Document Details

Generated Narrative: Bundle TEST PURPOSES ONLY - celdoxome

Document Subject

Generated Narrative: MedicinalProductDefinition mp0decee85458f6211fcf0121c6b6f6c83

identifier: http://ema.europa.eu/identifier/EU/1/22/1666/001

type: Medicinal Product

domain: Human use

status: active

legalStatusOfSupply: Medicinal product subject to medical prescription

name

productName: Celdoxome pegylated liposomal 2 mg/mL concentrate for dispersion for infusion

type: Full name

part

part: nan

type: Invented name part

part

part: nan

type: Scientific name part

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part: nan

type: Strength part

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part: nan

type: Pharmaceutical dose form part

Usages

-	Country	Jurisdiction	Language
*	EU	EU	en

Document Content

Generated Narrative: Composition composition-en-0decee85458f6211fcf0121c6b6f6c83

identifier: http://ema.europa.eu/identifier/EU/1/22/1666/001

status: Final

type: Package Leaflet

category: Raw

date: 2022-02-16 13:28:17+0000

author: Organization ACME industry

title: TEST PURPOSES ONLY - celdoxome

Attesters

What is in this leaflet

1. What Celdoxome pegylated liposomal is and what it is used for
2. What you need to know before you use Celdoxome pegylated liposomal
3. How to use Celdoxome pegylated liposomal
4. Possible side effects
5. How to store Celdoxome pegylated liposomal
6. Contents of the pack and other information

Celdoxome pegylated liposomal is an antitumour agent.

Celdoxome pegylated liposomal is used to treat cancer of the breast in patients at risk for heart problems. Celdoxome pegylated liposomal is also used to treat cancer of the ovary. It is used to kill cancer cells, shrink the size of the tumour, delay the growth of the tumour, and extend your survival.

Celdoxome pegylated liposomal is also used in combination with another medicine, bortezomib, to treat multiple myeloma, a cancer of the blood in patients who have received at least 1 prior therapy.

Celdoxome pegylated liposomal is also used to produce an improvement in your Kaposi s sarcoma including flattening, lightening and even shrinkage of the cancer. Other symptoms of Kaposi s sarcoma, such as swelling around the tumour, may also improve or disappear.

Celdoxome pegylated liposomal contains a medicine which is able to interact with cells in such a way as to selectively kill cancer cells. The doxorubicin hydrochloride in Celdoxome pegylated liposomal is enclosed in tiny spheres called pegylated liposomes which help to deliver the medicinal product from the blood stream to the cancerous tissue rather than healthy normal tissue.

Do not use Celdoxome pegylated liposomal

• if you are allergic to doxorubicin hydrochloride, peanut or soya, or any of the other ingredients of this medicine (listed in section 6).

Warnings and precautions
Talk to your doctor before receiving Celdoxome pegylated liposomal:

• if you are receiving any treatment for heart disease or liver disease
• if you are diabetic, because Celdoxome pegylated liposomal contains sugar which may require an adjustment to the treatment of your diabetes

if you have Kaposi s sarcoma and have had your spleen removed

if you notice sores, discolouration or any discomfort in your mouth.

The cases of Interstitial lung diseases have been observed in patients receiving pegylated liposomal doxorubicin including fatal cases. The symptoms of Interstitial lung disease are cough and shortness of breath sometimes with fever which are not caused by physical activity. Seek immediate medical attention, if you experience symptoms that may be signs of Interstitial lung disease.

Children and adolescents Celdoxome pegylated liposomal should not be used in children and adolescents, because it is not known how the medicine will affect them.

Other medicines and Celdoxome pegylated liposomal Tell your doctor or pharmacist

if you are taking, have recently taken or might take any other medicines

about any other cancer treatments you are on or have been taking, as particular care needs to be taken with treatments which reduce the number of white blood cells, as this may cause further reduction in the number of white blood cells. If you are unsure about what treatments you have received or any illnesses you have had, discuss these with your doctor.

Pregnancy and breast-feeding If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Because the active ingredient doxorubicin hydrochloride in Celdoxome pegylated liposomal may cause birth defects, it is important to tell your doctor if you think you are pregnant. Avoid becoming pregnant while you or your partner are taking Celdoxome pegylated liposomal and in the six months following discontinuation of Celdoxome pegylated liposomal treatment.

Because doxorubicin hydrochloride may be harmful to nursing infants, women must discontinue breast-feeding before starting treatment with Celdoxome pegylated liposomal. Health experts recommend that HIV infected women do not breast-feed their infants under any circumstances in order to avoid transmission of HIV.

Driving and using machines Do not drive or use any tools or machines if you feel tired or sleepy from treatment with Celdoxome pegylated liposomal.

Celdoxome pegylated liposomal contains soya oil and sodium Celdoxome pegylated liposomal contains soya oil. If you are allergic to peanut or soya, do not use this medicine. See Do not use Celdoxome pegylated liposomal . Celdoxome pegylated liposomal contains less than 1 mmol sodium (23 mg) per dose, that is to say essentially sodium-free .

Celdoxome pegylated liposomal is a unique formulation. It must not be used interchangeably with other formulations of doxorubicin hydrochloride.

How much Celdoxome pegylated liposomal is given If you are being treated for breast cancer or ovarian cancer, Celdoxome pegylated liposomal will be administered at a dose of 50 mg per square metre of your body surface area (based on your height and weight). The dose is repeated every 4 weeks for as long as the disease does not progress and you are able to tolerate the treatment.

If you are being treated for multiple myeloma, and have already received at least 1 prior therapy, Celdoxome pegylated liposomal will be administered at a dose of 30 mg per square metre of your body surface area (based on your height and weight) as a 1 hour intravenous infusion on Day 4 of the bortezomib 3 week regimen immediately after the bortezomib infusion. The dose is repeated as long as you respond satisfactorily and tolerate treatment.

If you are being treated for Kaposi s sarcoma, Celdoxome pegylated liposomal will be administered at a dose of 20 mg per square metre of your body surface area (based on your height and weight). The dose is repeated every 2 to 3 weeks for 2-3 months, then as often as necessary to maintain an improvement in your condition.

How Celdoxome pegylated liposomal is given Celdoxome pegylated liposomal will be given to you by your doctor in a drip (infusion) into a vein. Depending on the dose and indication, this may take from 30 minutes to more than one hour (i.e., 90 minutes).

If you use more Celdoxome pegylated liposomal than you should Acute overdosing worsens side effects like sores in the mouth or decreases the number of white blood cells and platelets in the blood. Treatment will include administration of antibiotics, platelet cell transfusions, use of factors which stimulate production of white blood cells and symptomatic treatment of mouth sores.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

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

During the infusion

During the infusion of Celdoxome pegylated liposomal, the following reactions may occur:

severe allergic reaction that may include a swollen face, lips, mouth, tongue or throat; difficulty swallowing or breathing; itchy rash (hives)

• inflamed and narrowed airways in the lungs, causing coughing, wheezing and shortness of breath (asthma)
• flushing, sweating, chills or a fever
• chest pain or discomfort
• back pain
• high or low blood pressure
• fast heart beat

fits (seizures)

Leaking of the injection fluid from the veins into the tissues under the skin may occur. If the drip stings or hurts while you are receiving a dose of Celdoxome pegylated liposomal, tell your doctor immediately.

Serious side effects

Your doctor should be contacted immediately if any of the following serious side effects are noticed:

you develop fever, feel tired, or if you have signs of bruising or bleeding (very common)

redness, swelling, peeling or tenderness, mainly on the hands or feet ( hand-foot syndrome). These effects have been seen very commonly and are sometimes severe. In severe cases, these effects may interfere with certain daily activities, and may last for 4 weeks or longer before resolving completely. The doctor may wish to delay the start and/or reduce the dose of the next treatment (see Strategies to prevent and treat hand foot syndrome, below)

sores in mouth, severe diarrhoea or vomiting or nausea (very common)

infections (common), including lung infections (pneumonia) or infections that may affect your vision

being short of breath (common)

severe stomach pain (common)

severe weakness (common)

severe allergic reaction that may include a swollen face, lips, mouth, tongue or throat; difficulty swallowing or breathing; itchy rash (hives) (uncommon)

cardiac arrest (heart stops beating); heart failure, in which the heart does not pump enough blood to the rest of the body, which makes you short of breath and may lead to swollen legs (uncommon)

blood clot that moves to the lungs, causes chest pain and makes you short of breath (uncommon)

swelling, warmth, or tenderness in the soft tissues of your leg, sometimes with pain which gets worse when you stand or walk (rare)

severe or life-threatening rash with blisters and peeling skin, particularly around the mouth, nose, eyes and genitals (Stevens-Johnson syndrome) or over most of the body (toxic epidermal necrolysis) (rare)

Other side effects Between infusions, the following may occur:

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

decrease in the number of white blood cells, which can increase the chances of infections. In rare cases, having low white blood cells may lead to severe infection. Anaemia (reduction in red blood cells) may cause tiredness, and decreased platelets in the blood may increase the risk of bleeding. It is because of the potential changes in your blood cells that you will have regular blood tests.

decreased appetite

constipation

skin rashes, including redness of the skin, allergic skin rash, red or raised rash on the skin

hair loss

pain including in the muscles and chest muscle, joint, arm, or leg

feeling very tired

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

infections, including severe infection throughout the body (sepsis), lung infections, herpes zoster virus infections (shingles), a type of bacterial infection (mycobacterium avium complex infection), urinary tract infection, fungal infections (including thrush and oral thrush in the mouth) infection of the hair roots, infected or irritated throat, infected nose, sinuses or throat (cold)

low number of a type of white blood cell (neutrophils), with a fever

severe weight loss and muscle wasting, not enough water in the body (dehydration), low level of potassium, sodium, or calcium in the blood

feeling confused, feeling anxious, depression, difficulty sleeping

nerve damage that may cause tingling, numbness, pain or loss of pain sensation, nerve pain, unusual feeling in the skin (such as tingling or a crawling feeling), decreased feeling or sensitivity, especially in the skin

change in sense of taste, headache, feeling very sleepy with low energy, feeling dizzy

inflamed eyes (conjunctivitis)

fast heart beat

high or low blood pressure, flushing

shortness of breath that may be brought on by physical activity, nose bleeds, cough

inflamed stomach lining or foodpipe, ulcers (sores) in the mouth, indigestion, difficulty swallowing, mouth pain, dry mouth

skin problems, including flaky or dry skin, redness of the skin, blister or ulcer (sore) on the skin, itching, dark skin patches

excessive sweating

muscle spasms or aches

pain including in the muscles, bone, or back

pain when passing urine

allergic reaction to infusion of the medicine, flu-like illness, chills, inflamed lining of the cavities and passages in the body, such as the nose, mouth or windpipe, feeling weak, generally feeling unwell, swelling caused by fluid build up in the body, swollen hands, ankles or feet

weight loss

When Celdoxome pegylated liposomal is used alone, some of these effects are less likely to occur, and some have not occurred at all.

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

herpes simplex virus infections (cold sores or genital herpes), fungal infection

low number of all types of blood cells, increased number of platelets (cells that help blood to clot)

allergic reaction

high level of potassium in the blood, low level of magnesium in the blood

nerve damage affecting more than one area of the body

fits (seizures), fainting

unpleasant or painful sensation, especially to touch, feeling sleepy

blurred vision, watery eyes

heart beat feels fast or uneven (palpitations), heart muscle disease, heart damage

tissue damage (necrosis) where the injection is given, inflamed veins that cause swelling and pain, feeling dizzy upon sitting up or standing up

chest discomfort

passing wind, inflamed gums (gingivitis)

skin problems or rashes, including flaky or peeling skin, allergic skin rash, ulcer (sore) or hives on the skin, discoloured skin, change in the natural colour (pigment) of the skin, small red or purple spots caused by bleeding under the skin, nail problems, acne

muscle weakness

breast pain

irritation or pain where the injection is given

swollen face, high body temperature

symptoms (such as inflammation, redness or pain) come back at a part of the body that previously received radiation therapy or was previously damaged by a chemotherapy injection into a vein

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

infection that occurs in people with a weak immune system

low number of blood cells made in the bone marrow

inflamed retina, which may cause changes in vision or blindness

abnormal heart rhythm, abnormal heart tracing on an ECG (electrocardiogram) and may be with a slow heart beat, problem with the heart that affects the heart beat and rhythm, blue colour to the skin and mucosa caused by low oxygen in the blood

widening of blood vessels

tight feeling in the throat

sore and swollen tongue, ulcer (sore) on the lip

skin rash with fluid-filled blisters

vaginal infection, redness of the scrotum

problems with the lining of the cavities and passages in the body, such as the nose, mouth or windpipe

abnormal liver blood test results, increased level of creatinine in the blood

Not known (frequency cannot be estimated from the available data)

cancer of the blood that develops quickly and affects the blood cells (acute myeloid leukaemia), bone marrow disease that affects the blood cells (myelodysplastic syndrome), cancer of the mouth or lip

• Coughing and shortness of breath, possibly accompanied by fever, that is not brought on by physical activity (Interstitial lung disease)

Reporting of side effects If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the national reporting system listed in Appendix V. By reporting side effects you can help provide more information on the safety of this medicine.

Strategies to prevent and treat hand-foot syndrome include

soaking hands and/or feet in basins of cold water when possible (e.g., while watching television, reading, or listening to the radio)

keeping hands and feet uncovered (no gloves, socks, etc.)

staying in cool places

taking cool baths during hot weather

avoiding vigorous exercise that might cause trauma to the feet (e.g., jogging)

avoiding exposure of skin to very hot water (e.g., jacuzzis, saunas)

avoiding tight fitting footwear or high-heeled shoes.

Pyridoxine (vitamin B6):

vitamin B6 is available without prescription

take 50-150 mg daily beginning at the first signs of redness or tingling.

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

Do not use this medicine after the expiry date which is stated on the label and carton.

Unopened vial

Store in a refrigerator (2 C 8 C). Do not freeze.

After dilution

Chemical and physical in-use stability has been demonstrated for 24 hours at 2 C to 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 should not be longer than 24 hours at 2 C to 8 C. Partially used vials must be discarded.

Do not use this medicine if you notice that it shows evidence of precipitation or any other particulate matter.

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.

What Celdoxome pegylated liposomal contains

• The active substance is doxorubicin hydrochloride. Each mL Celdoxome pegylated liposomal contains 2 mg doxorubicin hydrochloride in a pegylated liposomal formulation.
• The other ingredients are N-(carbonyl-methoxypolyethylene glycol 2000)-1,2-distearoyl-sn- glycero-3 phosphoethanolamine sodium salt (MPEG-DSPE), phosphatidylcholine, hydrogenated (soya bean) (HSPC), cholest-5-en-3 -ol, ammonium sulphate, sucrose, histidine, water for injections, hydrochloric acid (for pH-adjustment) and sodium hydroxide (for pH- adjustment). See section 2 Celdoxome pegylated liposomal contains soya oil and sodium .

What Celdoxome pegylated liposomal looks like and contents of the pack The concentrate for dispersion for infusion is sterile, translucent and red with a pH of 6.5. Celdoxome pegylated liposomal is available in glass vials with 10 mL (20 mg) or 25 mL (50 mg).

Each pack contains 1 or 10 vials.

Not all pack sizes may be marketed.

Marketing Authorisation Holder
YES Pharmaceutical Development Services GmbH Basler Stra e 7 61352 Bad Homburg Germany

Manufacturer Baxter Oncology GmbH Kantstrasse 2 33790 Halle/Westfalen Germany

This leaflet was last revised in .

Other sources of information

Detailed information on this medicine is available on the European Medicines Agency web site: