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Drug Safety-related Labeling Changes (SrLC)

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LIKMEZ (NDA-216755)

(METRONIDAZOLE)

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

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07/08/2024 (SUPPL-3)

Approved Drug Label (PDF)

5 Warnings and Precautions

5.2 Severe Cutaneous Adverse Reactions

Newly added subsection:

Severe cutaneous adverse reactions (SCARs) including toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome (SJS), drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP) have been reported with the use of metronidazole. Symptoms can be serious and potentially life threatening. If symptoms or signs of SCARs develop, discontinue LIKMEZ immediately and institute appropriate therapy.

6 Adverse Reactions

Addition of the following to the bulleted line listing:

  • Severe Cutaneous Adverse Reactions [see Warnings and Precautions (5.2)]

6.2 Postmarketing Experience

Additions and/or revisions underlined:

Central and Peripheral Nervous System: Tinnitus, hearing impairment, and hearing loss.

Hypersensitivity: Drug reaction with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous pustulosis (AGEP) [see Warnings and Precautions (5.2)].

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

PATIENT COUNSELING INFORMATION

Additions and/or revisions underlined:

Severe Cutaneous Adverse Reactions

Advise patients that LIKMEZ may increase the risk of serious and sometimes fatal dermatologic reactions, including toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome (SJS), and drug reaction with eosinophilia and systemic symptoms (DRESS). Instruct the patient to be alert for skin rash, blisters, fever or other signs and symptoms of these hypersensitivity reactions. Advise patients to stop LIKMEZ immediately if they develop any type of rash and seek medical attention [see Warnings and Precautions (5.2)].

PATIENT INFORMATION

Additions and/or revisions underlined:

LIKMEZ may cause serious side effects including:

  • Severe skin reactions. Serious skin reactions that may affect any part of the body and can lead to death, including toxic epidermal necrolysis (TEN), Stevens-Johnson Syndrome (SJS), drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP), have happened in some people taking metronidazole (the active ingredient in LIKMEZ). These severe skin reactions may be life threatening and you may need to be treated in a hospital. Stop taking LIKMEZ right away and call your healthcare provider or get emergency help if you have any of the following symptoms:

    • skin rash or acne

    • blisters or sores in your mouth

    • dry skin

    • peeling of your skin

    • itching

    • fever

    • blisters on your skin

    • muscle or joint aches

    • redness or swelling of your face, hands, or soles of your feet

    • swollen glands