TEPADINA® 15 mg
powder for concentrate for solution for infusion
Thiotepa
Read all of this leaflet carefully before you start using this medicine.
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Keep this leaflet. You may need to read it again.
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If you have any further questions, ask your doctor.
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If any of the side effects get serious, or if you notice any side effects not listed in this leaflet, please tell your doctor.
In this leaflet:
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What TEPADINA® is and what it is used for
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Before you use TEPADINA®
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How to use TEPADINA®
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Possible side effects
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How to store TEPADINA®
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Further information
1. WHAT TEPADINA® IS AND WHAT IT IS USED FOR
TEPADINA® contains the active substance thiotepa, which belongs to a group of medicines called alkylating agents.
TEPADINA® is used to prepare patients for bone marrow transplantation. It works by destroying bone marrow cells. This enables the transplantation of new bone marrow cells (haematopoietic progenitor cells), which in turn enable the body to produce healthy blood cells. TEPADINA® can be used in adults and children.
2. BEFORE YOU USE TEPADINA®
Do not use TEPADINA®
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if you are allergic (hypersensitive) to thiotepa,
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if you are pregnant or think you may be pregnant (see below),
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if you are breast-feeding,
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if you are receiving yellow fever vaccination, live virus and bacterial vaccines.
Take special care with TEPADINA®
You should tell your doctor if you have:
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liver or kidney problems,
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heart or lung problems,
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seizures/fits (epilepsy) or have had them in the past (if treated with phenytoin or fosphenytoin).
You will have to take regular blood tests during treatment to check your blood cell counts.
You will have to use anti-infectives to prevent and manage infections.
TEPADINA® may cause another type of cancer in the future. Your doctor will discuss this risk with you.
Pregnancy and breast-feeding
You must tell your doctor if you are or think you may be pregnant before you receive TEPADINA® . You must not use TEPADINA® during pregnancy.
Both women and men using TEPADINA® must use effective contraceptive methods during treatment.
It is not known whether this medicinal product is excreted in breast milk. As a precautionary measure, women must not breast-feed during treatment with TEPADINA® .
TEPADINA® can impair male and female fertility. Male patients should seek for sperm preservation before therapy is started and should not father while treated and during the year after cessation of treatment.
Using other medicines
Please tell your doctor if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
3. HOW TO USE TEPADINA®
Your doctor will calculate the dose according to your body surface or weight and your disease.
How TEPADINA® is given
TEPADINA® is administered by a qualified healthcare professional as an intravenous infusion (drip in a vein) after dilution of the individual vial. Each infusion will last 2 - 4 hours.
Frequency of administration
You will receive your infusions every 12 or 24 hours. The duration of treatment can last up to 3 days. Frequency of administration and duration of treatment depend on your disease.
4. POSSIBLE SIDE EFFECTS
Like all medicines, TEPADINA® can cause side effects, although not everybody gets them.
The most serious side effects of TEPADINA® therapy or the transplant procedure may include
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decrease in circulating blood cell counts (intended effect of the medicine to prepare you for your transplant infusion)
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infection
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liver disorders including blocking of a liver vein
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the graft attacks your body (graft versus host disease)
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respiratory complications
Your doctor will monitor your blood counts and liver enzymes regularly to detect and manage these events.
Side effects of TEPADINA® may occur with certain frequencies, which are defined as follows:
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very common: affects more than 1 user in 10
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common: affects 1 to 10 users in 100
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uncommon: affects 1 to 10 users in 1,000
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rare: affects 1 to 10 users in 10,000
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very rare: affects less than 1 user in 10,000
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not known: frequency cannot be estimated from the available data.
Very common side effects
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increased susceptibility to infection
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whole-body inflammatory state (sepsis)
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decreased counts of white blood cells, platelets and red blood cells (anaemia)
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the transplanted cells attack your body (graft versus host disease)
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dizziness, headache, blurred vision
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uncontrolled shaking of the body (convulsion)
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sensation of tingling, pricking or numbness (paraesthesia)
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partial loss of movement
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cardiac arrest
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nausea, vomiting, diarrhoea
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inflammation of the mucosa of the mouth (mucositis)
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irritated stomach, gullet, intestine
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inflammation of the colon
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anorexia, decreased appetite
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high glucose in the blood
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skin rash, itching, shedding
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skin colour disorder (do not confuse with jaundice - see below)
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redness of the skin (erythema)
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hair loss
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back and abdominal pain, pain
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muscle and joint pain
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abnormal electrical activity in the heart (arrhythmia)
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inflammation of lung tissue
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enlarged liver
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altered organ function
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blocking of a liver vein (VOD)
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yellowing of the skin and eyes (jaundice)
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hearing impaired
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lymphatic obstruction
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high blood pressure
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increased liver, renal and digestive enzymes
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abnormal blood electrolytes
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weight gain
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fever, general weakness, chills
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bleeding (haemorrhage)
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nasal bleeding
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general swelling due to fluid retention (oedema)
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pain or inflammation at the injection site
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eye infection (conjunctivitis)
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decreased sperm cell count
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vaginal bleeding
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absence of menstrual periods (amenorrhea)
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memory loss
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delaying in weight and height increase
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bladder disfunction
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underproduction of testosterone
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insufficient production of thyroid hormone
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deficient activity of the pituitary gland
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confusional state
Common side effects
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anxiety, confusion
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abnormal bulging outward of one of the arteries in the brain (intracranial aneurysm)
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creatinine elevated
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allergic reactions
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occlusion of a blood vessel (embolism)
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heart rhythm disorder
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heart inability
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cardiovascular inability
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oxygen deficiency
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fluid accumulation in the lungs (pulmonary oedema)
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pulmonary bleeding
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respiratory arrest
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blood in the urine (haematuria) and moderate renal insufficiency
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inflammation of the urinary bladder
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discomfort in urination and decrease in urine output (disuria and oliguria)
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increase in the amount of nitrogen components in the blood stream (BUN increase)
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cataract
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inability of the liver
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cerebral haemorrhage
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cough
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constipation and upset stomach
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obstruction of the bowel
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perforation of stomach
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changes in muscle tone
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gross lack of coordination of muscle movements
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bruises due to a low platelet count
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menopausal symptoms
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cancer (second primary malignancies)
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abnormal brain function
Uncommon side effects
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inflammation and exfoliation of the skin (erythrodermic psoriasis)
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delirium, nervousness, hallucination, agitation
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gastrointestinal ulcer
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inflammation of the muscular tissue of the heart (myocarditis)
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abnormal heart condition (cardiomyopathy)
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male and female infertility
If any of the side effects gets serious, or if you notice any side effects not mentioned in this leaflet, please tell your doctor or nurse.
5. HOW TO STORE TEPADINA®
Keep out of the reach and sight of children.
Do not use TEPADINA® after the expiry date which is stated on the carton and vial label, after EXP. The expiry date refers to the last day of that month.
Store and transport refrigerated (2 °C - 8 °C).
Do not freeze.
After reconstitution the product is stable for 8 hours when stored at 2 °C - 8 °C.
After dilution the product is stable for 24 hours when stored at 2 °C - 8 °C and for 4 hours when stored at 25 °C. From a microbiological point of view, the product should be used immediately.
Any unused product or waste material should be disposed of in accordance with local requirements.
6. FURTHER INFORMATION
What TEPADINA® contains
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The active substance is thiotepa. One vial contains 15 mg thiotepa. After reconstitution, each ml contains 10 mg thiotepa (10 mg/ml).
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TEPADINA ® does not contain any other ingredients.
What TEPADINA® looks like and contents of the pack
TEPADINA® is a white crystalline powder supplied in a glass vial containing 15 mg thiotepa.
Each carton contains 1 vial.
Marketing Authorisation Holder
ADIENNE S.r.l.
Via Broseta 64/B
24128 Bergamo
Italy
+39 035 19964047
adienne@adienne.com
Manufacturer
RIEMSER Arzneimittel AG
7 An der Wiek
17493 Greifswald
Insel Riems
Germany
For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:
This leaflet was last approved in:
Detailed information on this medicine is available on the European Medicines Agency web site: http://www.ema.europa.eu