- Approval Id
- 5f9b6478c95776e0
- Drug Name
- VASITIMB TABLETS 10MG/10MG
- Product Name
- VASITIMB TABLETS 10MG/10MG
- Approval Number
- SIN17038P
- Approval Date
- 2024-07-03
- Registrant
- SINGAPORE PHARMACEUTICAL PRIVATE LIMITED
- Licence Holder
- SINGAPORE PHARMACEUTICAL PRIVATE LIMITED
- Drug Type
- Therapeutic
- Forensic Classification
- PRESCRIPTION ONLY MEDICINES
- Dosage Form
- TABLET
- Dosage
- <p><strong>4.2 Posology and method of administration</strong></p>
<p><u>Posology</u></p>
<p>The patient should be placed on a standard cholesterol-lowering diet before receiving Vasitimb and should continue on this diet during treatment with Vasitimb. The dosage should be individualized according to the baseline LDL-C level, the recommended goal of therapy, and the patient’s response. Vasitimb should be taken as a single daily dose in the evening, with or without food.</p>
<p>The dosage range is 10/10 mg/day through 10/80 mg/day. The recommended usual starting dose is 10/20 mg/day. Initiation of therapy with 10/10 mg/day may be considered for patients requiring less aggressive LDL-C reductions. Patients who require a larger reduction in LDL-C (greater than 55%) may be started at 10/40 mg/day. After initiation or titration of Vasitimb, lipid levels may be analyzed after 2 or more weeks and dosage adjusted, if needed. Due to the increased risk of myopathy, including rhabdomyolysis, particularly during the first year of treatment, use of the 10/80-mg dose of ezetimibe/simvastatin should be restricted to patients who have been taking ezetimibe/simvastatin 10/80 mg chronically (e.g., for 12 months or more) without evidence of muscle toxicity (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><u>Dosage in Patients with Homozygous Familial Hypercholesterolemia</u><br>
The recommended dosage for patients with homozygous familial hypercholesterolemia is ezetimibe/simvastatin 10/40 mg/day or 10/80 mg/day in the evening. The 10/80 mg dose is only recommended when the benefits are expected to outweigh the potential risks (see sections 4.3 and 4.4 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>). Vasitimb should be used as an adjunct to other lipid-lowering treatments (e.g., LDL apheresis) in these patients or if such treatments are unavailable.<br>
In patients taking lomitapide concomitantly with ezetimibe/simvastatin, the dose of ezetimibe/simvastatin should not exceed 10/40 mg/day (see sections 4.4 and 4.5 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p><u>Patients with Renal Impairment</u><br>
In patients with mild renal insufficiency (estimated GFR ≥60 mL/min/1.73 m<sup>2</sup>) no dosage adjustment is necessary. In patients with chronic kidney disease and estimated glomerular filtration rate <60 mL/min/1.73 m<sup>2</sup>, the dose of ezetimibe/simvastatin is 10/20 mg once a day in the evening. In such patients, the use of higher doses should be closely monitored (see sections 4.4, 5.1 and 5.2 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p><u>Use in the Elderly</u><br>
No dosage adjustment is required for 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><u>Use in Pediatric Patients</u><br>
Treatment with Vasitimb is not recommended.</p>
<p><u>Use in Hepatic Impairment</u><br>
No dosage adjustment is required in patients with mild hepatic insufficiency (Child-Pugh score 5 or 6). Treatment with Vasitimb is not recommended in patients with moderate (Child-Pugh score 7 to 9) or severe (Child-Pugh score >9) liver dysfunction (see sections 4.4 and 5.2 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p><u>Coadministration with other medicines</u><br>
Dosing of Vasitimb should occur either ≥2 hours before or ≥4 hours after administration of a bile acid sequestrant.</p>
<p>In patients taking amiodarone, verapamil, diltiazem, or products containing elbasvir or grazoprevir concomitantly with ezetimibe/simvastatin, the dose of ezetimibe/simvastatin should not exceed 10/20 mg/day (see sections 4.4 and 4.5 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p>In patients taking amlodipine or ticagrelor concomitantly with ezetimibe/simvastatin, the dose of ezetimibe/simvastatin should not exceed 10/40 mg/day (see sections 4.4 and 4.5 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p>The safety and effectiveness of ezetimibe/simvastatin administered with fibrates have not been studied. Therefore, the combination of ezetimibe/simvastatin and fibrates should be avoided (see sections 4.3, 4.4 and 4.5 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
- Route Of Administration
- ORAL
- Indication Info
- <p><strong>4.1 Therapeutic indications</strong></p>
<p><u>Primary Hypercholesterolemia</u><br>
Vasitimb is indicated as adjunctive therapy to diet for the reduction of elevated total cholesterol (total-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (Apo B), triglycerides (TG), and non-high-density lipoprotein cholesterol (non-HDL-C), and to increase high-density lipoprotein cholesterol (HDL-C) in patients with primary (heterozygous familial and non-familial) hypercholesterolemia or mixed hyperlipidemia.</p>
<p><u>Homozygous Familial Hypercholesterolemia (HoFH)</u><br>
Vasitimb is indicated for the reduction of elevated total-C and LDL-C levels in patients with HoFH, as an adjunct to other lipid-lowering treatments (e.g., LDL apheresis) or if such treatments are unavailable.</p>
- Contraindications
- <p><strong>4.3 Contraindications</strong></p>
<ul class="dash">
<li>Hypersensitivity to the active substances or to any of the excipients.</li>
<li>Active liver disease or unexplained persistent elevations of serum transaminases.</li>
<li>Pregnancy and nursing (see section 4.6 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</li>
<li>Concomitant administration of potent CYP3A4 inhibitors (e.g., itraconazole, ketoconazole, posaconazole, voriconazole, HIV protease inhibitors, erythromycin, boceprevir, telaprevir, clarithromycin, telithromycin, nefazodone, and drugs containing cobicistat) (see sections 4.4 and 4.5 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</li>
<li>Concomitant administration of gemfibrozil, cyclosporine, or danazol (see sections 4.4 and 4.5 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</li>
</ul>