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Drug Safety-related Labeling Changes (SrLC)

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GONAL-F RFF REDI-JECT (BLA-021684)

(FOLLITROPIN ALFA/BETA)

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

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05/13/2024 (SUPPL-50)

Approved Drug Label (PDF)

6 Adverse Reactions

6.2 Postmarketing Experience

Additions and/or revisions underlined:

Vascular disorders: thromboembolism [see Warnings and Precautions (5.4)]

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

PATIENT INFORMATION

Additions and/or revisions underlined:

Who should not use Gonal-f® RFF Redi-ject®? Do not use the Gonal-f® RFF Redi-ject® if you:

  • are allergic to recombinant human FSH or any of the ingredients in Gonal-f® RFF Redi-ject®. See the end of this leaflet for a complete list of ingredients in Gonal-f® RFF Redi-ject®.

  • have a high level of FSH in your blood that shows your ovaries no longer make eggs (primary ovarian failure)

  • have uncontrolled thyroid, adrenal, or pituitary problems

  • have a tumor in your female organs, including your ovaries, breast, or uterus that may get worse with high levels of estrogen

  • have a tumor in your brain, such as a tumor in your pituitary or hypothalamus

  • have abnormal bleeding from your uterus or vagina from an unknown cause

  • have ovarian cysts or large ovaries from an unknown cause.

    What should I tell my healthcare provider before using Gonal-f® RFF Redi- ject®?

    Before you use Gonal-f® RFF Redi-ject®, tell your healthcare provider if you:

  • are pregnant or think you may be pregnant. Gonal-f® RFF Redi-ject® is not for pregnant women. Your healthcare provider will give you a pregnancy test before starting Gonal-f® RFF Redi-ject®.

  • are breastfeeding. It is not known if Gonal-f® RFF Redi-ject® passes into your breast milk. You and your healthcare provider should decide if you will take Gonal-f® RFF Redi-ject® or breastfeed. You should not do both.

  • are not an adult. Gonal-f® RFF Redi-ject® is not for children. It is not known if Gonal-f® RFF Redi-ject® is safe or works for children.

    What are the possible side effects of Gonal-f® RFF Redi-ject®? Gonal-f® RFF Redi-ject® may cause serious side effects, including:

  • ectopic pregnancy (pregnancy outside your womb). Gonal-f® RFF Redi- ject® may increase your chance of having a pregnancy that is abnormally outside of your womb. Your chance of having a pregnancy outside of your womb is increased if you also have fallopian tube problems. Call your healthcare provider right away if you have symptoms of an ectopic pregnancy including:

  • stomach or pelvic pain especially on one side

  • shoulder pain

  • neck pain

  • rectal pain

  • nausea and vomiting

The most common side effects of Gonal-f® RFF Redi-ject® include:

  • ovarian cyst

  • headache

  • OHSS

  • stomach pain

  • stomach bloating

  • gas

  • bruising at the injection site

  • nausea

  • diarrhea

How should I store Gonal-f® RFF Redi-ject®?

  • Before you use Gonal-f® RFF Redi-ject® for the first time, store your Pen in the original carton to protect from light:

    What are the ingredients in Gonal-f® RFF Redi-ject®?

    Active ingredient: follitropin alfa

    Inactive ingredients: dibasic sodium phosphate, m-cresol, methionine, monobasic sodium phosphate, poloxamer, sucrose and Water for Injection. Phosphoric acid and/or sodium hydroxide may be used for pH adjustment.

05/13/2024 (SUPPL-51)

Approved Drug Label (PDF)

8 Use in Specific Populations

8.1 Pregnancy

PLLR conversion

Risk Summary

Gonal-f® RFF Redi-ject® is not indicated in pregnant women.

The incidence of congenital malformations after some Assisted Reproductive Technology (ART), procedures, specifically in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI)], may be slightly higher than after spontaneous conception. This slightly higher incidence is thought to be related to differences in parental characteristics (e.g., maternal age, maternal and paternal genetic background, sperm characteristics) and to a higher incidence of multi-fetal gestations after IVF or ICSI. There is no human data that the use of gonadotropins (including Gonal-f® RFF Redi-ject®), alone or as part of IVF or ICSI cycles, increases the risk of congenital malformations.

The risk of spontaneous abortion (miscarriage) is increased in women who have used gonadotropins products (including Gonal-f® RFF Redi-ject®) to achieve pregnancy.

In animal studies, the continuous administration of recombinant human FSH during pregnancy resulted in a decrease in the number of viable fetuses and difficult and prolonged delivery. No teratogenic effect has been observed.

In the US general population, the estimated background risk of major birth defects and miscarriage after spontaneous clinically recognized pregnancies, is 2% to 4% and 15% to 20%, respectively.

Data

Human Data

Data on a limited number of exposed pregnancies indicate no adverse reactions of gonadotropins on pregnancy, embryonal or fetal development, parturition or postnatal development following controlled ovarian stimulation.

Animal Data

Embryofetal development studies with recombinant human FSH in rats, where dosing occurred during organogenesis, showed a dose dependent increase in difficult and prolonged parturition in dams, and dose dependent increases in resorptions, pre- and post-implantation losses, and stillborn pups at doses representing 5 and 41 times the lowest clinical dose of 75 IU based on body surface area. Pre-/post-natal development studies with recombinant human FSH in rats, where dosing occurred from mid-gestation through lactation, showed difficult and prolonged parturition in all dams dosed at 41 times the lowest clinical dose of 75 IU based on body surface area, along with maternal death and stillborn pups associated with the difficult and prolonged parturition. This toxicity was not observed in dams and offspring dosed at a level 5 times the lowest clinical dose of 75 IU based on body surface area.

8.2 Lactation

PLLR conversion

There are no data on the presence of GONAL-F RFF in human milk, the effects on the breastfed infant, or the effects on milk production. Because the secretion of prolactin during lactation can result in inadequate response to ovarian stimulation, advise women not to breast feed during treatment with Gonal-f® RFF Redi-ject®.

8.3 Females and Males of Reproductive Potential

PLLR conversion

Since Gonal-f® RFF Redi-ject® is not indicated in pregnant women, verify a negative pregnancy test before administering Gonal-f® RFF Redi-ject® to a woman [see Dosage and Administration (2.2, 2.3)].

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

PATIENT INFORMATION

Additions and/or revisions underlined:

Who should not use Gonal-f® RFF Redi-ject®? Do not use the Gonal-f® RFF Redi-ject® if you:

  • are allergic to recombinant human FSH or any of the ingredients in Gonal-f® RFF Redi-ject®. See the end of this leaflet for a complete list of ingredients in Gonal-f® RFF Redi-ject®.

  • have a high level of FSH in your blood that shows your ovaries no longer make eggs (primary ovarian failure)

  • have uncontrolled thyroid, adrenal, or pituitary problems

  • have a tumor in your female organs, including your ovaries, breast, or uterus that may get worse with high levels of estrogen

  • have a tumor in your brain, such as a tumor in your pituitary or hypothalamus

  • have abnormal bleeding from your uterus or vagina from an unknown cause

  • have ovarian cysts or large ovaries from an unknown cause.

    What should I tell my healthcare provider before using Gonal-f® RFF Redi- ject®?

    Before you use Gonal-f® RFF Redi-ject®, tell your healthcare provider if you:

  • are pregnant or think you may be pregnant. Gonal-f® RFF Redi-ject® is not for pregnant women. Your healthcare provider will give you a pregnancy test before starting Gonal-f® RFF Redi-ject®.

  • are breastfeeding. It is not known if Gonal-f® RFF Redi-ject® passes into your breast milk. You and your healthcare provider should decide if you will take Gonal-f® RFF Redi-ject® or breastfeed. You should not do both.

  • are not an adult. Gonal-f® RFF Redi-ject® is not for children. It is not known if Gonal-f® RFF Redi-ject® is safe or works for children.

    What are the possible side effects of Gonal-f® RFF Redi-ject®? Gonal-f® RFF Redi-ject® may cause serious side effects, including:

  • ectopic pregnancy (pregnancy outside your womb). Gonal-f® RFF Redi- ject® may increase your chance of having a pregnancy that is abnormally outside of your womb. Your chance of having a pregnancy outside of your womb is increased if you also have fallopian tube problems. Call your healthcare provider right away if you have symptoms of an ectopic pregnancy including:
  • stomach or pelvic pain especially on one side

  • shoulder pain

  • neck pain

  • rectal pain

  • nausea and vomiting

    The most common side effects of Gonal-f® RFF Redi-ject® include:

  • ovarian cyst
  • headache
  • OHSS
  • stomach pain
  • stomach bloating
  • gas
  • bruising at the injection site
  • nausea
  • diarrhea

How should I store Gonal-f® RFF Redi-ject®?

  • Before you use Gonal-f® RFF Redi-ject® for the first time, store your Pen in the original carton to protect from light:

    What are the ingredients in Gonal-f® RFF Redi-ject®?

    Active ingredient: follitropin alfa

    Inactive ingredients: dibasic sodium phosphate, m-cresol, methionine, monobasic sodium phosphate, poloxamer, sucrose and Water for Injection. Phosphoric acid and/or sodium hydroxide may be used for pH adjustment.