- Approval Id
- 6497bbb989d895d6
- Drug Name
- XGEVA SOLUTION FOR INJECTION IN PRE‐FILLED SYRINGE 120 MG/ML
- Product Name
- XGEVA SOLUTION FOR INJECTION IN PRE‐FILLED SYRINGE 120 MG/ML
- Approval Number
- SIN17364P
- Approval Date
- 2025-10-17
- Registrant
- AMGEN BIOTECHNOLOGY SINGAPORE PTE LTD
- Licence Holder
- AMGEN BIOTECHNOLOGY SINGAPORE PTE LTD
- Drug Type
- Therapeutic
- Forensic Classification
- Prescription Only
- Dosage Form
- INJECTION, SOLUTION
- Dosage
- <p><strong>4.2 Posology and method of administration</strong></p>
<p>XGEVA should be administered under the responsibility of a healthcare professional.</p>
<p><u>Posology</u></p>
<p>Supplementation of at least 500 mg calcium and 400 international units vitamin D is required in all patients, unless hypercalcaemia is present (see section 4.4 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p><em>Prevention of skeletal-related events in patients with multiple myeloma and in patients with bone metastases from solid tumours</em><br>
The recommended dose of XGEVA is 120 mg administered as a single subcutaneous injection once every 4 weeks into the thigh, abdomen or upper arm.</p>
<p><em>Giant cell tumour of the bone</em><br>
The recommended dose of XGEVA is 120 mg administered as a subcutaneous injection once every 4 weeks into the thigh, abdomen or upper arm, with additional 120 mg doses on days 8 and 15 of treatment of the first month of therapy.</p>
<p><em>Renal impairment</em><br>
No dose adjustment is required in patients with renal impairment (see sections 4.4 for recommendations relating to monitoring of calcium, 4.8 and 5.2 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p>In clinical studies of patients without advanced cancer with varying degrees of renal function (including severe renal impairment [creatinine clearance < 30 ml/min] or receiving dialysis) there was a greater risk of developing hypocalcaemia with increasing degree of renal impairment and in the absence of calcium supplementation. Monitoring calcium levels and adequate intake of calcium and vitamin D is important in patients with severe renal impairment or receiving dialysis (see section 4.4 – <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><br>
The safety and efficacy of denosumab have not been studied in patients with 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>Elderly patients (age ≥ 65)</em><br>
No dose adjustment is required 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>Paediatric population</em><br>
The safety and efficacy of XGEVA have not been established in paediatric patients (age < 18) other than skeletally mature adolescents (aged 13 – 17 years) with giant cell tumour of bone.</p>
<p>XGEVA is not recommended for use in paediatric patients other than skeletally mature adolescents (aged 13 – 17 years) with giant cell tumour of bone (see section 4.4 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p>XGEVA was studied in a phase II open-label trial that enrolled a subset of 28 paediatric patients (aged 13 – 17 years) with giant cell tumour of bone who had reached skeletal maturity defined by at least 1 mature long bone (e.g., closed epiphyseal growth plate of the humerus) and body weight ≥ 45 kg. In animal studies, inhibition of RANK/RANK ligand (RANKL) with a construct of osteoprotegerin bound to Fc (OPG-Fc) has been coupled to inhibition of bone growth and lack of tooth eruption (see section 5.3 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>). Therefore, treatment with denosumab may impair bone growth in children with open growth plates and may inhibit eruption of dentition.</p>
<p><u>Method of administration</u><br>
For subcutaneous use.</p>
<p><em>The XGEVA 120 mg/1.7 ml solution in a single use vial:</em><br>
The administration of the 120 mg/1.7 ml vial should only be performed by a healthcare professional.</p>
<p><em>The XGEVA 120 mg/1.0 ml solution in a pre-filled syringe:</em><br>
The administration using the 120 mg/1.0 ml pre-filled syringe can be administered by a patient or caregiver who has been trained in injection techniques by a healthcare professional. The first self-administration with the XGEVA pre-filled syringe should be supervised by a healthcare professional.</p>
<p>For instructions for use, handling and disposal see section 6.6 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>.</p>
- Route Of Administration
- SUBCUTANEOUS
- Indication Info
- <p><strong>4.1 Therapeutic indications</strong></p>
<p>Prevention of skeletal-related events (pathological fracture, radiation to bone, spinal cord compression or surgery to bone) in patients with multiple myeloma and in patients with bone metastases from solid tumours.</p>
<p>Treatment of adults and skeletally mature adolescents with giant cell tumour of bone that is unresectable or where surgical resection is likely to result in severe morbidity.</p>
- Contraindications
- <p><strong>4.3 Contraindications</strong></p>
<p>Hypersensitivity to the active substance or to 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>
<p>Severe, untreated hypocalcaemia (see section 4.4 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>