- Approval Id
- 0b1ca9641ef579f7
- Drug Name
- VITRAKVI HARD CAPSULE 25MG
- Product Name
- VITRAKVI HARD CAPSULE 25MG
- Approval Number
- SIN15992P
- Approval Date
- 2020-08-17
- Registrant
- BAYER (SOUTH EAST ASIA) PTE LTD
- Licence Holder
- BAYER (SOUTH EAST ASIA) PTE LTD
- Drug Type
- Therapeutic
- Forensic Classification
- Prescription Only
- Dosage Form
- CAPSULE
- Dosage
- <p><strong>4.2 Posology and method of administration</strong></p>
<p>Confirm the presence of an NTRK gene fusion in a tumor specimen prior to initiation of treatment with VITRAKVI.</p>
<p><strong>4.2.1 Dosage regimen</strong></p>
<p><em>Adults</em></p>
<p>The recommended dose of VITRAKVI in adults is 100 mg taken orally, twice daily until disease progression or until unacceptable toxicity occurs.</p>
<p><em>Pediatric</em></p>
<p>Dosing in pediatric patients is based on body surface area (BSA). The recommended dose of VITRAKVI in pediatric patients is 100 mg/m<sup>2</sup> taken orally, twice daily with a maximum of 100 mg per dose until disease progression or until unacceptable toxicity occurs.</p>
<p><em>Missed dose</em></p>
<p>If a dose is missed, the patient should not take two doses at the same time to make up for a missed dose. Patients should take the next dose at the next scheduled time. If the patient vomits after taking a dose, the patient should not take an additional dose to make up for vomiting.</p>
<p><em><u>Dose modification</u></em></p>
<p>For all grade 2 adverse reactions, continued dosing may be appropriate, though close monitoring to ensure no worsening of the toxicity is advised.<br>
For all grade 3 or 4 adverse reactions not referring to liver function test abnormalities:</p>
<ul class="dash">
<li><p>VITRAKVI should be withheld until the adverse reaction resolves or improves to baseline or grade 1. Resume at the next dosage modification if resolution occurs within 4 weeks.</p></li>
<li><p>VITRAKVI should be permanently discontinued if an adverse reaction does not resolve within 4 weeks.</p></li>
</ul>
<p>The recommended dosage modifications for VITRAKVI for adverse reactions are provided in Table 1.</p>
<img src="/TGIF/Vitrakvi-Table1.png" alt="Vitrakvi Dosage Table 1" /><br><br>
<p>VITRAKVI should be permanently discontinued in patients who are unable to tolerate VITRAKVI after three dose modifications.</p>
<p>The recommended dose modifications in case of liver function tests abnormalities during treatment with VITRAKVI are provided in Table 2.</p>
<img src="/TGIF/Vitrakvi-Table2.png" alt="Vitrakvi Dosage Table 2" /><br><br>
<p><strong>Special populations</strong></p>
<p><em>Elderly</em></p>
<p>No dose adjustment is necessary in elderly patients (see section 5.2 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p><em>Hepatic impairment</em></p>
<p>The starting dose of VITRAKVI should be reduced by 50% in patients with moderate (Child-Pugh B) to severe (Child-Pugh C) hepatic impairment (see section 5.2 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>). No dose adjustment is required in patients with mild (Child-Pugh A) hepatic impairment (see section 5.2 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p><em>Renal impairment</em></p>
<p>No dose adjustment is required for patients with renal impairment (see section 5.2 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p><em>Co-administration with Strong CYP3A4 Inhibitors</em><br>
If coadministration of a strong CYP3A4 inhibitor cannot be avoided, reduce the VITRAKVI dose by 50%. After the inhibitor has been discontinued for 3 to 5 elimination half-lives, resume the VITRAKVI dose taken prior to initiating the CYP3A4 inhibitor (see section 4.5 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p><u>Method of administration</u><br>
VITRAKVI is for oral use.</p>
<p>VITRAKVI is available as a capsule or oral solution with equivalent oral bioavailability and may be used interchangeably.</p>
<p><u>Capsule</u><br>
The patient should be advised to swallow the capsule whole with a glass of water. Due to the bitter taste, the capsule should not be opened, chewed or crushed.<br>
The capsules can be taken with or without food but should not be taken with grapefruit or grapefruit juice.</p>
<p><u>Oral Solution</u><br>
The oral solution should be administered by mouth using an oral syringe of 1 mL or 5 mL volume or enterally by using a nasogastric feeding tube.</p>
<ul class="dash">
<li>For doses below 1 mL a 1 mL oral syringe should be used. The calculated dose volume should be rounded to the nearest 0.1 mL.</li>
<li>For doses of 1 mL and higher a 5 mL oral syringe should be used. The dose volume should be calculated to the nearest 0.2 mL.</li>
<li>VITRAKVI should not be mixed with feeding formulas, if administered via nasogastric feeding tube. Mixing with the feeding formulas could lead to tube blockages.</li>
</ul>
<p>The oral solution can be taken with or without food but should not be taken with grapefruit or grapefruit juice.</p>
- Route Of Administration
- ORAL
- Indication Info
- <p><strong>4.1 Therapeutic indication(s)</strong></p>
<p>VITRAKVI as monotherapy is indicated for the treatment of adult and pediatric patients with solid tumors</p>
<ul>
<li><p>that display a neurotrophic receptor tyrosine kinase (NTRK) gene fusion without a known acquired resistance mutation,</p></li>
<li><p>who have a disease that is locally advanced, metastatic or where surgical resection is likely to result in severe morbidity, and</p></li>
<li><p>who have no satisfactory treatment options</p></li>
</ul>
- Contraindications
- <p><strong>4.3 Contraindications</strong></p>
<p>Hypersensitivity to the active substance or any of the excipients listed in section 6.1 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>.</p>
- Atc Code
- L01XF01
- Atc Item Name
- tretinoin
- Pharma Manufacturer Name
- BAYER (SOUTH EAST ASIA) PTE LTD