- Approval Id
- fa2a68c0d66b7d94
- Drug Name
- ONIVYDE PEGYLATED LIPOSOMAL (IRINOTECAN) CONCENTRATE FOR DISPERSION FOR INFUSION 4.3 MG/ML
- Product Name
- ONIVYDE PEGYLATED LIPOSOMAL (IRINOTECAN) CONCENTRATE FOR DISPERSION FOR INFUSION 4.3 MG/ML
- Approval Number
- SIN15397P
- Approval Date
- 2017-12-28
- Registrant
- SERVIER (S) PTE LTD
- Licence Holder
- SERVIER (S) PTE LTD
- Drug Type
- Therapeutic
- Forensic Classification
- PRESCRIPTION ONLY MEDICINES
- Dosage Form
- INFUSION, SOLUTION CONCENTRATE
- Dosage
- <p><strong>13 DOSAGE AND ADMINISTRATION</strong></p>
<p><strong>13.1 Important Use Information</strong></p>
<p><strong>DO NOT SUBSTITUTE</strong> ONIVYDE pegylated liposomal for other drugs containing irinotecan HCl.</p>
<p><strong>13.2 Recommended Use</strong></p>
<p>ONIVYDE pegylated liposomal should not be administered as a single agent and should be continued until disease progression or no longer tolerated by the patient.</p>
<p>There is no recommended dose of ONIVYDE pegylated liposomal for patients with serum bilirubin above the upper limit of normal <em>[see Adverse Reactions (9.1) and Clinical Studies (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><em>ONIVYDE pegylated liposomal in combination with oxaliplatin, 5-fluorouracil and leucovorin:</em></p>
<p>ONIVYDE pegylated liposomal, oxaliplatin, LV and 5-FU should be administered sequentially.</p>
<ul>
<li>The recommended dose of ONIVYDE pegylated liposomal is 50 mg/m<sup>2</sup> intravenously over 90 minutes, followed by oxaliplatin 60 mg/m<sup>2</sup> intravenously over 120 minutes, followed by LV 400 mg/m<sup>2</sup> intravenously over 30 minutes, followed by 5-FU 2,400 mg/m<sup>2</sup> intravenously over 46 hours. This regimen should be administered every 2 weeks.</li>
<li>Oxaliplatin may be discontinued if not well tolerated and treatment with ONIVYDE pegylated liposomal + 5-FU/LV can continue.</li>
<li>The recommended starting dose of ONIVYDE pegylated liposomal in patients known to be homozygous for UGT1A1*28 allele is unchanged and remains 50 mg/m<sup>2</sup> administered intravenously over 90 minutes.</li>
</ul>
<p><em>ONIVYDE pegylated liposomal in combination with 5-fluorouracil and leucovorin:</em></p>
<p>Administer ONIVYDE pegylated liposomal prior to leucovorin and fluorouracil <em>[see Clinical Studies (5)</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em><em>]</em>.</p>
<ul>
<li><p>The recommended dose of ONIVYDE pegylated liposomal is 70 mg/m<sup>2</sup> administered by intravenous infusion over 90 minutes every 2 weeks.</p></li>
<li><p>A reduced starting dose of ONIVYDE pegylated liposomal of 50 mg/m<sup>2</sup> should be considered in patients known to be homozygous for the UGT1A1*28 allele. A dose increase of ONIVYDE pegylated liposomal to 70 mg/m<sup>2</sup> should be considered if tolerated in subsequent cycles.</p></li>
</ul>
<p><u>Premedication</u><br>
Administer a corticosteroid and an anti-emetic 30 minutes prior to ONIVYDE pegylated liposomal infusion.</p>
<p><strong>13.3 Dose Modifications for Adverse Reactions</strong></p>
<p>All dose modifications should be based on the worst preceding toxicity. LV dose does not require adjustment.</p>
<p><em>ONIVYDE pegylated liposomal in combination with oxaliplatin, 5-fluorouracil and leucovorin:</em></p>
<img src="/TGIF/OnivydePegylatedLiposomal-Table8.png" alt="Onivyde Pegylated Liposomal Dosage Table 8" /><br><br>
<p>Patients homozygous for the UGT1A1*28 allele should initiate ONIVYDE pegylated liposomal at the same dose and the same dose reduction requirements should apply.</p>
<p><em>ONIVYDE pegylated liposomal in combination with 5-fluorouracil and leucovorin:</em></p>
<p>For patients who start treatment with 50 mg/m<sup>2</sup> ONIVYDE pegylated liposomal and do not dose escalate to 70 mg/m<sup>2</sup>, the recommended first dose reduction is to 43 mg/m<sup>2</sup> and the second dose reduction is to 35 mg/m<sup>2</sup>. Patients who require further dose reduction should discontinue treatment.</p>
<p>Patients who are known to be homozygous for UGT1A1*28 and without drug related toxicities during the first cycle of therapy (reduced dose of 50 mg/m<sup>2</sup>) may have the dose of ONIVYDE pegylated liposomal increased to a total dose of 70 mg/m<sup>2</sup> in subsequent cycles based on individual patient tolerance.</p>
<img src="/TGIF/OnivydePegylatedLiposomal-Table9.png" alt="Onivyde Pegylated Liposomal Dosage Table 9" /><br><br>
<img src="/TGIF/OnivydePegylatedLiposomal-Table10.png" alt="Onivyde Pegylated Liposomal Dosage Table 10" /><br><br>
<p>For recommended dose modifications of fluorouracil (5-FU) or leucovorin (LV), refer to the Full Prescribing Information; refer to Clinical Studies (5) – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>.</p>
<p><strong>13.4 Preparation and Administration</strong></p>
<p>ONIVYDE pegylated liposomal is a cytotoxic drug. Follow applicable special handling and disposal procedures.<sub>1</sub></p>
<p><u>Preparation</u></p>
<ul>
<li><p>Withdraw the calculated volume of ONIVYDE pegylated liposomal from the vial using a needle not larger than 21 gauge. Dilute ONIVYDE pegylated liposomal in 500 mL 5% Dextrose Injection, USP or 0.9% Sodium Chloride Injection, USP and mix diluted dispersion by gentle inversion.</p></li>
<li><p>Protect diluted dispersion from light.</p></li>
<li><p>Chemical and physical stability for the diluted dispersion for infusion has been demonstrated at 15°C to 25°C for up to 4 hours or in the refrigerator (2°C to 8°C) for not more than 24 hours. Allow diluted dispersion to come to room temperature prior to administration. From a microbiological point of view, the product should be used immediately. If not used immediately, in-use storage times and conditions are the responsibility of the user.</p></li>
<li><p>Do NOT freeze.</p></li>
</ul>
<p><u>Administration</u></p>
<ul>
<li>Infuse diluted dispersion intravenously over 90 minutes. Do not use in-line filters. Discard unused portion.</li>
</ul>
<hr>
<p><strong>16 REFERENCES</strong></p>
<ol>
<li>OSHA Hazardous Drugs. <em>OSHA.</em> http://www.osha.gov/SLTC/hazardousdrugs/index.html</li>
</ol>
- Route Of Administration
- INTRAVENOUS
- Indication Info
- <p><strong>6 INDICATION AND USAGE</strong></p>
<p>ONIVYDE pegylated liposomal is indicated:</p>
<ul class="dash">
<li>in combination with oxaliplatin, 5-fluorouracil (5-FU) and leucovorin (LV) for the first-line<br />treatment of adult patients with metastatic adenocarcinoma of the pancreas,</li>
<li>in combination with 5-FU and LV for the treatment of metastatic adenocarcinoma of the pancreas in adult patients who have progressed following gemcitabine-based therapy.</li>
</ul>
<p>Limitation of Use: ONIVYDE pegylated liposomal is not indicated as a single agent for the treatment of patients with metastatic adenocarcinoma of the pancreas <em>[see Clinical Studies (5)</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em><em>]</em>.</p>
- Contraindications
- <p><strong>7 CONTRAINDICATIONS</strong></p>
<p>ONIVYDE pegylated liposomal is contraindicated in patients who have experienced a severe hypersensitivity reaction to ONIVYDE pegylated liposomal or irinotecan HCl.</p>
- Atc Code
- L01XX19
- Atc Item Name
- xl 01 xx 19
- Pharma Manufacturer Name
- SERVIER (S) PTE LTD
- Company Detail Path
- /organization/servier-s-pte-ltd