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Drug Safety-related Labeling Changes (SrLC)

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SIMBRINZA (NDA-204251)

(BRIMONIDINE TARTRATE; BRINZOLAMIDE)

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

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05/05/2023 (SUPPL-12)

Approved Drug Label (PDF)

5 Warnings and Precautions

5.1 Sulfonamide Hypersensitivity Reactions

Additions and/or revisions underlined:

SIMBRINZA contains brinzolamide, a sulfonamide, and although administered topically is absorbed systemically. Therefore, the same types of adverse reactions that are attributable to sulfonamides may occur with topical administration of SIMBRINZA. Fatalities have occurred due to severe reactions to sulfonamides including Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anemia, and other blood dyscrasias.

Sensitization may recur when a sulfonamide is re-administered irrespective of the route of administration. If signs of serious reactions or hypersensitivity occur, discontinue the use of this preparation immediately [see Adverse Reactions (6.2) and Patient Counseling Information (17)].

 

6 Adverse Reactions

6.1 Clinical Trials Experience

Subsection title revised
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 to the rates in the clinical trials of another drug and may not reflect the rates observed in practice.

 6.2 Postmarketing Experience

Additions and/or revisions underlined:

Brinzolamide

The following adverse reactions have been identified during postapproval use of brinzolamide containing products. 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. Serious skin and subcutaneous tissue reactions such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) may occur with the use of brinzolamide due to the sulfonamide component [see Warnings and Precautions (5.1) and Patient Counseling Information Sulfonamide Reactions (17)].

Brimonidine Tartrate

8 Use in Specific Populations

8.2 Lactation

Subsection title revised

8.4 Pediatric Use

Additions and/or revisions underlined:

The individual component, brinzolamide, has been studied in pediatric glaucoma patients 4 weeks to 5 years of age. The individual component, brimonidine tartrate, has been studied in pediatric patients 2 to 7 years old. Somnolence (50-83%) and decreased alertness was seen in patients 2 to 6 years old. SIMBRINZA ophthalmic suspension is contraindicated in children under the age of 2 years [see Contraindications (4.2)].

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

PATIENT COUNSELING INFORMATION

Additions and/or revisions underlined:

Sulfonamide Hypersensitivity Reactions

Advise patients that if serious or unusual ocular or systemic reactions or signs of hypersensitivity occur, they should discontinue the use of the product and consult their physician immediately [see Warnings and Precautions (5.1) and Adverse Reactions (6.2)].