- Approval Id
- 02d44cd0fe939e40
- Drug Name
- WINREVAIR® POWDER FOR SOLUTION FOR INJECTION 60MG
- Product Name
- WINREVAIR® POWDER FOR SOLUTION FOR INJECTION 60MG
- Approval Number
- SIN17092P
- Approval Date
- 2024-09-20
- Registrant
- MSD PHARMA (SINGAPORE) PTE. LTD.
- Licence Holder
- MSD PHARMA (SINGAPORE) PTE. LTD.
- Drug Type
- Therapeutic
- Forensic Classification
- Prescription Only
- Dosage Form
- INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION
- Dosage
- <p><strong>2. DOSAGE AND ADMINISTRATION</strong></p>
<p><strong>2.1 Recommended Starting Dosage in Adults</strong><br>
WINREVAIR is administered once every 3 weeks by subcutaneous (SC) injection according to patient weight. The starting dose of WINREVAIR is 0.3 mg/kg (see Table 1).</p>
<p>Obtain hemoglobin (Hgb) and platelet count prior to the first dose of WINREVAIR. Rapid increases in Hgb of more than 2 g/dL have been observed after initiating treatment. It is not recommended to initiate treatment if platelet count is <50,000/mm<sup>3</sup> (<50.0 x 10<sup>9</sup>/L) <em>[see Dosage and Administration (2.3)]</em>.</p>
<img src="/TGIF/Winrevair-Table1.png" alt="Winrevair Dosage Table 1" /><br><br>
<p><strong>2.2 Recommended Target Dosage in Adults</strong><br>
The target dose of WINREVAIR is 0.7 mg/kg (see Table 2) administered every 3 weeks.</p>
<p>Obtain and review hemoglobin (Hgb) and platelet count prior to increasing to the target dose. Continue treatment at 0.7 mg/kg every 3 weeks unless dosage adjustments are required <em>[see Dosage and Administration (2.3)]</em>.</p>
<img src="/TGIF/Winrevair-Table2.png" alt="Winrevair Dosage Table 2" /><br><br>
<p><u>Missed Dose, Overdose, or Underdose</u><br>
If a dose of WINREVAIR is missed, administer as soon as possible. If the missed dose of WINREVAIR is not taken within 3 days of the scheduled date, adjust the schedule to maintain 3-week dosing intervals. In case of an overdose or underdose, consider retraining the patient or caregiver on proper administration as appropriate. In case of an overdose, monitor for erythrocytosis <em>[see Overdosage (9)</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em><em>]</em>.</p>
<p><strong>2.3 Dosage Modifications in Adults Due to Hemoglobin Increase or Platelet Count Decrease</strong><br>
Increases in Hgb to levels greater than 2 g/dL above the upper limit of normal (ULN) and decreases in platelet count <50,000/mm<sup>3</sup> (<50.0 x 10<sup>9</sup>/L) have been observed. Check Hgb and platelet count before each dose for the first 5 doses, or longer if values are unstable. Thereafter, monitor Hgb and platelet count periodically. Consider assessment of benefit-risk for the individual patient in determining whether dose modification is appropriate <em>[see Warnings and Precautions (5.1, 5.2)</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em><em>]</em>.</p>
<p>Delay treatment for 3 weeks if any of the following occur:</p>
<ul>
<li>Hgb increases >2.0 g/dL from the previous dose and is above ULN.</li>
<li>Hgb increases >4.0 g/dL from baseline.</li>
<li>Hgb increases >2.0 g/dL above ULN.</li>
<li>Platelet count decreases to <50,000/mm<sup>3</sup> (<50.0 x 10<sup>9</sup>/L).</li>
</ul>
<p>For treatment delays lasting >9 weeks, restart treatment at 0.3 mg/kg.</p>
<p><strong>2.4 Pediatric Patients</strong><br>
Safety and efficacy of WINREVAIR have not been established in patients less than 18 years of age.</p>
<p><strong>2.5 Geriatric Patients</strong><br>
No dose adjustment of WINREVAIR is required based on age <em>[see 7. Use in Specific Populations (7.5) and Clinical Pharmacology (11.4)</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em><em>]</em>.</p>
<p><strong>2.6 Renal Impairment</strong><br>
No dose adjustment of WINREVAIR is required based on renal impairment. Sotatercept has not been studied in PAH patients with severe renal impairment (eGFR <30 mL/min/1.73m<sup>2</sup>) <em>[see 7. Use in Specific Populations (7.6) and Clinical Pharmacology (11.4)</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em><em>]</em>.</p>
<p><strong>2.7 Hepatic Impairment</strong><br>
WINREVAIR use has not been studied in patients with hepatic impairment (Child-Pugh Classification A to C). Hepatic impairment is not expected to influence sotatercept metabolism since sotatercept is metabolized via cellular catabolism <em>[see 7. Use in Specific Populations (7.7) and Clinical Pharmacology (11.4)</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em><em>]</em>.</p>
<p><strong>2.8 Preparation and Administration</strong><br>
WINREVAIR is intended for use under the guidance of a health care professional. Patients and caregivers may administer WINREVAIR when considered appropriate and when they receive training and follow-up from the doctor in how to reconstitute, prepare, measure, and inject WINREVAIR.</p>
<p>Consider confirming at subsequent visits that the patient or caregiver can prepare and administer WINREVAIR correctly:</p>
<ul>
<li>if the dose changes or the patient requires a different kit</li>
<li>if the patient develops erythrocytosis <em>[see Warnings and Precautions (5.1)</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em><em>]</em>.</li>
</ul>
<p>Refer to the Instructions for Use (IFU) for detailed instructions on the proper preparation and administration of WINREVAIR.</p>
<p><u>Selecting the Appropriate Product Kit</u><br>
If a patient’s weight requires the use of two 45 mg vials or two 60 mg vials of lyophilized product, a 2-vial kit should be used instead of two individual 1-vial kits. A 2-vial kit includes instructions to combine the contents of two vials, which aids in measuring the proper dosage and eliminates the need for multiple injections <em>[see Pharmaceutical Particulars (15.5)</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em><em>]</em>.</p>
<p><u>Reconstitution Instructions</u></p>
<ul>
<li>Remove the injection kit from the refrigerator and wait 15 minutes to allow the prefilled syringe(s) and drug product to come to room temperature prior to preparation.</li>
<li>Check the vial to ensure the product is not expired. The powder should be white to off-white and may look like a whole or fragmented cake.</li>
<li>Remove the lid from the vial containing the WINREVAIR lyophilized powder and swab the rubber stopper with an alcohol wipe.</li>
<li>Attach the vial adapter to the vial.</li>
<li>Visually inspect the pre-filled syringe for any damage or leaks and the sterile water inside to ensure there are no visible particles.</li>
<li>Snap off the cap of the pre-filled syringe and attach the syringe to the vial adapter.</li>
<li>Inject all of the sterile water from the attached syringe into the vial containing the lyophilized powder. This will provide a final concentration of 50 mg/mL.</li>
<li>Gently swirl the vial to reconstitute the drug product. DO NOT shake or vigorously agitate.</li>
<li>Allow the vial to stand for up to 3 minutes to allow bubbles to disappear.</li>
<li>Visually inspect the reconstituted solution. When properly mixed, WINREVAIR should be clear to opalescent and colorless to slightly brownish-yellow and does not have clumps or powder.</li>
<li>Unscrew the syringe from the vial adapter and discard the emptied syringe into a sharps container.</li>
<li>If prescribed a 2-vial presentation, repeat the steps within this section to prepare the second vial.</li>
<li>Use the reconstituted solution as soon as possible, but no later than 4 hours after reconstitution.</li>
</ul>
<p><u>Syringe Preparation</u></p>
<ul>
<li>Swab the vial adapter with an alcohol wipe.</li>
<li>Remove dosing syringe from packaging and attach the syringe to the vial adapter.</li>
<li>Turn the syringe and vial upside-down and withdraw the appropriate volume for injection, based on the patient’s weight.
<ul class="circle">
<li>If the dose amount requires the use of two vials, withdraw the entire contents of the first vial and slowly transfer full contents into the second vial.</li>
<li>Turn the syringe and vial upside-down and withdraw the required amount of drug product.</li>
</ul>
</li>
<li>If necessary, push plunger in to remove excess drug product or air from the syringe.</li>
<li>Remove the syringe from the vial and attach the needle.</li>
</ul>
<p><u>Administration Instructions</u></p>
<p>WINREVAIR is for subcutaneous injection.</p>
<ul>
<li>Select the injection site on the abdomen (at least 2 inches away from navel), upper thigh, or upper arm, and swab with an alcohol wipe. Select a new site for each injection that is not scarred, tender, or bruised.
<ul class="circle">
<li>For administration by the patient or caregiver, use only the abdomen and upper thigh (see IFU).</li>
</ul></li>
<li>Perform subcutaneous injection.</li>
<li>Discard the emptied syringe into a sharps container. Do not reuse the syringe.</li>
</ul>
- Route Of Administration
- SUBCUTANEOUS
- Indication Info
- <p><strong>1. INDICATIONS AND USAGE</strong></p>
<p>WINREVAIR is indicated for the treatment of adults with pulmonary arterial hypertension (PAH, World Health Organization [WHO] Group 1; Functional Class [FC] II to III) to increase exercise capacity, improve WHO functional class, and delay disease progression.</p>
- Contraindications
- <p><strong>4. CONTRAINDICATIONS</strong></p>
<p>None.</p>
- Atc Code
- C02KX06
- Pharma Manufacturer Name
- MSD PHARMA (SINGAPORE) PTE. LTD.