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Fabrazyme Indications, Dosage, Storage, Stability - Agalsidase Beta
INDICATIONS AND USAGE
FabrazymeÒ (agalsidase beta) is indicated for use in patients with Fabry disease. FabrazymeÒ reduces globotriaosylceramide (GL-3) deposition in capillary endothelium of the kidney and certain other cell types (see CLINICAL STUDIES under CLINICAL PHARMACOLOGY).
The recommended dosage of FabrazymeÒ is 1.0 mg/kg body weight infused every 2 weeks as an IV infusion.
The initial IV infusion rate should be no more than 0.25 mg/min (15 mg/hr). The infusion rate may be slowed in the event of infusion-associated reactions. After patient tolerance to the infusion is well established, the infusion rate may be increased in increments of 0.05 to 0.08 mg/min (increments of 3 to 5 mg/hr) each subsequent infusion. Thirty-one of 58 (53%) patients have received infusions at rates = 33 mg/hr.
Patients should receive antipyretics prior to infusion (see WARNINGS).
Instructions for Use
FabrazymeÒ does not contain any preservatives. Vials are for single-use only. Any unused product should be discarded.
Shaking or agitation of this product should be avoided. Do not use filter needles during the preparation of the infusion.
Reconstitution and Dilution (using Aseptic Technique)
1. FabrazymeÒ vials and diluent should be allowed to reach room temperature prior to reconstitution (approximately 30 minutes). The number of vials needed is based on the patient’s body weight (kg) and the recommended dose of 1.0 mg/kg.
Patient weight (in kg) = Patient dose (in mg)
Patient dose (in mg) ÷ 35 mg/vial = Number of vials to reconstitute (if the number of vials includes a fraction, round up to the next whole number)
Example: Patient weight (80 kg) = Patient dose (80 mg)
80 mg ÷ 35 mg/vial = 2.29 vials, therefore, 3 vials should be reconstituted.
2. Reconstitute each vial of FabrazymeÒ by slowly injecting 7.2 mL of Sterile Water for Injection, USP down the inside wall of each vial. Roll and tilt each vial gently. Each vial will yield a 5.0 mg/mL clear, colorless solution (total extractable amount per vial is 35 mg, 7.0 mL).
3. Visually inspect the reconstituted vials for particulate matter and discoloration. Do not use the reconstituted solution if there is particulate matter or if it is discolored.
4. The reconstituted solution should be further diluted with 0.9% Sodium Chloride Injection, USP to a final total volume of 500 mL. Prior to adding the volume of reconstituted FabrazymeÒ required for the patient dose, remove an equal volume of 0.9% Sodium Chloride for Injection, USP from the 500 mL infusion bag.
Patient dose (in mg) ÷ 5 mg/mL = Number of mL of reconstituted FabrazymeÒ required for patient dose.
Example: Patient dose = 80 mg
80 mg ÷ 5 mg/mL = 16 mL of FabrazymeÒ
Slowly withdraw the reconstituted solution from each vial up to the total volume required for the patient dose. Inject the reconstituted FabrazymeÒ solution directly into the Sodium Chloride solution. Do not inject in the airspace within the infusion bag. Discard any vial with unused reconstituted solution.
5. Gently invert infusion bag to mix the solution, avoiding vigorous shaking and agitation.
6. FabrazymeÒ should not be infused in the same intravenous line with other products.
7. The diluted solution may be filtered through an in-line low protein-binding 0.2 mm filter during administration.
Storage
Store FabrazymeÒ under refrigeration between 2° - 8°C (36° - 46°F). DO NOT USE FabrazymeÒ after the expiration date on the vial.
Reconstituted and diluted solutions of FabrazymeÒ should be used immediately. This product contains no preservatives. If immediate use is not possible, the reconstituted and diluted solution may be stored for up to 24 hours at 2° - 8°C (36° - 46°F).
FabrazymeÒ is supplied as a sterile, nonpyrogenic, white to off-white lyophilized cake or powder. FabrazymeÒ is supplied in single-use, clear Type I glass 20 ml (cc) vials. The closure consists of a siliconized butyl stopper and an aluminum seal with a plastic purple flip-off cap. NDC 58468-0040-1
U.S. Patent Number: 5,356,804
FabrazymeÒ is manufactured and distributed by: Genzyme Corporation One Kendall Square Cambridge, MA 02139 1-800-745-4447 (phone)
US License Number: 1596 Issued: 24 April 2003
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