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Drug Safety-related Labeling Changes (SrLC)

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RUKOBIA (NDA-212950)

(FOSTEMSAVIR TROMETHAMINE)

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

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02/13/2024 (SUPPL-4)

Approved Drug Label (PDF)

8 Use in Specific Populations

8.2 Lactation

Additions and/or revisions underlined:

Risk Summary

It is not known whether RUKOBIA is present in human breast milk, affects human milk production, or has effects on the breastfed infant. When administered to lactating rats, fostemsavir-related drug was present in rat milk (see Data). When a drug is present in animal milk, it is likely that the drug will be present in human milk.

Potential risks of breastfeeding include: (1) HIV-1 transmission (in HIV-1–negative infants), (2) developing viral resistance (in HIV-1–positive infants), and (3) adverse reactions in a breastfed infant similar to those seen in adults.

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

PATIENT COUNSELING INFORMATION

Additions and/or revisions underlined:

Lactation

Inform individuals with HIV-1 infection that the potential risks of breastfeeding include: (1) HIV-1 transmission (in HIV-1–negative infants), (2) developing viral resistance (in HIV-1– positive infants), and (3) adverse reactions in a breastfed infant similar to those seen in adults

[see Use in Specific Populations (8.2)].

PATIENT INFORMATION

Additions and/or revisions underlined:

RUKOBIA is a prescription medicine that is used with other human immunodeficiency virus-1 (HIV-1) medicines to treat HIV-1 infection in adults who:

  • have received several HIV-1 medicines in the past, and

  • have HIV-1 virus that is resistant to many HIV-1 medicines, and

  • are failing their current HIV-1 medicines. Your HIV-1 medicines could be failing because they are not working or no longer work, you are not able to tolerate the side effects, or there are other safety reasons why you cannot take them.

…

Before taking RUKOBIA, tell your healthcare provider about all of your medical conditions, including if you:

…

  • are pregnant or plan to become pregnant. It is not known if RUKOBIA will harm your unborn baby. Tell your healthcare provider if you become pregnant during treatment with RUKOBIA.

    Pregnancy Exposure Registry. There is a pregnancy exposure registry for those who take RUKOBIA during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. Talk to your healthcare provider about how you can take part in this registry.

  • are breastfeeding or plan to breastfeed. RUKOBIA may pass into your breast milk. Talk with your healthcare

    provider about the following risks to your baby from breastfeeding during treatment with RUKOBIA:

    • the HIV-1 virus may pass to your baby if your baby does not have HIV-1 infection.

    • the HIV-1 virus may become harder to treat if your baby has HIV-1 infection.

    • your baby may get side effects from RUKOBIA.

…

What are the possible side effects of RUKOBIA?

RUKOBIA can cause serious side effects including:

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  • Heart rhythm problems (QTc prolongation). RUKOBIA may cause a heart rhythm problem called QTc prolongation. QTc prolongation causes an irregular heartbeat. If you are elderly, or if you take certain other medicines, you may be at a greater risk for developing this heart problem with RUKOBIA.

…

What are the ingredients in RUKOBIA?

Active ingredient: fostemsavir tromethamine