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Drug Safety-related Labeling Changes (SrLC)

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INCRUSE ELLIPTA (NDA-205382)

(UMECLIDINIUM BROMIDE)

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

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12/13/2023 (SUPPL-13)

Approved Drug Label (PDF)

6 Adverse Reactions

6.1 Clinical Trials Experience

(Additions and/or revisions underlined)

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared with rates in the clinical trials of another drug and may not reflect the rates observed in practice.

In the 8 clinical trials conducted to support initial approval of INCRUSE ELLIPTA, a total of 1,663 subjects with COPD (mean age: 62.7 years; 89% white; 65% male across all treatments, including placebo) received at least 1 inhalation dose of umeclidinium at doses of 62.5 or 125 mcg. In the 4 randomized, double-blind, placebo- or active-controlled, efficacy clinical trials, 1,185 subjects received umeclidinium for up to 24 weeks, of which 487 subjects received the recommended dose of umeclidinium 62.5 mcg. In a 12-month, randomized, double-blind, placebo-controlled, long-term safety trial, 227 subjects received umeclidinium 125 mcg for up to 52 weeks [see Clinical Studies (14)].

The incidence of adverse reactions associated with INCRUSE ELLIPTA in Table 1 is based upon 2 placebo-controlled trials: one 24-week trial (Trial 1) and one 12-week trial (Trial 2) [see Clinical Studies (14.2)].

6.2 Postmarketing Experience

(Additions and/or revisions underlined)

In addition to adverse reactions reported from clinical trials, the following adverse reactions have been identified during postapproval use of INCRUSE ELLIPTA. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. These events have been chosen for inclusion due to either their seriousness, frequency of reporting, or causal connection to INCRUSE ELLIPTA or a combination of these factors.

Eye Disorders

Eye pain, glaucoma, vision blurred.

Immune System Disorders

Hypersensitivity reactions, including anaphylaxis, angioedema, pruritus, and urticaria.

Renal and Urinary Disorders

Dysuria, urinary retention.

Respiratory, Thoracic and Mediastinal Disorders

Dysphonia, oropharyngeal pain.

8 Use in Specific Populations

8.4 Pediatric Use

(Additions and/or revisions underlined)

The safety and effectiveness of INCRUSE ELLIPTA have not been established in pediatric patients. INCRUSE ELLIPTA is not indicated for use in pediatric patients.


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

17 PATIENT COUNSELING INFORMATION

(Additions and/or revisions underlined)

Tell patients they should not stop therapy with INCRUSE ELLIPTA without physician/provider guidance since symptoms may recur after discontinuation. [See Warnings and Precautions (5.1).]

Paradoxical Bronchospasm

As with other inhaled medicines, INCRUSE ELLIPTA can cause paradoxical bronchospasm. If paradoxical bronchospasm occurs, instruct patients to discontinue INCRUSE ELLIPTA and contact their healthcare provider right away. [See Warnings and Precautions (5.2)]

Worsening of Narrow-Angle Glaucoma

Instruct patients to be alert for signs and symptoms of acute narrow-angle glaucoma (e.g., eye pain or discomfort, blurred vision, visual halos or colored images in association with red eyes from conjunctival congestion and corneal edema). Instruct patients to consult a physician immediately if any of these signs or symptoms develop. [See Warnings and Precautions (5.4).]

Worsening of Urinary Retention

Instruct patients to be alert for signs and symptoms of urinary retention (e.g., difficulty passing urine, painful urination). Instruct patients to consult a physician immediately if any of these signs or symptoms develop. [See Warnings and Precautions (5.5).]

...

06/06/2019 (SUPPL-10)

Approved Drug Label (PDF)

5 Warnings and Precautions

5.5 Worsening of Urinary Retention

Additions and/or revisions underlined:

INCRUSE ELLIPTA, like all medicines containing an anticholinergic, should be used …

6 Adverse Reactions

6.1 Clinical Trials Experience

Additions and/or revisions underlined:

The incidence of adverse reactions associated with INCRUSE ELLIPTA in Table 1 is based upon 2 placebo-controlled efficacy trials: one 24-week trial (Trial 1, NCT #01313650) and one 12-week trial (Trial 2, NCT #01772147).

In a long-term safety trial (Trial 3, NCT #01316887), 336 subjects …

The safety and efficacy of INCRUSE ELLIPTA in combination with an inhaled corticosteroid/long-acting beta2-adrenergic agonist (ICS/LABA) were also evaluated in four 12-week clinical trials (Trial 4, NCT #01957163; Trial 5, NCT #02119286; Trial 6, NCT #01772134; and Trial 7, NCT #01772147). A total of 1,637 subjects …

Two trials (Trials 4 and 5) evaluated INCRUSE ELLIPTA in combination with fluticasone furoate/vilanterol (FF/VI) 100 mcg/25 mcg administered once daily, and 2 trials (Trials 6 and 7) evaluated INCRUSE ELLIPTA administered once daily …

8 Use in Specific Populations

8.1 Pregnancy

8.2 Lactation

PLLR conversion; please refer to label for complete information.

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

PATIENT INFORMATION

Additions and/or revisions underlined:

What is INCRUSE ELLIPTA?

  • INCRUSE ELLIPTA is not used to relieve sudden breathing problems and will not replace a rescue inhaler. Always have a rescue inhaler (an inhaled, short-acting bronchodilator) with you to treat sudden breathing problems. If you do not have a rescue inhaler, contact your healthcare provider to have one prescribed for you.

    What are the possible side effects of INCRUSE ELLIPTA?

    INCRUSE ELLIPTA can cause serious side effects, including:

    Additions and/or revisions underlined:

  • new or worsening eye problems including acute narrow-angle glaucoma. You should have regular eye exams while using INCRUSE ELLIPTA. Acute narrow-angle glaucoma can …

10/20/2017 (SUPPL-8)

Approved Drug Label (PDF)

6 Adverse Reactions

6.2 Postmarketing Experience

(Additions and/or revisions are underlined)

…These events have been chosen for inclusion due to either their seriousness, frequency of reporting, or causal connection to INCRUSE ELLIPTA or a combination of these factors.

Eye Disorders

Eye pain, glaucoma, vision blurred.


Renal and Urinary Disorders

Dysuria, urinary retention.

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

PATIENT INFORMATION

(Additions and/or revisions are underlined)

How should I use INCRUSE ELLIPTA?

  • Do not stop using INCRUSE ELLIPTA, even if you are feeling better, unless your healthcare provider tells you to.

  • Talk to your healthcare provider right away if you stop using INCRUSE ELLIPTA.

06/13/2017 (SUPPL-6)

Approved Drug Label (PDF)

5 Warnings and Precautions

5.3 Hypersensitivity Reactions

(Additions and/or revisions are underlined)

Hypersensitivity reactions such as anaphylaxis, angioedema, pruritus, rash, and urticaria may occur after administration of INCRUSE ELLIPTA. Discontinue INCRUSE ELLIPTA if such reactions occur

6 Adverse Reactions

6.2 Postmarketing Experience

(Newly added subsection)

In addition to adverse reactions reported from clinical trials, the following adverse reactions have been identified during postapproval use of INCRUSE ELLIPTA. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. These events have been chosen for inclusion due to either their seriousness, frequency of reporting, or causal connection to INCRUSE ELLIPTA or a combination of these factors.


Immune System Disorders

Hypersensitivity reactions, including anaphylaxis, angioedema, pruritus, and urticaria.

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

PATIENT INFORMATION

(Additions and/or revisions are underlined)

What is INCRUSE ELLIPTA?

  • INCRUSE ELLIPTA is not used to relieve sudden breathing problems and will not replace a rescue inhaler.

How should I use INCRUSE ELLIPTA?

  • INCRUSE ELLIPTA does not relieve sudden symptoms of COPD and you should not take extra doses of INCRUSE ELLIPTA to relieve these sudden symptoms

What are the possible side effects of INCRUSE ELLIPTA?

INCRUSE ELLIPTA can cause serious side effects, including:

  • serious allergic reactions (anaphylaxis). Stop taking INCRUSE ELLIPTA and call your healthcare provider or go to the nearest emergency room right away if you get any of the following symptoms of a serious allergic reaction:
    • rash
    • hives
    • severe itching
    • swelling of your face, lips, mouth, or tongue
    • breathing problems

Common side effects of INCRUSE ELLIPTA include:

  • upper respiratory tract infection
  • stuffy or runny nose
  • cough
  • mouth and throat pain
  • joint pain
  • change in taste
  • muscle pain
  • tooth pain
  • stomach pain
  • bruising or dark areas of skin
  • fast or irregular heartbeat