Gravitate Health FHIR Implementation Guide
0.1.0 - CI Build
Gravitate Health FHIR Implementation Guide
0.1.0 - CI Build
Gravitate Health FHIR Implementation Guide, published by Gravitate Health Project. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/joofio/test-epi-composition/ and changes regularly. See the Directory of published versions
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<div xmlns="http://www.w3.org/1999/xhtml"><p>What is in this leaflet</p><ol type="1"><li>What Skyclarys is and what it is used for</li><li>What you need to know before you take Skyclarys</li><li>How to take Skyclarys</li><li>Possible side effects</li><li>How to store Skyclarys</li><li>Contents of the pack and other information</li></ol></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><p>What is Skyclarys? Skyclarys contains the active substance omaveloxolone, which activates a specific protein, Nrf2, in your body.</p><p>What is Skyclarys used for? Skyclarys is used to treat adults and adolescents who are at least 16 years of age who have Friedreich s ataxia, a neurodegenerative movement disorder. Friedreich s ataxia is a rare inherited disease that causes progressive damage to your nervous system and movement problems.</p><p>How does Skyclarys work? The protein called Nrf2 in your body has a key role in managing oxidative stress (a condition that can damage cells in your body) and has a protective role against neurodegenerative diseases. In patients with Friedreich s ataxia, Nrf2 activity is reduced. Skyclarys activates Nrf2 so it can manage oxidative stress.</p><p>In a clinical trial patients treated with Skyclarys scored better on tests of neurological function than patients who were treated with an inactive substance.</p></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><p>Do not take Skyclarys if you are allergic to omaveloxolone or any of the other ingredients of this medicine (listed in section 6).</p><p>Warnings and precautions</p><p>Talk to your doctor before taking Skyclarys:</p><ul><li>If you have problems with your liver, your doctor may decide to change the dose or not start treatment with Skyclarys.</li><li></li></ul><p>Tell your doctor about all the medicines you are taking before you start Skyclarys.</p><p>Your doctor will check to see how well your liver is working and will check your cholesterol level before you start taking Skyclarys. Your doctor will also check your level of BNP (B-type natriuretic peptide, a blood test for heart problems) before you start taking Skyclarys.</p><p>Talk to your doctor while taking Skyclarys Contact your doctor immediately if you have sudden weight gain, swelling of legs, ankles, or feet, or shortness of breath, which may be signs or symptoms of heart problems while taking Skyclarys. Your doctor will decide on treatment and whether Skyclarys should be continued.</p><p>Your doctor will be checking blood tests while you are taking Skyclarys. This will include liver blood tests to see how your liver is working while taking Skyclarys. Your doctor will decide on whether to discontinue Skyclarys if liver problems develop. Other blood tests that your doctor will do will check cholesterol and BNP after you start Skyclarys.</p><p>Tell your doctor if you have weight loss with Skyclarys.</p><p>Children and adolescents Do not give Skyclarys to children and adolescents below the age of 16 years because it has not yet been studied in this group of patients.</p><p>Other medicines and Skyclarys Tell your doctor if you are taking, have recently taken, or might take any other medicines. This is because some medicines may affect the way Skyclarys works. Also, Skyclarys may affect the way some medicines work.</p><p>Certain medicines may increase the risk of side effects of Skyclarys by increasing the levels of Skyclarys in the blood. Some of these medicines include:</p><ul><li>itraconazole, fluconazole, or ketoconazole (antifungal medicines used to treat a number of fungal infections)</li><li>cyclosporine (a medicine used after organ transplant)</li><li>ciprofloxacin or clarithromycin (antibiotics used for bacterial infections)</li><li>fluvoxamine (an antidepressant known as a selective serotinin reuptake inibitor [SSRI]) If your doctor prescribes one of these medicines, your dose of Skyclarys may be reduced to prevent side effects when taking both drugs at the same time.</li></ul><p>Certain medicines may reduce how well Skyclarys works by decreasing the amount of Skyclarys in the blood. Some of these medicines include:</p><ul><li>St. John s wort (a herbal remedy used for mild depression)</li><li>rifampicin (used to treat tuberculosis)</li><li>carbamazepine, phenobarbital, phenytoin, primidone (used to treat epilepsy)</li><li>efavirenz (medicine used for HIV)</li></ul><p>Skyclarys may reduce how well some other medicines work by decreasing the amount of these medicines in the blood. Some of these medicines include:</p><ul><li>midazolam (used as a sedative and to treat severe agitation)</li><li>repaglinide (a medicine to control type II diabetes)</li><li>rosuvastatin (a statin medicine used to reduce harmful lipids)</li><li>hormonal contraceptives (a type of birth control that uses homones to prevent pregnancy, such as the pill, patch, or ring)</li></ul><p>Talk to your doctor if you are taking any medicines, particularly those mentioned above, as they may affect the way Skyclarys or other medicines work.</p><p>Skyclarys with food and drink Avoid eating grapefruit or grapefruit juice while taking Skyclarys.</p><p>Pregnancy You should not take Skyclarys if you are pregnant, think you may be pregnant, or are planning to have a baby. Tell your doctor immediately if you become pregnant while you are being treated with Skyclarys.</p><p>Birth Control Using Skyclarys can reduce the effectiveness of hormonal birth control. You should use a different method of birth control, such as a non-hormonal IUD (intrauterine device) or barrier contraceptives such as condoms. A reliable method of birth control should be used during Skyclarys treatment and for 28 days after stopping treatment with Skyclarys. Talk to your doctor about the most suitable birth control for you.</p><p>Breast-feeding Do not breast-feed your baby while you are being treated with Skyclarys. It is not known if this medicine passes into the breast milk.</p><p>Driving and using machines Some patients may feel tired after taking this medicine. If you feel tired after taking Skyclarys, avoid driving and using machines.</p><p>Skyclarys contains a negligible amount of sodium This medicine contains less than 1 mmol sodium (23 mg) per dose, that is to say essentially sodium free .</p></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><p>Always take this medicine exactly as your doctor has told you. Check with your doctor if you are not sure.</p><p>The recommended dose is 150 mg (3 capsules) once per day.</p><p>Taking Skyclarys</p><ul><li>Take the capsules on an empty stomach at least one hour before or two hours after eating.</li><li>Take the capsules at about the same time during the day.</li><li>Swallow the capsules whole with a glass of water.</li><li>If you are unable to swallow the capsules whole, open them and sprinkle the entire contents onto 2 tablespoonfuls of apple puree. You must eat all the apple puree/medicine mixture immediately after making it. Do not store the apple puree/medicine mixture for future use. If you have problems with your liver, your doctor may decide to change the dose or not start treatment with Skyclarys.</li></ul><p>Some medicines may cause side effects when taken at the same time as Skyclarys. If your doctor prescribes one of these medicines while you are taking Skyclarys, your doctor may reduce the dose of Skyclarys to prevent side effects when taking both drugs at the same time.</p><p>If you are sick after taking your usual dose, do not take replacement capsules. Take the capsules as usual the following day.</p><p>If you take more Skyclarys than you should If you take more Skyclarys than your doctor prescribed, talk to a doctor immediately. Take this leaflet with you.</p><p>If you forget to take Skyclarys If you miss a dose of Skyclarys, take the next dose as usual the following day. Do not take a double dose to make up for a forgotten dose.</p><p>If you stop taking Skyclarys Do not stop taking this medicine unless your doctor tells you. If you have any further questions on the use of this medicine, ask your doctor.</p></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><p>Like all medicines, this medicine can cause side effects, although not everybody gets them.</p><p>Some side effects with Skyclarys could be or could become serious</p><p>Talk to your doctor immediately if you have any of these side effects: Very common (may affect more than 1 in 10 people)</p><ul><li>digestive problems. You may have symptoms such as nausea (feeling sick) diarrhoea vomiting stomach pain decrease in weight If you have any of these side effects, talk to your doctor.</li></ul><p>Based on your blood tests, your doctor may tell you that you have:</p><ul><li>high liver enzymes in your blood (very common, may affect more than 1 in 10 people)</li><li>increased BNP (a marker for heart problems); (common, may affect up to 1 in 10 people)</li><li>changes in your blood cholesterol and triglycerides (common, may affect up to 1 in 10 people) Your doctor will decide on treatment and whether Skyclarys should be continued.</li></ul><p>Other possible side effects of Skyclarys Very common (may affect more than 1 in 10 people)</p><ul><li>headache</li><li>tiredness</li><li>sore throat</li><li>back pain</li><li>muscle spasm</li><li>flu</li><li>decreased appetite</li></ul><p>Common (may affect up to 1 in 10 people)</p><ul><li>urinary tract infection (infection of the structures that carry urine, UTI)</li><li>period pains in women (menstrual cramps)</li></ul><p>Reporting of side effects If you get any side effects, talk to your doctor. 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.</p></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><p>Keep this medicine out of the sight and reach of children.</p><p>Do not use this medicine after the expiry date which is stated on the carton after EXP . The expiry date refers to the last day of that month.</p><p>This medicine does not require any special storage conditions.</p><p>If the capsule is opened and mixed with apple puree you must eat all the apple puree/medicine mixture immediately after making it. See section 3, Taking Skyclarys.</p><p>Do not use this medicine if you notice that the pack is damaged or shows signs of tampering.</p><p>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.</p></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><p>What Skyclarys contains</p><ul><li>The active substance is omaveloxolone.</li><li>Each capsule contains 50 mg omaveloxolone.</li><li>The other ingredients are: Capsule fill: pregelatinized maize starch, microcrystalline cellulose, croscarmellose sodium, magnesium stearate, silica, colloidal anhydrous Capsule shell: hypromellose, titanium dioxide (E171), Brilliant Blue FCF (E133), ferric oxide yellow (E172) Printing ink: shellac (E904), titanium dioxide (E171)</li></ul><p>What Skyclarys looks like and contents of the pack Skyclarys 50 mg hard capsules are made of an opaque light green body imprinted with RTA 408 in white ink and a blue cap imprinted with 50 in white ink.</p><p>Skyclarys 50 mg is available in a pack containing 90 hard capsules and in a pack of 3 bottles, each containing 90 hard capsules.</p><p>Marketing Authorisation Holder Reata Ireland Limited Block A, George s Quay Plaza George s Quay Dublin 2 D02 E440 Ireland</p><p>Manufacturer Jenson R+ (Ireland) Limited Unit Daingean Hall N4 Axis Centre Longford N39 W6K0 Ireland</p><p>For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:</p><p>Belgi /Belgique/Belgien Biogen Belgium N.V./S.A. T l/Tel: +32 2 219 12 Lietuva Biogen Lithuania UAB Tel: +370 5 259 6</p><p>Te .: +359 2 962 12 Luxembourg/Luxemburg Biogen Belgium N.V./S.A. T l/Tel: +32 2 219 12 esk republika Biogen (Czech Republic) s.r.o. Tel: +420 255 706 Magyarorsz g Biogen Hungary Kft. Tel.: +36 (1) 899 9Danmark Biogen (Denmark) A/S Tlf: +45 77 41 57 Malta Pharma MT limited Tel: +356 213 37008/9</p><p>Deutschland Biogen GmbH Tel: +49 (0) 89 99 6Nederland Biogen Netherlands B.V. Tel: +31 20 542 2Eesti Biogen Estonia O<br/>Tel: + 372 618 9Norge Biogen Norway AS Tlf: +47 23 40 01<br/>Genesis Pharma SA : +30 210 8771 sterreich Biogen Austria GmbH Tel: +43 1 484 46 Espa a Biogen Spain SL Tel: +34 91 310 7Polska Biogen Poland Sp. z o.o. Tel.: +48 22 351 51 France Biogen France SAS T l: +33 (0)1 41 37 95 Portugal Biogen Portugal Tel.: +351 21 318 8Hrvatska Biogen Pharma d.o.o. Tel: +385 (0) 1 775 73 Rom nia Ewopharma AG Representative Office Tel: + 40 377 881 Ireland Biogen Idec (Ireland) Ltd. Tel: +353 (0)1 463 7Slovenija Biogen Pharma d.o.o. Tel.: +386 1 511 02 sland Icepharma hf S mi: +354 540 8Slovensk republika Biogen Slovakia s.r.o. Tel.: +421 2 323 340 Italia Biogen Italia s.r.l. Tel: +39 02 584 9Suomi/Finland Biogen Finland Oy Puh/Tel: +358 207 401<br/>Genesis Pharma Cyprus Ltd : +357 22765Sverige Biogen Sweden AB Tel: +46 8 594 113 Latvija Biogen Latvia SIA Tel: + 371 68 688 United Kingdom (Northern Ireland) Biogen Idec (Ireland) Limited Tel: +44 (0) 1628 50 1This leaflet was last revised in</p><p>Other sources of information Detailed information on this medicine is available on the European Medicines Agency web site:</p></div>
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<code value="EU"/>
<display value="EU"/>
</coding>
</jurisdiction>
<language>
<coding>
<system value="urn:ietf:bcp:47"/>
<code value="en"/>
<display value="en"/>
</coding>
</language>
</usage>
</name>
</MedicinalProductDefinition>
</resource>
</entry>
</Bundle>
IG © 2021+ Gravitate Health Project. Package hl7.eu.fhir.ghepi#0.1.0 based on FHIR 5.0.0. Generated 2024-10-14
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QA Report
The Gravitate Health project has received funding from the IMI 2 Joint Undertaking under grant agreement No 945334.
This joint undertaking receives support from the EU H2020 research and innovation programme and EFPIA.
