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Drug Safety-related Labeling Changes (SrLC)

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JALYN (NDA-022460)

(DUTASTERIDE; TAMSULOSIN HYDROCHLORIDE)

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

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12/28/2020 (SUPPL-11)

Approved Drug Label (PDF)

4 Contraindications

Additions underlined

JALYN is contraindicated for use in:

  • Pregnancy. Dutasteride use is contraindicated in females who are pregnant. In animal reproduction and developmental toxicity studies, dutasteride inhibited development of male

fetus external genitalia. Therefore, JALYN may cause fetal harm when administered to a

pregnant female [see Warnings and Precautions (5.6), Use in Specific Populations (8.1)].

5 Warnings and Precautions

5.11 Effect on Semen Characteristics

Additions and or revisions underlined

Dutasteride

The effects of dutasteride 0.5 mg/day on semen characteristics were evaluated in healthy men throughout 52 weeks of treatment and 24 weeks of post-treatment follow-up. At 52 weeks, compared with placebo, dutasteride treatment resulted in mean reduction in total sperm count, semen volume, and sperm motility; the effects on total sperm count were not reversible after 24 weeks of follow-up. Sperm concentration and sperm morphology were unaffected and mean values for all semen parameters remained within the normal range at all timepoints. The clinical significance of the effect of dutasteride on semen characteristics for an individual patient’s fertility is not known [see Use in Specific Populations (8.3)].

5.2 Drug-Drug Interactions

Additions underlined

Strong Inhibitors of Cytochrome P450 (CYP) 3A4

Tamsulosin-containing products, including JALYN, should not be coadministered with strong

CYP3A4 inhibitors (e.g., ketoconazole) as this can significantly increase tamsulosin exposure

[see Drug Interactions (7.1), Clinical Pharmacology (12.3)].

5.6 Transdermal Exposure of JALYN in Pregnant Females—Risk to Male Fetus

Additions underlined

JALYN capsules should not be handled by females who are pregnant or may be pregnant. Dutasteride can be absorbed through the skin and could result in unintended fetal exposure and potential risk to a male fetus.

8 Use in Specific Populations

8.1 Pregnancy

PLLR conversion, please refer to label for complete information

8.2 Lactation

PLLR conversion

Risk Summary

JALYN is not indicated for use in females.

8.3 Females and Males of Reproductive Potential

PLLR conversion

Infertility

Dutasteride: Males: The effects of dutasteride 0.5 mg/day on semen characteristics were evaluated in normal volunteers aged 18 to 52 years (n = 27 dutasteride, n = 23 placebo) throughout 52 weeks of treatment and 24 weeks of post-treatment follow-up. At 52 weeks, the mean percent reductions from baseline in total sperm count, semen volume, and sperm motility were 23%, 26%, and 18%, respectively, in the dutasteride group when adjusted for changes from baseline in the placebo group. Sperm concentration and sperm morphology were unaffected.

After 24 weeks of follow-up, the mean percent change in total sperm count in the dutasteride group remained 23% lower than baseline. While mean values for all semen parameters at all timepoints remained within the normal ranges and did not meet predefined criteria for a clinically significant change (30%), 2 subjects in the dutasteride group had decreases in sperm count of greater than 90% from baseline at 52 weeks, with partial recovery at the 24-week follow-up. The clinical significance of these effects on semen characteristics for an individual patient’s fertility is not known [see Warnings and Precautions (5.11)].

Tamsulosin: Males: Abnormal ejaculation including ejaculation failure, ejaculation disorder, retrograde ejaculation, and decreased ejaculation has been associated with tamsulosin hydrochloride. Studies in rats revealed significantly reduced fertility in males, considered to be due to impairment of ejaculation, which was reversible [see Nonclinical Toxicology (13.1)].

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

PATIENT COUNSELING INFORMATION

Additions underlined

Effects on Semen Parameters

Advise men that JALYN may affect sperm characteristics but the effect on fertility is unknown

[see Warnings and Precautions (5.11), Use in Specific Populations (8.3)].

PATIENT INFORMATION

Additions underlined

What is JALYN?

JALYN is a prescription medicine that contains 2 medicines: dutasteride and tamsulosin. JALYN is used to treat the symptoms of benign prostatic hyperplasia (BPH) in men with an enlarged prostate. The

2 medications in JALYN work in different ways to improve symptoms of BPH. Dutasteride shrinks the enlarged prostate and tamsulosin relaxes muscles in the prostate and neck of the bladder. These

2 medications, when used together, can improve symptoms of BPH better than either medication when

used alone.

Before you take JALYN, tell your healthcare provider about all of your medical conditions, including if you:

11/01/2017 (SUPPL-7)

Approved Drug Label (PDF)

6 Adverse Reactions

6.2 Postmarketing Experience

Tamsulosin

Additions and/or revisions underlined:

Skin Disorders: Skin desquamation, including Stevens-Johnson syndrome, erythema multiforme, dermatitis exfoliative.

Gastrointestinal Disorders: Constipation, vomiting, dry mouth.

Respiratory: Epistaxis.

Ophthalmologic Disorders: Blurred vision, visual impairment.

11/01/2017 (SUPPL-8)

Approved Drug Label (PDF)

5 Warnings and Precautions

Additions and/or revisions underlined:

5.2 Drug-drug Interactions

Moderate Inhibitors of CYP3A4, Inhibitors of CYP2D6, or a Combination of Both CYP3A4 and CYP2D6 Inhibitors

… when coadministered with moderate inhibitors of CYP3A4 (e.g., erythromycin), strong (e.g., paroxetine) or moderate (e.g., terbinafine) inhibitors of CYP2D6, a combination of both CYP3A4 and CYP2D6 inhibitors, or in patients known to be …

5.9 Intraoperative Floppy Iris Syndrome

Intraoperative Floppy Iris Syndrome (IFIS) has been observed during cataract and glaucoma surgery in some patients …

… The benefit of stopping alpha-adrenergic antagonist therapy prior to cataract or glaucoma surgery has not been established. The initiation of therapy with tamsulosin in patients for whom cataract or glaucoma surgery is scheduled is not recommended.

 

6 Adverse Reactions

6.2 Postmarketing Experience

Tamsulosin

Additions and/or revisions underlined:

Ophthalmologic Disorders: … During cataract and glaucoma surgery, a variant of small pupil syndrome known as Intraoperative Floppy Iris Syndrome (IFIS) …

7 Drug Interactions

Additions and/or revisions underlined:

7.1 Cytochrome PYP450 Inhibition

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

PATIENT COUNSELING INFORMATION

Additions and/or revisions underlined:

Drug Interactions

Advise patients that JALYN should not be used in combination with strong inhibitors of CYP3A4.

Intraoperative Floppy Iris Syndrome (IFIS)

Advise patients considering cataract or glaucoma surgery to tell their ophthalmologist

PATIENT INFORMATION

Additions and/or revisions underlined:

Before you take JALYN, tell your healthcare provider if you:

  • plan to have cataract or glaucoma surgery

JALYN may cause serious side effects, including:

  • Eye problems during cataract or glaucoma surgery. During cataract or glaucoma surgery, a condition called Intraoperative Floppy Iris Syndrome (IFIS) can happen if you take or have taken JALYN in the past. If you need to have cataract or glaucoma surgery, tell your surgeon …