ATOVAQUONE suspension

Nchi: Marekani

Lugha: Kiingereza

Chanzo: NLM (National Library of Medicine)

Viambatanisho vya kazi:

ATOVAQUONE (UNII: Y883P1Z2LT) (ATOVAQUONE - UNII:Y883P1Z2LT)

Inapatikana kutoka:

Bionpharma Inc.

Njia ya uendeshaji:

ORAL

Dawa ya aina:

PRESCRIPTION DRUG

Matibabu dalili:

Atovaquone oral suspension is indicated for the prevention of Pneumocystis jirovecii pneumonia (PCP) in adults and adolescents (aged 13 years and older) who cannot tolerate trimethoprim-sulfamethoxazole (TMP-SMX). Atovaquone oral suspension is indicated for the acute oral treatment of mild-to-moderate PCP in adults and adolescents (aged 13 years and older) who cannot tolerate TMP-SMX. Clinical experience with atovaquone for the treatment of PCP has been limited to subjects with mild-to-moderate PCP (alveolar-arterial oxygen diffusion gradient [(A-a)DO 2 ] ≤ 45 mm Hg). Treatment of more severe episodes of PCP with atovaquone has not been studied. The efficacy of atovaquone in subjects who are failing therapy with TMP-SMX has also not been studied. Atovaquone oral suspension is contraindicated in patients who develop or have a history of hypersensitivity reactions (e.g., angioedema, bronchospasm, throat tightness, urticaria) to atovaquone or any of the components of atovaquone oral suspension. Risk Summary Available data from postmarketing experience with use of atovaquone in pregnant women are insufficient to identify a drug-associated risk for major birth defects, miscarriage, or adverse maternal or fetal outcomes. Pregnant women with HIV who are infected with PCP are at increased risk of adverse pregnancy outcomes (see Clinical Considerations) . Atovaquone given orally by gavage to pregnant rats and rabbits during organogenesis did not cause fetal malformations at plasma concentrations up to 3 times and 0.5 times, respectively, the estimated human exposure based on steady-state plasma concentrations (see Data) . The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. Clinical Considerations Disease-Associated Maternal and/or Embryo/Fetal Risk: Pregnant women with HIV who are infected with PCP are at increased risk of severe illness and maternal death associated with PCP compared with non-pregnant women. Data Animal Data: Atovaquone administered in oral doses of 250 mg, 500 mg, and 1,000 mg/kg/day to pregnant rats during organogenesis (Gestation Day [GD] 6 to GD15) did not cause maternal or embryo-fetal toxicity at doses up to 1,000 mg/kg/day corresponding to maternal plasma concentrations approximately 3 times the estimated human exposure during the treatment of PCP based on steady-state plasma concentrations. In pregnant rabbits, atovaquone administered in oral doses of 300 mg, 600 mg, and 1,200 mg/kg/day during organogenesis (GD6 to GD18) caused decreased fetal body length at a maternally toxic dose of 1,200 mg/kg/day corresponding to a plasma concentration that is approximately 0.5 times the estimated human exposure based on steady-state plasma concentrations. In a pre-and post-natal study in rats, atovaquone administered in oral doses of 250 mg, 500 mg, and 1,000 mg/kg/day from GD15 until Lactation Day (LD) 20 did not impair the growth or developmental effects in first generation offspring at doses up to 1,000 mg/kg/day corresponding to approximately 3 times the estimated human exposure based on steady-state plasma concentrations during the treatment of PCP. Atovaquone crossed the placenta and was present in fetal rat and rabbit tissue. Risk Summary The Centers for Disease Control and Prevention recommend that HIV-1 – infected mothers not breastfeed their infants to avoid risking postnatal transmission of HIV-1. There are no data on the presence of atovaquone in human milk, the effects on the breastfed child, or the effects on milk production. Atovaquone was detected in rat milk when lactating rats were administered oral atovaquone (see Data) . When a drug is present in animal milk, it is likely the drug will be present in human milk. Because of the potential for HIV-1 transmission to HIV-negative infants, instruct mothers with HIV-1 not to breastfeed if they are taking atovaquone for the prevention or treatment of PCP. Data In a rat study with doses of 10 mg and 250 mg/kg given orally by gavage on postpartum Day 11, atovaquone concentrations in the milk were 30% of the concurrent atovaquone concentrations in the maternal plasma at both doses. The concentration of drug in animal milk does not necessarily predict the concentration of drug in human milk. Evidence of safety and effectiveness in pediatric patients (aged 12 years and younger) has not been established. In a trial of atovaquone oral suspension administered once daily with food for 12 days to 27 HIV-1–infected, asymptomatic infants and children aged between 1-month and 13 years, the pharmacokinetics of atovaquone were age-dependent. The average steady-state plasma atovaquone concentrations in the 24 subjects with available concentration data are shown in Table 5. Table 5. Average Steady-State Plasma Atovaquone Concentrations in Pediatric Subjects C ss = Concentration at steady state. Clinical trials of atovaquone did not include sufficient numbers of subjects aged 65 years and older to determine whether they respond differently from younger subjects.

Bidhaa muhtasari:

Atovaquone oral suspension, USP (opaque yellow, artificial mixed berry-flavored) containing 750 mg atovaquone, USP per 5 mL. Bottle of 210 mL with child-resistant cap (NDC 69452-252-87). Store at 20° to 25°C (68° to 77°F); excursions permitted between 15° to 30°C (59° to 86°F) [see USP Controlled Room Temperature]. Do not freeze . Dispense in tight container as defined in USP.

Idhini hali ya:

Abbreviated New Drug Application

Tabia za bidhaa

ATOVAQUONE- ATOVAQUONE SUSPENSION
BIONPHARMA INC.
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HIGHLIGHTS OF PRESCRIBING INFORMATION
THESE HIGHLIGHTS DO NOT INCLUDE ALL THE INFORMATION NEEDED TO USE
ATOVAQUONE ORAL
SUSPENSION SAFELY AND EFFECTIVELY. SEE FULL PRESCRIBING INFORMATION
FOR ATOVAQUONE ORAL
SUSPENSION.
ATOVAQUONE ORAL SUSPENSION
INITIAL U.S. APPROVAL: 1992
INDICATIONS AND USAGE
Atovaquone oral suspension is a quinone antimicrobial drug indicated
for:
Prevention of _Pneumocystis jirovecii _pneumonia (PCP) in adults and
adolescents aged 13 years and
older who cannot tolerate trimethoprim-sulfamethoxazole (TMP-SMX). (
1.1)
Treatment of mild-to-moderate PCP in adults and adolescents aged 13
years and older who cannot
tolerate TMP-SMX . (1.2)
Limitations of Use (1.3):
Treatment of severe PCP (alveolar arterial oxygen diffusion gradient
[(A-a)DO
] > 45 mm Hg) with
atovaquone has not been studied.
The efficacy of atovaquone in subjects who are failing therapy with
TMP-SMX has also not been studied.
DOSAGE AND ADMINISTRATION
Prevention of PCP: 1,500 mg (10 mL) once daily with food (2.1)
Treatment of PCP: 750 mg (5 mL) twice daily with food for 21 days
(2.2)
Supplied in bottles: Shake bottle gently before use. (2.3)
DOSAGE FORMS AND STRENGTHS
Oral suspension: 750 mg per 5 mL (3)
CONTRAINDICATIONS
Known serious allergic/hypersensitivity reaction (e.g., angioedema,
bronchospasm, throat tightness,
urticaria) to atovaquone or any of the components of atovaquone oral
suspension. (4)
WARNINGS AND PRECAUTIONS
Failure to administer atovaquone oral suspension with food may result
in lower plasma atovaquone
concentrations and may limit response to therapy. Patients with
gastrointestinal disorders may have
limited absorption resulting in suboptimal atovaquone concentrations.
(5.1)
Hepatotoxicity: Elevated liver chemistry tests and cases of hepatitis
and fatal liver failure have been
reported. (5.2)
ADVERSE REACTIONS
PCP Prevention: The most frequent adverse reactions (≥ 25% that
required discontinuation) were
diarrhea, rash, headache, nausea, and fever.