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EMA Approval

Alkindi

H02AB09

hydrocortisone

Corticosteroids for systemic use

hydrocortisone

Adrenal Insufficiency

Basic Information

EMA regulatory identification and product classification information

EMA Identifiers

ATC CodeH02AB09
EMA European Classification

Overview Summary

Comprehensive product overview and regulatory summary

This is a summary of the European public assessment report (EPAR) for Alkindi. It explains how the Agency assessed the medicine to recommend its authorisation in the EU and its conditions of use. It is not intended to provide practical advice on how to use Alkindi.

For practical information about using Alkindi, patients should read the package leaflet or contact their doctor or pharmacist.

Authorisations (1)

EMEA/H/C/004416

Neurocrine Netherlands B.V.,Van Heuven Goedhartlaan 935 A,1181 LD Amstelveen,NETHERLANDS

Authorised

February 9, 2018

Active Substances (1)

hydrocortisone

Documents (9)

Alkindi : EPAR - Public assessment report

February 28, 2018

INITIAL_MARKETING_AUTHORISATION_DOCUMENTS

CHMP summary of positive opinion for Alkindi

December 15, 2017

INITIAL_MARKETING_AUTHORISATION_DOCUMENTS

Alkindi : EPAR - Public assessment report

February 28, 2018

CHANGES_SINCE_INITIAL_AUTHORISATION

CHMP summary of positive opinion for Alkindi

December 15, 2017

CHANGES_SINCE_INITIAL_AUTHORISATION

Alkindi : EPAR - All Authorised presentations

February 28, 2018

AUTHORISED_PRESENTATIONS

Alkindi : EPAR - Product Information

February 28, 2018

DRUG_PRODUCT_INFORMATION

Alkindi : EPAR - Risk-management-plan summary

February 28, 2018

RISK_MANAGEMENT_PLAN_SUMMARY

Alkindi : EPAR - Procedural steps taken and scientific information after authorisation

July 13, 2018

CHANGES_SINCE_INITIAL_AUTHORISATION

Alkindi : EPAR - Summary for the public

February 28, 2018

OVERVIEW_DOCUMENT

Overview Q&A (8)

Question

How is Alkindi used?

Answer

Alkindi is available as capsules containing granules. The capsules are opened and the granules are placed in the child’s mouth. The child should then be given water or milk to swallow the granules. The granules can also be sprinkled on a spoonful of soft food and given to the child immediately.

The dose is chosen to be lowest possible that controls the child’s symptoms. For further information, see the package leaflet.

The medicine can only be obtained with a prescription.

Question

How does Alkindi work?

Answer

The active substance in Alkindi, hydrocortisone, is the same as cortisol, the main steroid hormone released by the body’s adrenal gland. Hydrocortisone replaces the natural cortisol that is missing in children whose adrenal glands do not produce enough of the hormone, thereby helping to relieve their symptoms.

Question

What benefits of Alkindi have been shown in studies?

Answer

Studies on the benefits and risks of the active substance have already been carried out with the reference medicine and do not need to be repeated for Alkindi.

As for every medicine, the company provided studies on the quality of Alkindi. The company also carried out studies to show that it is ‘bioequivalent’ to the reference medicine. Two medicines are bioequivalent when they produce the same levels of the active substance in the body and are therefore expected to have the same effect.

Question

What are the risks associated with Alkindi?

Answer

No side effects were reported in studies with Alkindi, but some side effects have been reported with other hydrocortisone medicines. These include changes in behaviour, nausea, inflammation in the lining of the stomach and changes in blood potassium levels and excess acid in the blood. For the full list of side effects see the package leaflet.

Alkindi must not be used in patients with hypersensitivity (allergy) to the active substance or to any of the ingredients of Alkindi. It must also not be used in children with difficulty swallowing or in premature babies who haven’t started feeding by mouth.

Question

What measures are being taken to ensure the safe and effective use of Alkindi?

Answer

Recommendations and precautions to be followed by healthcare professionals and patients for the safe and effective use of Alkindi have been included in the summary of product characteristics and the package leaflet.

Question

Other information about Alkindi

Answer

The European Commission granted a marketing authorisation valid throughout the European Union for Alkindi on 9 February 2018.

For more information about treatment with Alkindi, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist.

Question

What is Alkindi and what is it used for?

Answer

Alkindi is a medicine for children (from birth to up to 18 years of age) whose adrenal glands cannot make enough of a hormone called cortisol.

Cortisol is needed to control many body processes (including inflammation and the control of sugar and mineral levels) and is sometimes referred to as the ‘stress hormone’ because it helps the body respond to stress. A lack of the hormone causes several symptoms, including weight loss, muscle weakness, tiredness and low blood pressure.

Alkindi is a ‘hybrid medicine’. This means that it is similar to a ‘reference medicine’ containing the same active substance (in this case Hydrocortisone Tablets Auden Mckenzie), but Alkindi is available in a different form (granules instead of tablets) and has been developed for children only.

Alkindi contains the active substance hydrocortisone.

Question

Why is Alkindi approved?

Answer

Alkindi produces similar levels of hydrocortisone in the blood to a reference medicine already authorised in the EU. Alkindi is also available in a form suitable for children and it is easier to give a precise dose with Alkindi than with other treatments which require crushing tablets and weighing up the right dose.

The European Medicines Agency concluded that the benefits of Alkindi are greater than its risks and recommended that it be approved for use in the EU.

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