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Drug Safety-related Labeling Changes (SrLC)

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ARIKAYCE KIT (NDA-207356)

(AMIKACIN SULFATE)

Safety-related Labeling Changes Approved by FDA Center for Drug Evaluation and Research (CDER)

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06/25/2026 (SUPPL-25)

Approved Drug Label (PDF)

6 Adverse Reactions

6.2 Postmarketing Experience

Newly added information:

Renal and urinary disorders: acute kidney injury, renal failure

12/05/2025 (SUPPL-19)

Approved Drug Label (PDF)

6 Adverse Reactions

6.2 Postmarketing Experience

Additions and/or revisions underlined:

…

Gastrointestinal disorders: dysphagia, glossitis, glossodynia, salivary hypersecretion, stomatitis, abdominal pain, abdominal distension

Immune system disorders: hypersensitivity, anaphylaxis, pharyngeal swelling [see Warnings and Precautions (5.5)]

Respiratory, thoracic, and mediastinal disorders: nasal dryness, rhinorrhea, sneezing, nasal congestion

17 PCI/PI/MG (Patient Counseling Information/Patient Information/Medication Guide)

MEDICATION GUIDE

Additions and/or revisions underlined:

…

How should I use ARIKAYCE?

…

  • Do not use ARIKAYCE unless you understand the directions provided. If you have questions talk to your health care provider or call Insmed inLighten™ Patient Support at 1-833-LIGHT-00 (1-833-544-4800).

    …

02/10/2023 (SUPPL-12)

Approved Drug Label (PDF)

5 Warnings and Precautions

5.6 Ototoxicity

Additions and/or revisions underlined

…

Risk of Ototoxicity Due to Mitochondrial DNA Variants

Cases of ototoxicity with aminoglycosides have been observed in patients with certain variants in the mitochondrially encoded 12S rRNA gene (MT-RNR1), particularly the m.1555A>G variant. Ototoxicity occurred in some patients even when their aminoglycoside serum levels were within the recommended range. Mitochondrial DNA variants are present in less than 1% of the general US population, and the proportion of the variant carriers who may develop ototoxicity as well as the severity of ototoxicity is unknown. In case of known maternal history of ototoxicity due to aminoglycoside use or a known mitochondrial DNA variant in the patient, consider alternative treatments other than aminoglycosides unless the increased risk of permanent hearing loss is outweighed by the severity of infection and lack of safe and effective alternative therapies.

17 PCI/PI/MG (Patient Counseling Information/Patient Information/Medication Guide)

MEDICATION GUIDE

 

Additions and/or revisions underlined

…

Before using ARIKAYCE, tell your healthcare provider about all of your medical conditions, including if you:

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  • have or have had hearing problems (including noises in your ears such as ringing or hissing), hearing loss, or your mother has had hearing problems after taking an aminoglycoside.

     

  • have been told you have certain gene variants (a change in the gene) related to hearing abnormalities inherited from your mother.

    …

03/13/2020 (SUPPL-4)

Approved Drug Label (PDF)

5 Warnings and Precautions

5.5 Anaphylaxis and Hypersensitivity Reactions

Newly added subsection:

Serious and potentially life-threatening hypersensitivity reactions, including anaphylaxis, have been reported in patients taking ARIKAYCE. Signs and symptoms include acute onset of skin and mucosal tissue hypersensitivity reactions (hives, itching, flushing, swollen lips/tongue/uvula), respiratory difficulty (shortness of breath, wheezing, stridor, cough), gastrointestinal symptoms (nausea, vomiting, diarrhea, crampy abdominal pain), and cardiovascular signs and symptoms of anaphylaxis (tachycardia, low blood pressure, syncope, incontinence, dizziness). Before therapy with ARIKAYCE is instituted, evaluate for previous hypersensitivity reactions to aminoglycosides. If anaphylaxis or a hypersensitivity reaction occurs, discontinue ARIKAYCE and institute appropriate supportive measures.

6 Adverse Reactions

Newly added to the bulleted line listing:

6.1 Clinical Trials Experience

Overview of Clinical Trials for Safety Evaluation

Additions and/or revisions underlined:

Trial 2 (NCT#02628600) was a single-arm extension …

Newly added subsection:

6.2 Postmarketing Experience

The following adverse reactions have been identified from postmarketing surveillance. Because these adverse reactions are reported voluntarily from a population of unknown size, precise estimates of frequency cannot be made and a causal relationship to drug exposure cannot be established.

Immune System Disorders: hypersensitivity, anaphylaxis [see Warnings and Precautions (5.5)]

17 PCI/PI/MG (Patient Counseling Information/Patient Information/Medication Guide)

MEDICATION GUIDE

What is the most important information I should know about ARIKAYCE?

ARIKAYCE can cause serious side effects, including:

Newly added information:

serious allergic reactions: Serious allergic reactions that may lead to death have happened to people who take ARIKAYCE. Stop taking ARIKAYCE right away and get emergency medical help if you have any of the following symptoms of a serious allergic reaction:

  • hives

  • noisy high-pitched breathing (stridor)

  • fast heart rate

  • itching

  • cough

  • feeling light headed

  • redness or blushing of the skin (flushing)

  • nausea

  • feeling faint

  • swollen lips, tongue or throat

  • vomiting

  • loss of control of the bowels or bladder (incontinence)

  • trouble breathing or wheezing

  • diarrhea

  • dizziness

  • shortness of breath

  • feel cramps in your stomach area

PATIENT COUNSELING INFORMATION

Newly added information:

Anaphylaxis and Hypersensitivity Reactions

Advise patients and caregivers that serious and potentially life-threatening hypersensitivity reactions, that require immediate treatment could occur. Advise the patient to discontinue ARIKAYCE and seek immediate medical attention if any signs or symptoms of a hypersensitivity reaction occur [see Warnings and Precautions (5.5)]