- Approval Id
- 2efaa885cccecf31
- Drug Name
- VOCABRIA PROLONGED-RELEASE SUSPENSION FOR INJECTION 600 MG/3 ML
- Product Name
- VOCABRIA PROLONGED-RELEASE SUSPENSION FOR INJECTION 600 MG/3 ML
- Approval Number
- SIN16542P
- Approval Date
- 2022-07-05
- Registrant
- GLAXOSMITHKLINE PTE LTD
- Licence Holder
- GLAXOSMITHKLINE PTE LTD
- Drug Type
- Therapeutic
- Forensic Classification
- Prescription Only
- Dosage Form
- INJECTION, SUSPENSION
- Dosage
- <p><strong>Dosage and Administration</strong></p>
<p><strong>Pharmaceutical Form</strong></p>
<p>Film-coated tablet and suspension for injection</p>
<p><strong>Posology</strong></p>
<p>Therapy should be initiated by a physician experienced in the management of HIV infection.</p>
<p><em>VOCABRIA</em> is indicated for the treatment of HIV in combination with rilpivirine, therefore, the prescribing information for rilpivirine should be consulted for recommended dosing.</p>
<p>Prior to starting <em>VOCABRIA</em>, healthcare professionals should have carefully selected patients who agree to the required injection schedule and counsel patients about the importance of adherence to scheduled dosing visits to help maintain viral suppression and reduce the risk of viral rebound and potential development of resistance with missed doses.</p>
<p><strong>Method of Administration</strong></p>
<p><strong>Film-coated Tablet</strong></p>
<p><em>VOCABRIA</em> may be taken with or without food. When taken at the same time as rilpivirine, <em>VOCABRIA</em> should be taken with a meal.</p>
<p><strong>Suspension for Injection</strong></p>
<p>Refer to the Instructions for Use for detailed step by step injection procedure (<em>see Instructions for Use & Handling</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p><em>VOCABRIA</em> injection should be administered by a healthcare professional.</p>
<p>When administering the <em>VOCABRIA</em> injection, healthcare professionals should take into consideration the BMI of the patient to ensure that the needle length is sufficient to reach the gluteus muscle.</p>
<p>Cabotegravir and rilpivirine injections should be administered at separate gluteal injection sites during the same visit.</p>
<p><strong>Adults and adolescents (at least 12 years of age and weighing at least 35 kg)</strong></p>
<p>The health care provider and patient may proceed directly to LA injectable therapy (see Tables 2 and 3, for monthly and every 2 month dosing recommendations, respectively).</p>
<p>Alternatively, <em>VOCABRIA</em> oral tablets may be used as an oral lead-in prior to the initiation of <em>VOCABRIA</em> injection to assess tolerability to cabotegravir (see Table 1).</p>
<p><strong><em>Oral lead-in</em> (Film-coated Tablets)</strong></p>
<p>When used for oral lead-in, <em>VOCABRIA</em> oral tablets are recommended for approximately one month (at least 28 days) in virologically suppressed patients prior to the initiation of <em>VOCABRIA</em> injection to assess tolerability to cabotegravir. <em>VOCABRIA</em> tablets should be taken together with rilpivirine tablets.</p>
<img src="/TGIF/Vocabria-Table1_141125.png" alt="Vocabria Dosage Table 1" /><br><br>
<p><strong>Monthly Dosing (Suspension for Injection)</strong></p>
<p><em><strong>Initiation Injection (600 mg corresponding to 3 mL dose)</strong></em></p>
<p>On the final day of prior antiretroviral therapy or oral lead-in, the recommended initial <em>VOCABRIA</em> injection dose is a single 3 mL (600 mg) intramuscular injection.</p>
<p><em><strong>Continuation Injection (400 mg corresponding to 2 mL dose)</strong></em></p>
<p>After the initiation injection, the recommended <em>VOCABRIA</em> continuation injection dose is a single 2 mL (400 mg) intramuscular injection, administered monthly. Patients may be given injections up to 7 days before or after the date of the monthly 2 mL dosing schedule.</p>
<img src="/TGIF/Vocabria-Table2_141125.png" alt="Vocabria Dosage Table 2" /><br><br>
<p><strong>Every 2 Month Dosing (Suspension for Injection)</strong></p>
<p><strong><em>Initiation Injections – 1 month apart (600 mg corresponding to 3 mL dose)</em></strong></p>
<p>On the final day of prior antiretroviral therapy or oral lead-in, the recommended initial <em>VOCABRIA</em> injection dose is a single 3 mL (600 mg) intramuscular injection. One month later, a second 3 mL (600 mg) intramuscular injection should be administered. Patients may be given the second 3 mL (600 mg) initiation injection up to 7 days before or after the scheduled dosing date.</p>
<p><em><strong>Continuation Injections – 2 months apart (600 mg corresponding to 3 mL dose)</strong></em></p>
<p>After the second initiation injection, the recommended <em>VOCABRIA</em> continuation injection dose is a single 3 mL (600 mg) intramuscular injection administered every 2 months. Patients may be given injections up to 7 days before or after the date of the every 2 month, 3 mL dosing schedule.</p>
<img src="/TGIF/Vocabria-Table3_141125.png" alt="Vocabria Dosage Table 3" /><br><br>
<p><strong>Change in Dosing Frequency</strong></p>
<p><strong>Dosing Recommendations when Switching from Monthly to Every 2 Month Injections</strong></p>
<p>Patients switching from a monthly continuation injection schedule to an every 2 month continuation injection dosing schedule should receive a single 3 mL (600 mg) intramuscular injection of <em>VOCABRIA</em> one month after the last 2 mL (400 mg) continuation injection dose and then 3 mL (600 mg) every 2 months thereafter.</p>
<p><strong>Dosing Recommendations when Switching from Every 2 Month to Monthly Injections</strong></p>
<p>Patients switching from an every 2 month continuation injection schedule to a monthly continuation dosing schedule should receive a single 400 mg intramuscular injection of <em>VOCABRIA</em> 2 months after the last 600 mg continuation injection dose and then 400 mg monthly thereafter.</p>
<p><em><strong>Missed dose</strong></em></p>
<p><strong>Film-coated Tablet</strong></p>
<p>If the patient misses a dose of oral <em>VOCABRIA</em>, the patient should take the missed dose as soon as possible.</p>
<p><strong>Suspension for Injection</strong></p>
<p>Adherence to the injection dosing schedule is strongly recommended. Patients who miss a scheduled injection visit should be clinically reassessed to ensure resumption of therapy remains appropriate (see Tables 4 and 5).</p>
<p><em>Missed monthly injection</em></p>
<p>If a delay of more than 7 days from a scheduled injection visit cannot be avoided, <em>VOCABRIA</em> tablets (30 mg) in combination with rilpivirine tablets (25 mg) once daily may be used for up to 2 consecutive months. Alternatively, any other fully suppressive oral antiretroviral regimen may be used until injections are resumed. Current HIV treatment guidelines should be considered when selecting the regimen.</p>
<p>The first dose of oral therapy should be taken one month (+/–7 days) after the last injection dose of <em>VOCABRIA</em> or rilpivirine. Injection dosing should be resumed on the day oral dosing completes, as recommended in Table 4.</p>
<img src="/TGIF/Vocabria-Table4_200124.png" alt="Vocabria Dosage Table 4" /><br><br>
<p><em>Missed 2 month injection</em></p>
<p>If a delay of more than 7 days from a scheduled injection visit cannot be avoided, <em>VOCABRIA</em> tablets (30 mg) in combination with rilpivirine tablets (25 mg) once daily may be used for up to 2 consecutive months. Alternatively, any other fully suppressive oral antiretroviral regimen may be used until injections are resumed. Current HIV treatment guidelines should be considered when selecting the regimen.</p>
<p>The first dose of oral therapy should be taken two months (+/–7 days) after the last injection dose of <em>VOCABRIA</em> or rilpivirine. Injection dosing should be resumed on the day oral dosing completes, as recommended in Table 5.</p>
<img src="/TGIF/Vocabria-Table5_200124.png" alt="Vocabria Dosage Table 5" /><br><br>
<p><strong>Children and Adolescents</strong></p>
<p>The safety and efficacy of <em>VOCABRIA</em> in children aged less than 12 years or adolescents weighing less than 35 kg have not been established.</p>
<p><strong>Elderly</strong></p>
<p>No dose adjustment is required in elderly patients. There are limited data available on the use of <em>VOCABRIA</em> in patients aged 65 years and over (<em>see Pharmacokinetics – Special Patient Populations</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p><strong>Renal impairment</strong></p>
<p>No dosage adjustment is required in patients with mild (creatinine clearance ≥60 to <90 mL/min), moderate (creatinine clearance ≥30 to <60 mL/min) or severe renal impairment (creatinine clearance ≥15 to <30 mL/min and not on dialysis) (<em>see Pharmacokinetics – Special Patient Populations</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>). Cabotegravir has not been studied in patients with end-stage renal disease on renal replacement therapy.</p>
<p><strong>Hepatic impairment</strong></p>
<p>No dosage adjustment is required in patients with mild or moderate hepatic impairment (Child-Pugh score A or B). <em>VOCABRIA</em> has not been studied in patients with severe hepatic impairment (Child-Pugh score C) (<em>see Pharmacokinetics – Special Patient Populations</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
- Route Of Administration
- INTRAMUSCULAR
- Indication Info
- <p><strong>Indications</strong></p>
<p><strong>Film-coated Tablets:</strong></p>
<p><em>VOCABRIA</em> tablets are indicated in combination with rilpivirine tablets for short term (<em>see Dosage and Administration</em>) treatment of human immunodeficiency virus (HIV)-1 infection in adults and adolescents at least 12 years of age and weighing at least 35 kg, who are virologically suppressed (HIV-1 RNA <50 copies/mL) on a stable antiretroviral regimen without present or past evidence of viral resistance to, and no prior virological failure with agents of the NNRTI and INI class:</p>
<ul>
<li><p>oral lead-in to assess tolerability of cabotegravir prior to administration of long acting (LA) <em>VOCABRIA</em> injection.</p></li>
<li><p>oral therapy for adults and adolescents who will miss planned dosing with <em>VOCABRIA</em> injection.</p></li>
</ul>
<p><strong>Suspension for Injection:</strong></p>
<p><em>VOCABRIA</em> injection is indicated in combination with rilpivirine injection for treatment of HIV-1 infection in adults and adolescents at least 12 years of age and weighing at least 35 kg, who are virologically suppressed (HIV-1 RNA <50 copies/mL) on a stable antiretroviral regimen without present or past evidence of viral resistance to, and no prior virological failure with agents of the NNRTI and INI class (<em>see Clinical studies</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
- Contraindications
- <p><strong>Contraindications</strong></p>
<p><em>VOCABRIA</em> is contraindicated in patients:</p>
<ul>
<li><p>with known hypersensitivity to cabotegravir or to any of the excipients in the tablets or the injection formulation.</p></li>
<li><p>receiving rifampicin, rifapentine, phenytoin, phenobarbital, carbamazepine and oxcarbazepine.</p></li>
</ul>
<p><em>VOCABRIA</em> is only indicated for treatment of HIV in combination with rilpivirine, therefore, the prescribing information for rilpivirine should also be consulted.</p>
- Atc Code
- J05AJ04
- Atc Item Name
- cabotegravir
- Pharma Manufacturer Name
- GLAXOSMITHKLINE PTE LTD