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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Document Details
Generated Narrative: Bundle TEST PURPOSES ONLY - benepali
Language: en
Profile: Bundle - ePI
Final Document at 2022-02-16 13:28:17+0000 by Organization ACME industry for Bundle: identifier = http://ema.europa.eu/identifier#None; type = document; timestamp = 2023-06-27 10:09:22+0000
Document Subject
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identifier: http://ema.europa.eu/identifier
/EU/1/15/1074/005
type: Medicinal Product
domain: Human use
status: active
legalStatusOfSupply: Medicinal product subject to medical prescription
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Usages
Country Jurisdiction Language EU EU en
Document Content
Generated Narrative: Composition composition-en-c5a54b11d8107e662bc760b43da975c8
Language: en
Profile: Composition (ePI)
identifier: http://ema.europa.eu/identifier
/EU/1/15/1074/005
status: Final
type: Package Leaflet
category: Raw
date: 2022-02-16 13:28:17+0000
author: Organization ACME industry
title: TEST PURPOSES ONLY - benepali
Mode | Time |
Official | 2022-02-16 13:28:17+0000 |
What is in this leaflet
Benepali contains the active substance etanercept.
Benepali is a medicine that is made from two human proteins. It blocks the activity of another protein in the body that causes inflammation. Benepali works by reducing the inflammation associated with certain diseases.
In adults (aged 18 and over), Benepali can be used for:
For rheumatoid arthritis, Benepali is usually used in combination with methotrexate, although it may also be used alone if treatment with methotrexate is unsuitable for you. Whether used alone or in combination with methotrexate, Benepali can slow down the damage to your joints caused by the rheumatoid arthritis and improve your ability to do normal daily activities.
For psoriatic arthritis patients with multiple joint involvement, Benepali can improve your ability to do normal daily activities.
For patients with multiple symmetrical painful or swollen joints (e.g., hands, wrists and feet), Benepali can slow down the structural damage to those joints caused by the disease.
Benepali is also prescribed for the treatment of the following diseases in children and adolescents.
For the following types of juvenile idiopathic arthritis when treatment with methotrexate has not worked well enough or is not suitable for them:
Polyarthritis (rheumatoid factor positive or negative) and extended oligoarthritis in patients from the age of 2 years and weighing 62.5 kg or more.
Psoriatic arthritis in patients from the age of 12 years and weighing 62.5 kg or more.
For enthesitis-related arthritis in patients from the age of 12 years and weighing 62.5 kg or more when other widely used treatments have not worked well enough or are not suitable for them.
Severe plaque psoriasis in patients from the age of 6 years and weighing 62.5 kg or more who have had an inadequate response to (or are unable to take) phototherapies or other systemic therapies.
Do not use Benepali
Warnings and precautions
Talk to your doctor before taking Benepali.
Children and adolescents Benepali is not indicated for use in children and adolescents who weigh less than 62.5 kg.
Benepali should not normally be used in children with polyarthritis or extended oligoarthritis below the age of 2 years or weighing less than 62.5 kg, or in children with enthesitis-related arthritis or psoriatic arthritis below the age of 12 years or weighing less than 62.5 kg, or in children with psoriasis below the age of 6 years or weighing less than 62.5 kg.
Other medicines and Benepali Tell your doctor or pharmacist if you or the child are taking, have recently taken or might take any other medicines (including anakinra, abatacept or sulfasalazine).
You or the child should not use Benepali with medicines that contain the active substance anakinra or abatacept.
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.
Women of childbearing potential should be advised to use appropriate contraception to avoid becoming pregnant during Benepali therapy and for three weeks after discontinuation of therapy.
Benepali should only be used during pregnancy if clearly needed.
If you received Benepali during pregnancy, your baby may have a higher risk of getting an infection. In addition, one study found more birth defects when the mother had received etanercept in pregnancy, compared with mothers who had not received etanercept or other similar medicines (TNF- antagonists), but there was no particular kind of birth defect reported. Another study found no increased risk of birth defects when the mother had received etanercept in pregnancy. Your doctor will help you to decide whether the benefits of treatment outweigh the potential risk to your baby. Talk to your doctor if you want to breastfeed while on Benepali treatment. It is important that you tell your baby s doctors and other healthcare professionals about the use of Benepali during pregnancy and breastfeeding before your baby receives any vaccine.
Driving and using machines No information is available if the use of Benepali effects the ability to drive or use machines.
Benepali contains sodium This medicinal product contains less than 1 mmol sodium (23 mg) per 25 mg, that is to say essentially sodium-free .
Always use this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.
If you feel that the effect of Benepali is too strong or too weak, talk to your doctor or pharmacist.
Use in adult patients (aged 18 years or over) Rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthritis including ankylosing spondylitis The usual dose is 25 mg given twice a week or 50 mg once a week as an injection under the skin. However, your doctor may determine an alternative frequency at which to inject Benepali.
Plaque psoriasis The usual dose is 25 mg twice a week or 50 mg once a week.
Alternatively, 50 mg may be given twice a week for up to 12 weeks, followed by 25 mg twice a week or 50 mg once a week.
Your doctor will decide how long you should use Benepali and whether retreatment is needed based on your response. If Benepali has no effect on your condition after 12 weeks, your doctor may tell you to stop using this medicine.
Use in children and adolescents Dose and frequency of dosing for the child or adolescent will depend on body weight and disease. Your doctor will determine the correct dose for the child and will prescribe an appropriate strength of etanercept.
Paediatric patients weighing 62.5 kg or more can be dosed 25 mg given twice a week or 50 mg given once a week using a fixed-dose pre-filled syringe or pre-filled pen.
Other etanercept products with appropriate dosage forms for children are available.
For polyarthritis or extended oligoarthritis in patients from the age of 2 years and weighing 62.5 kg or more, or enthesitis-related arthritis or psoriatic arthritis in patients from the age of 12 years and weighing 62.5 kg or more, the usual dose is 25 mg given twice a week or 50 mg given once a week.
For psoriasis in patients from the age of 6 years and weighing 62.5 kg or more, the usual dose is 50 mg and should be given once weekly. If Benepali has no effect on the child s condition after 12 weeks, your doctor may tell you to stop using this medicine.
The doctor will provide you with detailed directions for preparing and measuring the appropriate dose.
Method and route of administration Benepali is administered by an injection under the skin (subcutaneous use).
Detailed instructions on how to inject Benepali are provided in section 7 Instructions for use . Do not mix the Benepali solution with any other medicine.
To help you remember, it may be helpful to write in a diary which day(s) of the week Benepali should be used.
If you use more Benepali than you should If you have used more Benepali than you should (either by injecting too much on a single occasion or by using it too frequently), talk to a doctor or pharmacist immediately. Always have the outer carton of the medicine with you, even if it is empty.
If you forget to use Benepali If you forget a dose, you should inject it as soon as you remember, unless the next scheduled dose is the next day; in which case you should skip the missed dose. Then continue to inject the medicine on the usual day(s). If you do not remember until the day that the next injection is due, do not take a double dose (two doses on the same day) to make up for a forgotten dose.
If you stop using Benepali Your symptoms may return upon discontinuation.
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.
Allergic reactions If any of the following happen, do not inject more Benepali. Tell your doctor immediately, or go to the casualty department at your nearest hospital.
Serious allergic reactions are rare. However, any of the above symptoms may indicate an allergic reaction to Benepali, so you should seek immediate medical attention.
Serious side effects If you notice any of the following, you or the child may need urgent medical attention.
These are rare or uncommon side effects, but are serious conditions (some of which may rarely be fatal). If any of the above occurs, tell your doctor immediately, or visit the casualty department at your nearest hospital.
Other side effects The known side effects of Benepali include the following in groups of decreasing frequency:
Very common (may affect more than 1 in 10 people) Infections (including colds, sinusitis, bronchitis, urinary tract infections and skin infections); injection site reactions (including bleeding, bruising, redness, itching, pain, and swelling) (these do not occur as often after the first month of treatment; some patients have developed a reaction at an injection site that was recently used); and headache.
Common (may affect up to 1 in 10 people) Allergic reactions; fever; rash; itching; antibodies directed against normal tissue (autoantibody formation).
Uncommon (may affect up to 1 in 100 people) Serious infections (including pneumonia, deep skin infections, joint infections, blood infection, and infections at various sites); worsening of congestive heart failure; low red blood cell count, low white blood cell count, low neutrophil (a type of white blood cell) count; low blood platelet count; skin cancer (excluding melanoma); localised swelling of the skin (angioedema); hives (elevated patches of red or pale skin that often itch); eye inflammation; psoriasis (new or worsening); inflammation of the blood vessels affecting multiple organs; elevated liver blood tests (in patients also receiving methotrexate treatment, the frequency of elevated liver blood tests is common); abdominal cramps and pain, diarrhoea, weight loss or blood in the stool (signs of bowel problems).
Rare (may affect up to 1 in 1,000 people) Serious allergic reactions (including severe localised swelling of the skin and wheezing); lymphoma (a type of blood cancer); leukaemia (cancer affecting the blood and bone marrow);
melanoma (a type of skin cancer); combined low platelet, red, and white blood cell count; nervous system disorders (with severe muscle weakness and signs and symptoms similar to those of multiple sclerosis or inflammation of the nerves of the eyes or spinal cord); tuberculosis; new onset congestive heart failure; seizures; lupus or lupus-like syndrome (symptoms may include persistent rash, fever, joint pain, and tiredness); skin rash, which may lead to severe blistering and peeling of the skin; inflammation of the liver caused by the body's own immune system (autoimmune hepatitis; in patients also receiving methotrexate treatment, the frequency is uncommon); immune disorder that can affect the lungs, skin and lymph nodes (sarcoidosis); inflammation or scarring of the lungs (in patients also receiving methotrexate treatment, the frequency of inflammation or scarring of the lungs is uncommon); lichenoid reactions (itchy reddish-purple skin rash and/or threadlike white-grey lines on mucous membranes), opportunistic infections (which include tuberculosis and other infections that occur when resistance to disease is lowered), erythema multiforme (inflammatory skin rash), cutaneous vasculitis (inflammation of blood vessels in the skin); damage to nerves, including Guillain-Barr syndrome (a serious condition which can affect breathing and damage body organs).
Very rare (may affect up to 1 in 10,000 people) Failure of the bone marrow to produce crucial blood cells; toxic epidermal necrolysis (a life- threatening skin condition).
Not known (frequency cannot be estimated from available data) Merkel cell carcinoma (a type of skin cancer); Kaposi s sarcoma (a rare cancer related to infection with human herpes virus 8. Kaposi s sarcoma most commonly appears as purple lesions on the skin); excessive activation of white blood cells associated with inflammation (macrophage activation syndrome); recurrence of hepatitis B (a liver infection); worsening of a condition called dermatomyositis (muscle inflammation and weakness with an accompanying skin rash); listeria (a bacterial infection); damage to the tiny filters inside your kidneys leading to poor kidney function (glomerulonephritis).
Side effects in children and adolescents The side effects and their frequencies seen in children and adolescents are similar to those described above.
Reporting of side effects If you get any side effects, talk to your doctor or pharmacist. 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 carton and the label of the pre- filled syringe after EXP. The expiry date refers to the last day of that month.
Store in a refrigerator (2 C - 8 C). Do not freeze.
Keep the pre-filled syringes in the outer carton in order to protect from light.
After taking a syringe from the refrigerator, wait approximately 30 minutes to allow the Benepali solution in the syringe to reach room temperature. Do not warm in any other way. Immediate use is then recommended.
Benepali may be stored outside of the refrigerator at temperatures up to a maximum of 30 C for a single period of up to 31 days; after which, it should not be refrigerated again. Benepali should be discarded if not used within 31 days after removal from the refrigerator. It is recommended that you record the date that Benepali is removed from the refrigerator and the date after which Benepali should be discarded (no more than 31 days following the removal from the refrigerator).
Inspect the solution in the syringe. It should be clear to slightly opalescent, colourless or pale yellow, and may contain small white or almost transparent particles of protein. This appearance is normal for Benepali. Do not use this medicine if you notice the solution is discoloured, cloudy, or if particles other than those described above are present. If you are concerned with the appearance of the solution, then contact your pharmacist for assistance.
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 Benepali contains
What Benepali looks like and contents of the pack Benepali is supplied as a pre-filled syringe containing a clear to slightly opalescent, colourless or pale yellow solution for injection (injection).
Benepali is available in packs containing 4 pre-filled syringes, multipacks comprising 2 cartons, each containing 4 pre-filled syringes and multipacks comprising 6 cartons, each containing 4 pre-filled syringes. Not all pack sizes may be marketed.
Marketing Authorisation Holder Samsung Bioepis NL B.V. Olof Palmestraat 2616 LR Delft The Netherlands
Manufacturer Biogen Netherlands B.V. Prins Mauritslaan 1171 LP Badhoevedorp The Netherlands
Samsung Bioepis NL B.V. Olof Palmestraat 2616 LR Delft The Netherlands
For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:
Belgi /Belgique/Belgien
Biogen Belgium NV/S.A
T l/Tel: + 32 (0)2 808 5Lietuva Biogen Lithuania UAB Tel: +370 52 07 91
Ewopharma AG Representative Office Te .: + 359 249 176 Luxembourg/Luxemburg
Biogen Belgium NV/SA
T l/Tel: +35 227 772 esk republika
Biogen (Czech Republic) s.r.o.
Tel: + 420 228 884 Magyarorsz g
Biogen Hungary Kft.
Tel.: + 36 1 848 04 Danmark
Biogen (Denmark) A/S
Tlf: + 45 78 79 37 Malta
Pharma.MT Ltd Tel: + 356 27 78 15 Deutschland
Biogen GmbH
Tel: + 49 (0)89 996 177 Nederland
Biogen Netherlands B.V.
Tel: + 31 (0)20 808 02 Eesti
Biogen Estonia O
Tel: + 372 6 68 30 Norge
Biogen Norway AS
Tlf: + 47 21 93 95
Genesis Pharma S.A. : + 30 211 176 8 sterreich
Biogen Austria GmbH
Tel: + 43 (0)1 267 51 Espa a
Biogen Spain, S.L.
Tel: + 34 931 790 Polska
Biogen Poland Sp. z o.o.
Tel.: + 48 22 116 86 France
Biogen France SAS
T l: + 33 (0)1 776 968 Portugal
Biogen Portugal Sociedade Farmac utica,
Unipessoal, Lda
Tel: + 351 308 800 Hrvatska
Ewopharma d.o.o
Tel: + 385 (0)1 777 64 Rom nia
Ewopharma AG Representative Office
Tel: + 40 377 881 Ireland
Biogen Idec (Ireland) Ltd.
Tel: +353 (0)1 513 33 Slovenija
Biogen Pharma d.o.o.
Tel: + 386 (0)1 888 81 sland
Icepharma hf. S mi: + 354 800 9Slovensk republika
Biogen Slovakia s.r.o.
Tel: + 421 (0)2 333 257 Italia
Biogen Italia s.r.l.
Tel: + 39 (0)6 899 701 Suomi/Finland
Biogen Finland Oy
Puh/Tel: + 358 (0)9 427 041
Genesis Pharma (Cyprus) Ltd : + 357 22 00 04 Sverige
Biogen Sweden AB
Tel: +46 (0)8 525 038 Latvija Biogen Latvia SIA Tel: + 371 66 16 40 United Kingdom (Northern Ireland) Biogen Idec (Ireland) Ltd. Tel: +44 (0)20 360 886 This leaflet was last revised in
Detailed information on this medicine is available on the European Medicines Agency web site:
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Profile: Composition (ePI)
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type: Package Leaflet
category: Raw
date: 2022-02-16 13:28:17+0000
author: Organization ACME industry
title: TEST PURPOSES ONLY - benepali
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Mode Time Official 2022-02-16 13:28:17+0000
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Usages
Country Jurisdiction Language EU EU en