Zevtera 500mg Powder For Concentrate For Solution For Infusion
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Package leaflet: Information for the user
(basilea) - /Zevtera®
^ ceftobiprole medocaril IV
Zevtera 500 mg Powder for concentrate for Solution for Infusion
Ceftobiprole
This medicine is subject to additional monitoring. This will allow quick identification of new safety information. You can help by reporting any side effects you may get. See the end of section 4 for how to report side effects
Read all of this leaflet carefully before you start using this medicine because it contains important information for you.
- Keep this leaflet. You may need to read it again.
- If you have any further questions, ask your doctor or nurse.
- If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. See section 4.
What is in this leaflet
1. What Zevtera is and what it is used for
2. What you need to know before you use Zevtera
3. How to use Zevtera
4. Possible side effects
5. How to store Zevtera
6. Contents of the pack and other information
1. What Zevtera is and what it is used for
Zevtera is an antibiotic medicine that contains the active substance ceftobiprole medocaril sodium. It belongs to a group of medicines called ‘cephalosporin antibiotics'.
Zevtera is used to treat adults with infections of the lungs called ‘pneumonia'.
Zevtera works by killing certain bacteria, which can cause serious lung infections.
2. What you need to know before you use Zevtera
Do not use Zevtera:
- if you are allergic to ceftobiprole medocaril sodium or any of the other ingredients of this medicine (listed in section 6),
- if you are allergic to other cephalosporin or beta-lactam antibiotics,
- if you have had previous severe allergic reactions to other antibiotics like penicillin or carbapenem.
Do not use Zevtera if any of the above applies to you. If you are not sure, talk to your doctor or nurse before being given Zevtera.
Warnings and precautions
Talk to your doctor or nurse before using Zevtera:
- if you have kidney problems (your doctor may need to lower your dose of this medicine),
- if you have ever had any allergic reactions to other antibiotics like penicillin or carbapenem,
- if you have ever had fits (seizures or convulsions),
- if you have diarrhoea before, during or after your treatment with this medicine (you may have an inflammation of the bowel known as ‘colitis').
Do not take any medicine to treat diarrhoea without first checking with your doctor,
- if you are HIV positive,
- if your immune system is severely weakened,
- if your white blood counts are very low or your bone marrow function is suppressed,
- if your lung infection is developed more than 48 hours after onset of artificial ventilation Zevtera is not suitable for you (your doctor will prescribe a suitable antibiotic for you),
- if you require (or are expected to require) concomitant calcium-containing solutions, except Lactated Ringer's solution for injection, in the same intravenous administration line due to the risk of precipitation.
If your doctor thinks you need more fluids, you may be asked to drink plenty of liquids or you may need to have liquids given as a drip into a vein while you are receiving Zevtera.
If you start taking Zevtera and then require ventilation, your doctor will assess whether Zevtera is still suitable for you.
Lab tests
You may develop an abnormal lab test (called Coombs test) that looks for certain antibodies which may act against your red blood cells. Zevtera may also interact with tests to measure serum creatinine (Jaffe reaction) or with some tests to determine the glucose content in the urine. These tests may provide you with wrong results.
If any of the above apply to you (or you are not sure), talk to your doctor or nurse before using Zevtera.
Children and adolescents
Do not give this medicine to children and adolescents as not enough data exists in this population.
Other medicines and Zevtera
Tell your doctor or nurse if you are taking, have recently taken or might take any other medicines.
Pregnancy and breast-feeding
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before using this medicine.
Driving and using machines
Zevtera may cause side effects such as dizziness.This may impair your ability to drive or operate machinery. Zevtera contains approximately 1.3 mmol (29 mg) sodium per dose. If you have a controlled sodium diet, your doctor may need to adjust it.
3. How to use Zevtera
Zevtera will be given to you by a doctor or nurse.
The recommended dose is 500 mg ceftobiprole every eight hours given as a drip into a vein lasting two hours.
Patients with kidney problems
You may need a lower dose of Zevtera if you have kidney problems.
If you use more Zevtera than you should
If you think you have been given too much Zevtera, talk to your doctor or nurse straight away.
If you forget to use Zevtera
If you think you have missed a dose, talk to your doctor or nurse straight away.
If you have any further questions on the use of this medicine, ask your doctor or nurse.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them. The following side effects may happen with this medicine:
Tell your doctor straight away if you get these symptoms as you may need urgent medical treatment:
- Sudden swelling of your lips, face, throat or tongue; a severe rash; and, swallowing or breathing problems. These may be signs of a severe allergic reaction (anaphylaxis) and may be lifethreatening.
- Diarrhoea that becomes severe or does not go away or stool that contains blood or mucus during or after treatment with Zevtera. In this situation, you should not take medicines that stop or slow bowel movement.
Common: may affect up to 1 in 10 people
- Feeling sick (nausea)
- Headache, drowsiness (somnolence)
- Feeling dizzy
- Rash, itching or hives
- Diarrhoea, tell your doctor straight away if you get diarrhoea
- Being sick (vomiting)
- Stomach pain (abdominal pain), indigestion or 'heartburn' (dyspepsia)
- Unusual taste (dysgeusid)
- Fungal infections in different parts of your body
- Redness, pain or swelling were the injection was given
- Low levels of the mineral 'sodium' in your blood
- Increase in the level of some liver enzymes in your blood
- Hypersensitivity including skin reddening Uncommon: may affect up to 1 in 100 people
- Temporarily decreased or increased numbers of certain types of blood cells
- Blood testing showing decreased levels of potassium
- Sleeplessness and sleep disturbances, maybe including anxiety, panic attacks and nightmares
- Shortness of breath or difficulty breathing, asthma
- Muscle cramps
- Kidney problems
- Swelling, particularly of the ankles and legs
- Blood testing showing temporarily increased levels of triglycerides, blood sugar, or creatinine
Not known: frequency cannot be estimated from the available data
- A more severe decrease in a specific type of white blood cells (agranulocytosis)
- Convulsions, seizures, or fits Reporting of side effects
If you get any side effects, talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via Yellow Card Scheme, website: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.
5. How to store Zevtera
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the carton and vial after EXP.
The expiry date refers to the last day of that month.
Store in a refrigerator (2°C-8°C).
Keep the vial in the outer carton in order to protect from light.
For storage of Zevtera reconstituted and diluted infusion solutions, please see the accompanying information for medical or healthcare professionals.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.
6. Contents of the pack and other information
What Zevtera contains
- The active substance is ceftobiprole. Each vial contains 500 mg of ceftobiprole(as 666.6 mg of ceftobiprole medocaril sodium). After reconstitution, each ml of concentrate contains 50 mg ceftobiprole, equivalent to 66.7 mg ceftobiprole medocaril sodium.
- The other ingredients are citric acid monohydrate (E330) and sodium hydroxide (E524), see also section 2.
What Zevtera looks like and contents of the pack
Zevtera is a white, yellowish to slightly brownish, cake to broken cake or powder for concentrate for solution for infusion in a 20 mL vial. It is available in packs containing 10 vials.
Marketing Authorisation Holder and Manufacturer
Marketing Authorisation Holder:
Basilea Medical Ltd.
(c/o Cox Costello & Horne Limited)
Langwood House 63-81 High Street Rickmansworth Hertfordshire WD3 1EQ United Kingdom
National contact details of the Marketing Authorisation Holder for Medical Information:
Phone number: 0800 141 3328 Email: medical.information@basilea.com
Manufacturer:
Patheon UK Ltd Kingfisher Drive, Covingham Swindon, Wiltshire, SN3 5BZ United Kingdom
This medicinal product is authorised in the Member States of the EEA under the following names:
Austria: Zevtera 500 mg Pulver fur ein
Konzentrat zur Herstellung einer Infusionslosung
Belgium: Mabelio 500 mg, poudre pour
solution a diluer pour solution pour perfusion
Denmark: Zevtera
Finland: Zevtera 500 mg, kuiva-aine
valikonsentraatiksi infuusionestetta varten, liuos
France: Mabelio 500 mg, poudre pour
solution a diluer pour solution pour perfusion
Germany: Zevtera 500 mg Pulver fur ein
Konzentrat zur Herstellung einer Infusionslosung
Italy: Mabelio 500 mg, polvere per
concentrato per soluzione per infusione
Luxembourg: Mabelio 500 mg, poudre pour
solution a diluer pour solution pour perfusion
Norway: Zevtera 500 mg, pulver til konsentrat
til infusjonsvsske, opplosning Spain: Zevtera 500 mg, polvo para
concentrado para solucion para perfusion
Sweden: Zevtera 500 mg pulver for koncentrat
till infusionsvatska, losning United Kingdom: Zevtera 500mg powder for
concentrate for solution for infusion.
This leaflet was last revised in 12/2014.
Detailed information on this medicine is available on the web site of United Kingdom/Medicines and Healthcare Products Regulatory Agency.
The following information is intended for healthcare professionals only:
Each vial is for single use only.
Preparation of Zevtera infusion solutions
Zevtera must be reconstituted and then diluted prior to infusion.
Step 1: Reconstitution
10 ml of sterile water for injections or dextrose 50 mg/ml (5%) solution for injection should be added to the vial and the vial should be shaken vigorously until complete dissolution, which in some cases may take up to 10 minutes. The volume of the resulting concentrate is approximately 10.6 ml. Any foam should be allowed to dissipate and the reconstituted solution should be inspected visually to ensure the product is in solution and particulate matter is absent. The reconstituted concentrate contains 50 mg/ml of ceftobiprole (as 66.7 mg/ml of ceftobiprole medocaril sodium) and must be further diluted prior to administration. It is recommended that the reconstituted solution be further diluted immediately. However, if this is not possible the reconstituted solution can be stored at room temperature for up to one hour, or in a refrigerator for up to 24 hours.
Step 2: Dilution
Preparation of 500 mg dose of Zevtera solution for infusion
10 ml of the reconstituted solution should be withdrawn from the vial and injected into a suitable container (e.g. PVC or PE infusion bags, glass bottles) containing 250 ml of sodium chloride 9 mg/ml (0.9%) solution for injection, dextrose 50 mg/ml (5%) solution for injection, or Lactated Ringer's solution for injection. The infusion solution should be gently inverted 5-10 times to form a homogenous solution. Vigorous agitation should be avoided to prevent foaming. The entire contents of the infusion bag should be infused to administer a 500 mg dose of ceftobiprole.
Preparation of250 mg dose of Zevtera solution for infusion for patients with severe renal impairment 5 ml of the reconstituted solution should be withdrawn from the vial and injected into a suitable
container (e.g. PVC or PE infusion bags, glass bottles) containing 125 ml of sodium chloride 9 mg/ml (0.9%) solution for injection, dextrose 50 mg/ml (5%) solution for injection, or Lactated Ringer's solution for injection. The infusion solution should be gently inverted 5-10 times to form a homogenous solution. Vigorous agitation should be avoided to prevent foaming. The entire contents of the infusion bag should be infused to administer a 250 mg dose of ceftobiprole.
The solution for infusion should be clear to slightly opalescent and yellowish in colour. The solution for infusion should be inspected visually for particulate matter prior to administration, and discarded if particulate matter is visible.
See also section 3 for further information.
Storage of Zevtera reconstituted and diluted infusion solutions
Chemical and physical in-use stability of the reconstituted solution has been demonstrated for 1 hour at 25°C and up to 24 hours at 2°C-8°C.
Chemical and physical in-use stability data support the total times for dilution and infusion described in the table below:
Total time by which reconstitution and infusion (including a 2-hour period of infusion) must be completed
From a microbiological point of view, unless the method of reconstitution/dilution precludes the risk of microbiological contamination, the product should be used immediately. If not used immediately, in-use storage times and conditions prior to use are the responsibility of the user.
The reconstituted and infusion solutions should not be frozen or exposed to direct sunlight.
If the infusion solution is stored in the refrigerator, it should be equilibrated to room temperature prior to administration. The infusion solution does not need to be protected from light during administration.
See also section 5 for further information.
|
Infusion solution diluent |
Infusion solutions stored at 25°C Protected from NOT protected light from light |
Infusion solutions stored at 2°C-8°C (Refrigerator) Protected from light | |
|
Sodium chloride 9 mg/ml (0.9%) solution for injection |
24 hours |
8 hours |
96 hours |
|
Dextrose 50 mg/ml (5%) solution for injection |
12 hours |
8 hours |
96 hours |
|
Lactated Ringer's solution for injection |
24 hours |
8 hours |
Do not refrigerate |
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