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Drug Safety-related Labeling Changes (SrLC)

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FOSCAVIR (NDA-020068)

(FOSCARNET SODIUM)

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

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02/24/2017 (SUPPL-23)

Approved Drug Label (PDF)

5 Warnings and Precautions

WARNINGS

(Additions and/or revisions are underlined)

Hypersensitivity

Serious acute hypersensitivity reactions (e.g., anaphylactic shock, urticaria, angioedema)

have been reported postmarketing in patients receiving FOSCAVIR. If such an acute reaction occurs, therapy should be discontinued and appropriate medical therapy immediately instituted.

 

QT prolongation and torsade de pointes

FOSCAVIR has been associated with prolongation of the QT interval, an ECG abnormality

that has been associated with torsades de pointes, which has been reported during postmarketing surveillance for FOSCAVIR. Some of these patients had confounding risk factors such as underlying cardiac disease, electrolyte abnormalities and other concomitant medications.

Use with caution in patients who have a history of QT prolongation, in patients who are taking medications known to prolong the QT interval, in patients with electrolyte disturbances, or in patients who have other risk factors for QT prolongation. Electrocardiograms (ECGs) and measurement of electrolytes should be obtained prior to treatment initiation and periodically during treatment with FOSCAVIR.

6 Adverse Reactions

(Additions and/or revisions are underlined)

Incidence between 1% and 5%

Body as a Whole: back pain, chest pain (including reports of transient chest pain as part of infusion reactions), edema, influenza-like symptoms, bacterial infections, moniliasis, fungal infections, abscess

Adverse events that have been reported in post-marketing surveillance include: administration site extravasation, localized edema, hypersensitivity reactions (including anaphylactic shock, urticaria and angioedema) (see WARNINGS section), gastrointestinal hemorrhage, increased lipase, glomerulonephritis, nephrotic syndrome, proteinuria,…

7 Drug Interactions

(Additions and/or revisions are underlined)

Because of the risk of QT prolongation and the potential for torsades de pointes, the use of FOSCAVIR should be avoided in combination with agents known to prolong the QT interval including Class IA (e.g., quinidine or procainamide) or Class III (e.g., dofetilide, amiodarone, sotalol) antiarrhythmic agents, phenothiazines, tricyclic antidepressants, and certain macrolides and fluoroquinolones.

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

Information for Patients

(Additions and/or revisions are underlined)

General: …Patients should also be advised to promptly report any cardiac symptoms

11/10/2016 (SUPPL-22)

Approved Drug Label (PDF)

5 Warnings and Precautions

Seizures

… Several cases of seizures were associated with death. Cases of status epilepticus have been reported

6 Adverse Reactions

Following Table 12:

Adverse events that have been reported in post-marketing surveillance include: status epilepticus, ventricular arrhythmia, prolongation of QT interval, torsade de pointes, gamma GT increased, diabetes insipidus (usually nephrogenic), renal calculus, Fanconi syndrome acquired, renal tubular acidosis, renal tubular necrosis, crystal-induced nephropathy, hypercalcemia, hypernatremia, esophageal ulceration and muscle disorders including myopathy, myositis…