Document Details

Generated Narrative: Bundle TEST PURPOSES ONLY - trazimera

Document Subject

Generated Narrative: MedicinalProductDefinition mpc116ac444efe9566cd4664c5b73e7669

identifier: http://ema.europa.eu/identifier/EU/1/18/1295/001

type: Medicinal Product

domain: Human use

status: active

legalStatusOfSupply: Medicinal product subject to medical prescription

name

productName: Trazimera 150 mg powder for concentrate for solution 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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type: Pharmaceutical dose form part

Usages

-	Country	Jurisdiction	Language
*	EU	EU	en

Document Content

Generated Narrative: Composition composition-en-c116ac444efe9566cd4664c5b73e7669

identifier: http://ema.europa.eu/identifier/EU/1/18/1295/001

status: Final

type: Package Leaflet

category: Raw

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

author: Organization ACME industry

title: TEST PURPOSES ONLY - trazimera

Attesters

What is in this leaflet

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

Trazimera contains the active substance trastuzumab, which is a monoclonal antibody. Monoclonal antibodies attach to specific proteins or antigens. Trastuzumab is designed to bind selectively to an antigen called human epidermal growth factor receptor 2 (HER2). HER2 is found in large amounts on the surface of some cancer cells where it stimulates their growth. When Trazimera binds to HER2 it stops the growth of such cells and causes them to die.

Your doctor may prescribe Trazimera for the treatment of breast and gastric cancer when:

• You have early breast cancer, with high levels of a protein called HER2. * You have metastatic breast cancer (breast cancer that has spread beyond the original tumour) with high levels of HER2. Trazimera may be prescribed in combination with the chemotherapy medicine paclitaxel or docetaxel as first treatment for metastatic breast cancer or it may be prescribed alone if other treatments have proved unsuccessful. It is also used in combination with medicines called aromatase inhibitors with patients with high levels of HER2 and hormone receptor-positive metastatic breast cancer (cancer that is sensitive to the presence of female sex hormones).

• You have metastatic gastric cancer with high levels of HER2, when it is in combination with the other cancer medicines capecitabine or 5-flououracil and cisplatin.

Do not use Trazimera if

• you are allergic to trastuzumab, to murine (mouse) proteins, or to any of the other ingredients of this medicine (listed in section 6).

• you have severe breathing problems at rest due to your cancer or if you need oxygen treatment.

Warnings and precautions

Your doctor will closely supervise your therapy.

Heart checks Treatment with Trazimera alone or with a taxane may affect the heart, especially if you have ever used an anthracycline (taxanes and anthracyclines are two other kinds of medicine used to treat cancer). The effects may be moderate to severe and could cause death. Therefore, your heart function will be checked before, during (every three months) and after (up to two to five years) treatment with Trazimera. If you develop any signs of heart failure (inadequate pumping of blood by the heart), your heart function may be checked more frequently (every six to eight weeks), you may receive treatment for heart failure or you may have to stop Trazimera treatment.

Talk to your doctor, pharmacist or nurse before you are given Trazimera if:

• you have had heart failure, coronary artery disease, heart valve disease (heart murmurs), high blood pressure, taken any high blood pressure medicine or are currently taking any high blood pressure medicine.

• you have ever had or are currently using a medicine called doxorubicin or epirubicin (medicines used to treat cancer). These medicines (or any other anthracyclines) can damage heart muscle and increase the risk of heart problems with Trazimera.

• you suffer from breathlessness, especially if you are currently using a taxane. Trazimera can cause breathing difficulties, especially when it is first given. This could be more serious if you are already breathless. Very rarely, patients with severe breathing difficulties before treatment have died when they were given Trazimera.

• you have ever had any other treatment for cancer.

If you receive Trazimera with any other medicine to treat cancer, such as paclitaxel, docetaxel, an aromatase inhibitor, capecitabine, 5-fluorouracil, or cisplatin you should also read the patient information leaflets for these products.

Children and adolescents Trazimera is not recommended for anyone under the age of 18 years.

Other medicines and Trazimera Tell your doctor, pharmacist or nurse if you are taking, have recently taken or may take any other medicines.

It may take up to 7 months for Trazimera to be removed from the body. Therefore you should tell your doctor, pharmacist or nurse that you have had Trazimera if you start any new medicine in the 7 months after stopping treatment.

Pregnancy

• If you are pregnant, think you may be pregnant or are planning to have a baby, ask your doctor, pharmacist or nurse for advice before taking this medicine.

• You should use effective contraception during treatment with Trazimera and for at least 7 months after treatment has ended.

• Your doctor will advise you of the risks and benefits of taking Trazimera during pregnancy. In rare cases, a reduction in the amount of (amniotic) fluid that surrounds the developing baby within the womb has been observed in pregnant women receiving Trazimera. This condition may be harmful to your baby in the womb and has been associated with the lungs not developing fully resulting in foetal death. Breast-feeding Do not breast-feed your baby during Trazimera therapy and for 7 months after the last dose of Trazimera, as Trazimera may pass to your baby through your breast milk.

Ask your doctor or pharmacist for advice before taking any medicine.

Driving and using machines Trazimera may affect your ability to drive a car or operate machines. If during treatment you experience symptoms, such as dizziness, sleepiness, chills or fever, you should not drive or use machines until these symptoms disappear.

Before starting the treatment your doctor will determine the amount of HER2 in your tumour. Only patients with a large amount of HER2 will be treated with Trazimera. Trazimera should only be given by a doctor or nurse. Your doctor will prescribe a dose and treatment regimen that is right for you. The dose of Trazimera depends on your body weight.

Trazimera intravenous formulation is not for subcutaneous use and should be given as an intravenous infusion only.

Trazimera intravenous formulation is given as an intravenous infusion ( drip ) directly into your veins. The first dose of your treatment is given over 90 minutes and you will be observed by a health professional while it is being given in case you have any side effects. If the first dose is well tolerated the next doses may be given over 30 minutes (see section 2 under Warnings and precautions ). The number of infusions you receive will depend on how you respond to the treatment. Your doctor will discuss this with you.

In order to prevent medication errors it is important to check the vial labels to ensure that the medicine being prepared and given is Trazimera (trastuzumab) and not another trastuzumab-containing product (e.g. trastuzumab emtansine or trastuzumab deruxtecan).

For early breast cancer, metastatic breast cancer and metastatic gastric cancer, Trazimera is given every 3 weeks. Trazimera may also be given once a week for metastatic breast cancer.

If you stop using Trazimera Do not stop using this medicine without talking to your doctor first. All doses should be taken at the right time every week or every three weeks (depending on your dosing schedule). This helps your medicine work as well as it can.

It may take up to 7 months for Trazimera to be removed from your body. Therefore your doctor may decide to continue to check your heart functions, even after you finish treatment.

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

Like all medicines, Trazimera can cause side effects, although not everybody gets them. Some of these side effects may be serious and may lead to hospitalisation.

During a Trazimera infusion, chills, fever and other flu like symptoms may occur. These are very common (may affect more than 1 in 10 people). Other infusion-related symptoms are: feeling sick (nausea), vomiting, pain, increased muscle tension and shaking, headache, dizziness, breathing difficulties, high or low blood pressure, heart rhythm disturbances (palpitations, heart fluttering or irregular heart beat), swelling of the face and lips, rash and feeling tired. Some of these symptoms can be serious and some patients have died (see section 2 under Warnings and precautions ).

These effects mainly occur with the first intravenous infusion ( drip into your vein) and during the first few hours after the start of the infusion. They are usually temporary. You will be observed by a healthcare professional during the infusion and for at least six hours after the start of the first infusion and for two hours after the start of other infusions. If you develop a reaction, they will slow down or stop the infusion and may give you treatment to counteract the side effects. The infusion may be continued after the symptoms improve.

Occasionally, symptoms start later than six hours after the infusion begins. If this happens to you, contact your doctor immediately. Sometimes, symptoms may improve and then get worse later.

Serious side effects Other side effects can occur at any time during treatment with Trazimera, not just related to an infusion. Tell a doctor or nurse straight away, if you notice any of the following side effects:

• Heart problems can sometimes occur during treatment and occasionally after treatment has stopped and can be serious. They include weakening of the heart muscle possibly leading to heart failure, inflammation of the lining around the heart and heart rhythm disturbances. This can lead to symptoms such as breathlessness (including breathlessness at night), cough, fluid retention (swelling) in the legs or arms, and palpitations (heart fluttering or irregular heart beat) (see section 2 under Heart checks ).

Your doctor will monitor your heart regularly during and after treatment but you should tell your doctor immediately if you notice any of the above symptoms.

• Tumour lysis syndrome (a group of metabolic complications occurring after cancer treatment characterised by high blood levels of potassium and phosphate, and low blood levels of calcium). Symptoms may include kidney problems (weakness, shortness of breath, fatigue and confusion), heart problems (fluttering of the heart or a faster or slower heartbeat), seizures, vomiting or diarrhoea, and tingling in the mouth, hands or feet.

If you experience any of the above symptoms when your treatment with Trazimera has finished, you should see your doctor and tell them that you have previously been treated with Trazimera.

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

• infections
• diarrhoea
• constipation
• heartburn (dyspepsia)
• fatigue
• skin rashes
• chest pain
• abdominal pain
• joint pain
• low counts of red blood cells and white blood cells (which help fight infection) sometimes with fever
• muscle pain
• conjunctivitis
• watery eyes
• nose bleeds
• runny nose
• hair loss
• tremor
• hot flush
• dizziness
• nail disorders
• weight loss
• loss of appetite
• inability to sleep (insomnia)
• altered taste
• low platelet count
• bruising
• numbness or tingling of the fingers and toes, which occasionally may extend to the rest of the limb
• redness, swelling or sores in your mouth and/or throat
• pain, swelling, redness or tingling of hands and/or feet
• breathlessness
• headache
• cough
• vomiting
• nausea

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

• allergic reactions
• dry eyes
• throat infections
• sweating
• bladder and skin infections
• feeling weak and unwell
• inflammation of the breast
• anxiety
• inflammation of the liver
• depression
• kidney disorders
• asthma
• increased muscle tone or tension
• infection of lungs (hypertonia)
• lung disorders
• pain in the arms and/or legs
• back pain
• itchy rash
• neck pain
• sleepiness (somnolence)
• bone pain
• haemorrhoids
• acne
• itchiness
• leg cramps
• dry mouth and skin

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

• deafness
• bumpy rash
• wheezing
• inflammation or scarring of the lungs

Rare (may affect up to 1 in 1 000 people):

• jaundice
• anaphylactic reactions

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

• abnormal or impaired blood clotting
• high potassium levels
• swelling or bleeding at the back of the eyes
• shock
• abnormal heart rhythm
• respiratory distress
• respiratory failure
• acute accumulation of fluid in the lungs
• acute narrowing of the airways
• abnormally low oxygen levels in the blood
• difficulty in breathing when lying flat
• liver damage
• swelling of the face, lips and throat
• kidney failure
• abnormally low levels of fluid around baby in womb
• failure of the lungs of the baby to develop in the womb
• abnormal development of the kidneys of the baby in the womb

Some of the sideeffects you experience may be due to your underlying cancer. If you receive Trazimera in combination with chemotherapy, some of them may also be due to the chemotherapy.

If you get any side effects, talk to your doctor, pharmacist or nurse.

Reporting of side effects If you get any side effects, talk to your doctor, pharmacist 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.

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 outer carton and on the vial label after EXP. The expiry date refers to the last day of that month.

Store in a refrigerator (2 C 8 C).

Store in the original package in order to protect from light.

Unopened vials of Trazimera may be stored up to 30 C for a single period of up to 3 months. Upon removal from refrigerated storage, Trazimera must not be returned to refrigerated storage. Discard at the end of this 3-month period or by the expiry date on the vial, whichever occurs first. Record the discard by date in the date field provided on the carton.

Infusion solutions should be used immediately after dilution. Do not use Trazimera if you notice any particulate matter or discoloration prior to administration.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

What Trazimera contains

• The active substance is trastuzumab. One vial contains either:

• 150 mg trastuzumab that has to be dissolved in 7.2 mL of sterile water for injections, or
• 420 mg trastuzumab that has to be dissolved in 20 mL of sterile water for injections.
  The resulting solution contains approximately 21 mg/mL trastuzumab.

• The other ingredient(s) are L-histidine hydrochloride monohydrate, L-histidine, sucrose, polysorbate 20 (E 432).

What Trazimera looks like and contents of the pack

Trazimera is a powder for concentrate for solution for infusion, which is supplied in a glass vial with a rubber stopper containing either 150 mg or 420 mg of trastuzumab. The powder is a white cake. Each carton contains 1 vial of powder.

Marketing Authorisation Holder

Pfizer Europe MA EEIG Boulevard de la Plaine 1050 Bruxelles Belgium

Manufacturer

Pfizer Manufacturing Belgium NV Rijksweg 2870 Puurs-Sint-Amands Belgium

For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder.

Belgi /Belgique/Belgien Luxembourg/Luxemburg Pfizer NV/SA T l/Tel: +32 (0)2 554 62 K
Pfizer A.E. (Cyprus Branch) T : +357 22817 esk republika Pfizer, spol. s r.o. Tel: +420 283 004 Magyarorsz g Pfizer Kft. Tel.: +36 1 488 37 Danmark Pfizer ApS Tlf: +45 44 20 11 Malta Drugsales Ltd Tel: +356 21419070/1/2

Deutschland PFIZER PHARMA GmbH Tel: +49 (0)30 550055-51Nederland Pfizer bv Tel: +31 (0)800 63 34
,

Te .: +359 2 970 4Norge Pfizer AS Tlf: +47 67 52 61 Eesti Pfizer Luxembourg SARL Eesti filiaal Tel: +372 666 7 sterreich Pfizer Corporation Austria Ges.m.b.H. Tel: +43 (0)1 521 15-0

Pfizer A.E. : +30 210 6785Polska Pfizer Polska Sp. z o.o. Tel.: +48 22 335 61 Espa a Pfizer, S.L. Tel: +34 91 490 99 Portugal Laborat rios Pfizer, Lda. Tel: +351 21 423 5France Pfizer T l: + 33 (0)1 58 07 34 Rom nia Pfizer Romania S.R.L Tel: +40 (0) 21 207 28 Hrvatska Pfizer Croatia d.o.o. Tel: +385 1 3908 Slovenija Pfizer Luxembourg SARL Pfizer, podru nica za svetovanje s podro ja farmacevtske dejavnosti, Ljubljana Tel: +386 (0)1 52 11 Ireland Pfizer Healthcare Ireland Tel: +1800 633 363 (toll free) Tel: +44 (0)1304 616Slovensk republika Pfizer Luxembourg SARL, organiza n zlo ka Tel: +421 2 3355 5 sland Icepharma hf. S mi: +354 540 8Suomi/Finland Pfizer Oy Puh/Tel: +358 (0)9 430 Italia Pfizer S.r.l. Tel: +39 06 33 18 Sverige Pfizer AB Tel: +46 (0)8 550 520 Latvija Pfizer Luxembourg SARL fili le Latvij
Tel: +371 670 35 United Kingdom (Northern Ireland) Pfizer Limited Tel: +44 (0)1304 616Lietuva Pfizer Luxembourg SARL filialas Lietuvoje Tel: +370 5 251 4This leaflet was last revised in MM/YYYY.

Other sources of information

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