage. Thus, 5 ml of reconstituted solution is equivalent to 50 mg of the active substance. The reconstituted solution should be yellow to orange in colour; if not, the solution should be discarded. Parenteral products should be inspected visually for particulate matter and discolouration (e.g. green or black) prior to administration.

Tigecycline should be administered intravenously through a dedicated line or through a Y-site. If the same intravenous line is used for sequential infusion of several active substances, the line should be flushed before and after infusion of tigecycline with either sodium chloride 9 mg/ml (0.9 %) solution for injection or dextrose 50 mg/ml (5 %) solution for injection. Injection should be made with an infusion solution compatible with tigecycline and any other medicinal product(s) via this common line.

Compatible intravenous solutions include: sodium chloride 9 mg/ml (0.9 %) solution for injection, dextrose 50 mg/ml (5 %) solution for injection, and Lactated Ringer’s solution for injection.

When administered through a Y-site, compatibility of tigecycline diluted in sodium chloride 0.9 % for injection is demonstrated with the following medicinal products or diluents: amikacin, dobutamine, dopamine HCl, gentamicin, haloperidol, Lactated Ringer’s, lidocaine HCl, metoclopramide, morphine, norepinephrine, piperacillin/tazobactam (EDTA formulation), potassium chloride, propofol, ranitidine HCl, theophylline, and tobramycin.

Tigecycline Accord must not be mixed with other medicinal products for which compatibility data are not available.

For single use only, any unused solution should be discarded.