PRAXBIND Solution for injection Ref.[8938] Active ingredients: Idarucizumab

Idarucizumab binds specifically to dabigatran and reverses its anticoagulant effect. It will not reverse the effects of other anticoagulants (see section 5.1).

Praxbind treatment can be used in conjunction with standard supportive measures, which should be considered as medically appropriate.

Traceability

In order to improve the traceability of biological medicinal products, the name and the batch number of the administered product should be clearly recorded.

Hypersensitivity

The risk of using Praxbind in patients with known hypersensitivity (e.g. anaphylactoid reaction) to idarucizumab or to any of the excipients needs to be weighed cautiously against the potential benefit of such an emergency treatment. If an anaphylactic reaction or other serious allergic reaction occurs, administration of Praxbind should be discontinued immediately and appropriate therapy initiated.

Hereditary fructose intolerance

The recommended dose of Praxbind contains 4 g sorbitol as an excipient. In patients with hereditary fructose intolerance, parenteral administration of sorbitol has been associated with reports of hypoglycemia, hypophosphatemia, metabolic acidosis, increase in uric acid, acute liver failure with breakdown of excretory and synthetic function, and death. Therefore, in patients with hereditary fructose intolerance the risk of treatment with Praxbind must be weighed against the potential benefit of such an emergency treatment. If Praxbind is administered in these patients, intensified medical care during Praxbind exposure and within 24 hours of exposure is required.

Thromboembolic Events

Patients being treated with dabigatran have underlying disease states that predispose them to thromboembolic events. Reversing dabigatran therapy exposes patients to the thrombotic risk of their underlying disease. To reduce this risk, resumption of anticoagulant therapy should be considered as soon as medically appropriate (see section 4.2).

Urinary protein testing

Praxbind causes transient proteinuria as a physiologic reaction to renal protein overflow after bolus/short term application of 5g idarucizumab intravenously (see section 5.2). The transient proteinuria is not indicative of renal damage, which should be taken into account for urine testing.

Sodium content

This medicinal product contains 50 mg sodium per dose, equivalent to 2.5% of the WHO recommended maximum daily intake of 2 g sodium for an adult.

No formal interaction studies with Praxbind and other medicinal products have been performed. Based on the pharmacokinetic properties and the high specificity in binding to dabigatran, clinically relevant interactions with other medicinal products are considered unlikely.

Preclinical investigations with idarucizumab have shown no interactions with:

• volume expanders.
• coagulation factor concentrates, such as prothrombin complex concentrates (PCCs, e.g. 3 factor and 4 factor), activated PCCs (aPCCs) and recombinant factor VIIa.
• other anticoagulants (e.g. thrombin inhibitors other than dabigatran, Factor Xa inhibitors including low-molecular weight heparin, vitamin K-antagonists, heparin). Thus idarucizumab will not reverse the effects of other anticoagulants.

Pregnancy

There are no data for the use of Praxbind in pregnant women. Reproductive and developmental toxicity studies have not been performed, given the nature and the intended clinical use of the medicinal product. Praxbind may be used during pregnancy, if the expected clinical benefit outweighs the potential risks.

Breast-feeding

It is unknown whether idarucizumab is excreted in human milk.

Fertility

There are no data on the effect of Praxbind on fertility (see section 5.3).

Not relevant.

In a phase III trial the safety of Praxbind has been evaluated in 503 patients, who had uncontrolled bleeding or required emergency surgery or procedures and were under treatment with Pradaxa (dabigatran etexilate), as well as in 224 volunteers in phase I trials.

No adverse reactions have been identified.

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the national reporting system listed in Appendix V.

This medicinal product must not be mixed with other medicinal products.