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Drug Safety-related Labeling Changes (SrLC)

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FOLLISTIM AQ (BLA-021211)

(FOLLITROPIN ALFA/BETA)

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

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02/24/2026 (SUPPL-47)

Approved Drug Label (PDF)

6 Adverse Reactions

6.2 Postmarketing Experience

Newly added information:

Immune system disorders

Hypersensitivity reactions including anaphylaxis, pruritus, rash, and urticaria

8 Use in Specific Populations

8.1 Pregnancy

Newly added information:

Risk Summary

…

The incidence of congenital malformations after some Assisted Reproductive Technology, specifically in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI)], may be slightly higher than that after spontaneous conception. This slightly higher incidence is thought to be related to differences in parental characteristics (e.g., maternal age, maternal and paternal genetic background, sperm characteristics) and to a higher incidence of multi-fetal gestations after IVF or ICSI [see Warnings and Precautions (5.6)]. There is no human data that the use of gonadotropins (including FOLLISTIM AQ Cartridge) alone or as part of IVF or ICSI cycles, increases the risk of congenital malformations.

The risk of spontaneous abortion (miscarriage) is increased in women who have used gonadotropins products to achieve pregnancy [see Warnings and Precautions (5.8)].

In the US general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively.

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

PATIENT COUNSELING INFORMATION

Newly added information:

Hypersensitivity Reactions and Anaphylaxis

Advise patients to discontinue FOLLISTIM AQ Cartridge and seek immediate medical attention if any signs or symptoms of a hypersensitivity reaction occur [see Contraindications (4) and Adverse Reactions (6.2)].

PATIENT INFORMATION

Extensive changes; please refer to label for complete information

03/21/2023 (SUPPL-27)

Approved Drug Label (PDF)

6 Adverse Reactions

Addition of the following to the bulleted line listing:

  • Abnormal Ovarian Enlargement [see Warnings and Precautions (5.1)]

  • Ovarian Neoplasms [see Warnings and Precautions (5.9)]

8 Use in Specific Populations

8.1 Pregnancy

Additions and/or revisions underlined:

Risk Summary

Follistim AQ Cartridge is contraindicated for use in pregnant women and offers no benefit during pregnancy.

8.2 Lactation

Additions and/or revisions underlined:

Risk Summary

It is not known whether this drug is excreted in human milk. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for Follistim AQ Cartridge and any potential adverse effects on the breastfed child from Follistim AQ Cartridge or from the underlying maternal condition.

03/21/2023 (SUPPL-36)

Approved Drug Label (PDF)

8 Use in Specific Populations

8.4 Pediatric Use

Additions and/or revisions underlined:

Follistim AQ Cartridge is not indicated for use in pediatric patients. Clinical studies have not been conducted in the pediatric population.

8.5 Geriatric Use

Additions and/or revisions underlined:

Clinical studies of Follistim AQ Cartridge have not been conducted in patients 65 years of age and older.

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

PATIENT COUNSELING INFORMATION

Additions and/or revisions underlined:

Advise the patient to read the FDA-approved patient labeling (Patient Information).

…

 

PATIENT INFORMATION

Additions and/or revisions underlined:

Follistim® (Fol’-lis-tim) AQ Cartridge (follitropin beta) injection for subcutaneous use

Read this Patient Information before you start using Follistim® AQ Cartridge and each time you get a refill. There may be new information. This information does not take the place of talking with your healthcare provider about your medical condition or treatment.

…

Who should not use Follistim AQ Cartridge?

Do not start using Follistim AQ Cartridge if you are a Woman or Man who:

  • is allergic to recombinant human FSH products

  • has a high level of FSH in your blood indicating that your ovaries (women only) or testes (men only) may be permanently damaged and do not work at all

  • has uncontrolled thyroid, pituitary, or adrenal gland problems

  • is allergic to streptomycin or neomycin (types of antibiotics)

  • has a tumor of the hypothalamus, pituitary gland, breast, uterus (women only), ovary (women only), or testis (men only)

Do not start using Follistim AQ Cartridge if you are a Woman who:

  • is pregnant or think you may be pregnant

  • has heavy or irregular vaginal bleeding and the cause is not known

  • has ovarian cysts or enlarged ovaries, not due to polycystic ovary syndrome (PCOS)

Talk to your healthcare provider before taking this medicine if you have any of the conditions listed above.

Before you use Follistim AQ, tell your healthcare provider about all of your medical conditions, including if you:

  • have an increased risk of blood clots (thrombosis)…

…

Some medicines may affect how Follistim AQ Cartridge works. Follistim AQ Cartridge may also affect how your other medicines work. Keep a list of your medicines and show it to your healthcare provider and pharmacist when you get a new medicine.

…

What are the possible side effects of Follistim AQ Cartridge?

Side effects are grouped by how serious they are and how often they may happen. Serious side effects include:

In women:

  • Ovarian enlargement …

…

Call your healthcare provider right away if you develop any of the following:

  • pain in your lower stomach area

  • nausea

  • vomiting

  • weight gain

  • diarrhea

  • decreased urine output

  • trouble breathing

  • any other unusual symptoms that concern you

…

The most common side effects of Follistim AQ Cartridge include:

…

In men:

  • headache

  • pain at the injection site

  • bruising, swelling or redness at the injection site

  • breast enlargement

  • acne

  • testicular cyst

…

What are the ingredients in Follistim AQ Cartridge?

Active ingredient: follitropin beta

Inactive ingredients: benzyl alcohol NF-10 mg/mL (preservative), methionine, polysorbate 20, sodium citrate, sucrose, Water for Injection. Hydrochloric acid and/or sodium hydroxide are used to adjust the pH.

03/21/2023 (SUPPL-42)

Approved Drug Label (PDF)

8 Use in Specific Populations

8.4 Pediatric Use

Additions and/or revisions underlined:

Follistim AQ Cartridge is not indicated for use in pediatric patients. Clinical studies have not been conducted in the pediatric population.

8.5 Geriatric Use

Additions and/or revisions underlined:

Clinical studies of Follistim AQ Cartridge have not been conducted in patients 65 years of age and older.

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

PATIENT COUNSELING INFORMATION

Additions and/or revisions underlined:

Advise the patient to read the FDA-approved patient labeling (Patient Information).

…

 

PATIENT INFORMATION

Additions and/or revisions underlined:

Follistim® (Fol’-lis-tim) AQ Cartridge (follitropin beta) injection for subcutaneous use

Read this Patient Information before you start using Follistim® AQ Cartridge and each time you get a refill. There may be new information. This information does not take the place of talking with your healthcare provider about your medical condition or treatment.

…

Who should not use Follistim AQ Cartridge?

Do not start using Follistim AQ Cartridge if you are a Woman or Man who:

  • is allergic to recombinant human FSH products

  • has a high level of FSH in your blood indicating that your ovaries (women only) or testes (men only) may be permanently damaged and do not work at all

  • has uncontrolled thyroid, pituitary, or adrenal gland problems

  • is allergic to streptomycin or neomycin (types of antibiotics)

  • has a tumor of the hypothalamus, pituitary gland, breast, uterus (women only), ovary (women only), or testis (men only)

    Do not start using Follistim AQ Cartridge if you are a Woman who:

  • is pregnant or think you may be pregnant

  • has heavy or irregular vaginal bleeding and the cause is not known

  • has ovarian cysts or enlarged ovaries, not due to polycystic ovary syndrome (PCOS)

Talk to your healthcare provider before taking this medicine if you have any of the conditions listed above.

Before you use Follistim AQ, tell your healthcare provider about all of your medical conditions, including if you:

  • have an increased risk of blood clots (thrombosis)…

…

Some medicines may affect how Follistim AQ Cartridge works. Follistim AQ Cartridge may also affect how your other medicines work. Keep a list of your medicines and show it to your healthcare provider and pharmacist when you get a new medicine.

…

What are the possible side effects of Follistim AQ Cartridge?

Side effects are grouped by how serious they are and how often they may happen. Serious side effects include:

In women:

  • Ovarian enlargement …

…

Call your healthcare provider right away if you develop any of the following:

  • pain in your lower stomach area

  • nausea

  • vomiting

  • weight gain

  • diarrhea

  • decreased urine output

  • trouble breathing

  • any other unusual symptoms that concern you

…

The most common side effects of Follistim AQ Cartridge include:

…

In men:

  • headache

  • pain at the injection site

  • bruising, swelling or redness at the injection site

  • breast enlargement

  • acne

  • testicular cyst

…

What are the ingredients in Follistim AQ Cartridge?

Active ingredient: follitropin beta

Inactive ingredients: benzyl alcohol NF-10 mg/mL (preservative), methionine, polysorbate 20, sodium citrate, sucrose, Water for Injection. Hydrochloric acid and/or sodium hydroxide are used to adjust the pH.