PROLIA Solution for injection Ref.[6758] Active ingredients: Denosumab

Source: European Medicines Agency (EU)  Revision Year: 2023  Publisher: Amgen Europe B.V., Minervum 7061, NL-4817 ZK Breda, The Netherlands

Therapeutic indications

Treatment of osteoporosis in postmenopausal women and in men at increased risk of fractures. In postmenopausal women Prolia significantly reduces the risk of vertebral, non-vertebral and hip fractures.

Treatment of bone loss associated with hormone ablation in men with prostate cancer at increased risk of fractures (see section 5.1). In men with prostate cancer receiving hormone ablation, Prolia significantly reduces the risk of vertebral fractures.

Treatment of bone loss associated with long-term systemic glucocorticoid therapy in adult patients at increased risk of fracture (see section 5.1).

Posology and method of administration

Posology

The recommended dose is 60 mg denosumab administered as a single subcutaneous injection once every 6 months into the thigh, abdomen or upper arm.

Patients must be adequately supplemented with calcium and vitamin D (see section 4.4).

Patients treated with Prolia should be given the package leaflet and the patient reminder card.

The optimal total duration of antiresorptive treatment for osteoporosis (including both denosumab and bisphosphonates) has not been established. The need for continued treatment should be re-evaluated periodically based on the benefits and potential risks of denosumab on an individual patient basis, particularly after 5 or more years of use (see section 4.4).

Elderly (age ≥65)

No dose adjustment is required in elderly patients.

Renal impairment

No dose adjustment is required in patients with renal impairment (see section 4.4 for recommendations relating to monitoring of calcium).

No data is available in patients with long-term systemic glucocorticoid therapy and severe renal impairment (GFR <30 ml/min).

Hepatic impairment

The safety and efficacy of denosumab have not been studied in patients with hepatic impairment (see section 5.2).

Paediatric population

Prolia should not be used in children aged <18 years because of safety concerns of serious hypercalcaemia, and potential inhibition of bone growth and lack of tooth eruption (see sections 4.4 and 5.3). Currently available data for children aged 2 to 17 years are described in sections 5.1 and 5.2.

Method of administration

For subcutaneous use.

Administration should be performed by an individual who has been adequately trained in injection techniques.

The instructions for use, handling and disposal are given in section 6.6.

Overdose

There is no experience with overdose in clinical studies. Denosumab has been administered in clinical studies using doses up to 180 mg every 4 weeks (cumulative doses up to 1,080 mg over 6 months), and no additional adverse reactions were observed.

Shelf life

3 years.

Once removed from the refrigerator, Prolia may be stored at room temperature (up to 25°C) for up to 30 days in the original container. It must be used within this 30 days period.

Special precautions for storage

Store in a refrigerator (2°C–8°C).

Do not freeze.

Keep the container in the outer carton in order to protect from light.

Nature and contents of container

One mL solution in a single use pre-filled syringe made from type I glass with stainless steel 27 gauge needle, with or without needle guard.

The needle cover of the pre-filled syringe contains dry natural rubber, which is a derivative of latex (see section 4.4).

Pack size of one pre-filled syringe, presented in blistered (pre-filled syringe with or without a needle guard) or unblistered packaging (pre-filled syringe without a needle guard only).

Not all pack sizes may be marketed.

Special precautions for disposal and other handling

  • Before administration, the solution should be inspected. Do not inject the solution if it contains particles, or is cloudy or discoloured.
  • Do not shake.
  • To avoid discomfort at the site of injection, allow the pre-filled syringe to reach room temperature (up to 25°C) before injecting and inject slowly.
  • Inject the entire contents of the pre-filled syringe.

Any unused medicinal product or waste material should be disposed of in accordance with local requirements.

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