MedPath
EMA Approval

Sibnayal

A12BA30

potassium (different salts in combination)

Mineral supplements

potassium citratepotassium hydrogen carbonate

Acidosis, Renal Tubular

potassium citrate monohydrated
Potassium citrate monohydrated

Basic Information

EMA regulatory identification and product classification information

EMA Identifiers

ATC CodeA12BA30
EMA European Classification

Overview Summary

Comprehensive product overview and regulatory summary

Sibnayal is a medicine used to treat patients from the age of one year with distal renal tubular acidosis (dRTA), a disease in which the kidneys do not remove acid through the urine well enough. This results in a build-up of acid in the blood, which leads to a range of symptoms including hearing and growth problems, vomiting, kidney stones and lack of alertness. The disease also causes levels of potassium in the blood to fall, which can lead to muscle weakness and paralysis.

Sibnayal contains the active substances potassium citrate and potassium hydrogen carbonate.

Authorisations (1)

EMEA/H/C/005407

Advicenne S.A.,262 rue du Faubourg Saint Honoré,75008 Paris,France

Authorised

April 30, 2021

Active Substances (4)

potassium citrate monohydrated

potassium hydrogen carbonate

Potassium citrate monohydrated

Potassium hydrogen carbonate

Documents (13)

Sibnayal : Orphan designation withdrawal assessment report (initial authorisation)

May 3, 2021

INITIAL_MARKETING_AUTHORISATION_DOCUMENTS

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

April 26, 2022

CHANGES_SINCE_INITIAL_AUTHORISATION

CHMP summary of positive opinion for Sibnayal

December 11, 2020

INITIAL_MARKETING_AUTHORISATION_DOCUMENTS

Sibnayal : EPAR - Risk-management-plan summary

May 3, 2021

RISK_MANAGEMENT_PLAN_SUMMARY

Sibnayal : EPAR - Product information

May 3, 2021

DRUG_PRODUCT_INFORMATION

Sibnayal : EPAR - All authorised presentations

May 3, 2021

AUTHORISED_PRESENTATIONS

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

May 16, 2025

CHANGES_SINCE_INITIAL_AUTHORISATION

Sibnayal : EPAR - Public assessment report

May 3, 2021

CHANGES_SINCE_INITIAL_AUTHORISATION

CHMP summary of positive opinion for Sibnayal

December 11, 2020

CHANGES_SINCE_INITIAL_AUTHORISATION

Sibnayal : EPAR - Public assessment report

May 2, 2021

INITIAL_MARKETING_AUTHORISATION_DOCUMENTS

Sibnayal : EPAR - Procedural steps taken and scientific information after authorisation (archive)

April 26, 2022

CHANGES_SINCE_INITIAL_AUTHORISATION

Sibnayal : Orphan designation withdrawal assessment report (initial authorisation)

May 3, 2021

CHANGES_SINCE_INITIAL_AUTHORISATION

Sibnayal : EPAR - Medicine overview

May 3, 2021

OVERVIEW_DOCUMENT

Overview Q&A (7)

Question

What are the risks associated with Sibnayal?

Answer

The most common side effects with Sibnayal (which may affect more than 1 in 10 people) is abdominal (belly) pain. Nausea (feeling sick) at start of treatment, stomach pain and gut pain may affect up to 1 in 10 people. For the full list of side effects of Sibnayal, see the package leaflet.

Sibnayal must not be used in patients with moderately or severely impaired kidney function and in patients with hyperkalaemia (high blood potassium levels). For the full list of restrictions, see the package leaflet.

Question

Why is Sibnayal authorised in the EU?

Answer

Sibnayal was shown to be effective at reducing the level of acid and normalising the level of potassium in dRTA patients’ blood. The safety of Sibnayal was considered acceptable, and its side effects manageable and in line with other treatments for this disease. The European Medicines Agency therefore decided that Sibnayal’s benefits are greater than its risks and it can be authorised for use in the EU.

Question

What benefits of Sibnayal have been shown in studies?

Answer

One study in 37 patients with dRTA showed that Sibnayal was effective at reducing the level of acid and normalising the level of potassium in the blood.

Patients were first treated with their usual medicines for neutralising excess acid for 5 days, then switched to Sibnayal. The optimal dose of Sibnayal was reached gradually over 30 days, after which patients were given this dose for at least 5 days.

The large majority (90%) of patients had a reduction in blood acid levels during treatment with Sibnayal, and this effect was generally maintained during 24 months of treatment. In addition, blood potassium levels returned to normal in 83% of patients. The corresponding figures during treatment with other medicines were 45% and 82%, respectively.

Question

How is Sibnayal used?

Answer

Sibnayal is available as prolonged-release granules to be taken by mouth, and can only be obtained with a prescription. Prolonged release means that the active substance in Sibnayal is released slowly into the body over a few hours after being taken. The starting dose depends on the age and body weight of the patient, and is gradually increased to obtain the optimal dose that provides adequate control of acid and potassium levels in the blood. Sibnayal is taken twice daily, typically twelve hours apart.

For more information about using Sibnayal, see the package leaflet or contact your doctor or pharmacist.

Question

How does Sibnayal work?

Answer

Sibnayal contains a combination of two salts, potassium citrate and potassium hydrogen carbonate. Because the combination is alkaline and contains potassium, it neutralises excess acid in the blood and restores levels of potassium, thus relieving the symptoms of the disease.

Question

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

Answer

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

As for all medicines, data on the use of Sibnayal are continuously monitored. Side effects reported with Sibnayal are carefully evaluated and any necessary action taken to protect patients.

Question

Other information about Sibnayal

Answer

Sibnayal received a marketing authorisation valid throughout the EU on 30 April 2021.

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